Obuekwe Obinna, Clark Haley, Saffati Gal, Yatsenko Tatyana, Oscar-Thompson Laura, Riveros Carlos, Muthigi Akhil
Department of Urology, Houston Methodist Hospital, Houston, TX, USA.
School of Engineering Medicine, Texas A&M University, Houston, TX, USA.
Int J Impot Res. 2025 Jul 8. doi: 10.1038/s41443-025-01127-1.
Solid organ transplantation (SOT) restores organ function and prolongs survival, but its impact on sexual dysfunction and infertility is underexplored. This study evaluated changes in their prevalence before and after transplantation across organ types. We conducted a retrospective cohort study using TriNetX, including 64 932 U.S. adults (≥18 years) who underwent heart, kidney, liver, lung, or pancreas transplants within the past 20 years. Sexual dysfunction (e.g., erectile dysfunction, dyspareunia) and infertility were identified using ICD-10 codes. Pre-post analysis assessed relative and absolute risk reduction (ARR). Analyses were stratified by sex and organ type. SOT was associated with reduced sexual dysfunction (ARR 1.40%, p < 0.001) and infertility (ARR 0.10%, p = 0.013). Males experienced a greater reduction in sexual dysfunction (ARR 2.11%, p < 0.001) than females (ARR 0.20%, p = 0.035). Sexual dysfunction declined following heart (ARR 2.21%, p = 0.001), kidney (ARR 1.42%, p < 0.001), lung (ARR 1.24%, p = 0.042), and liver (ARR 0.74%, p = 0.003) transplants. No difference was seen following pancreas transplantation, and infertility prevalence did not differ across SOT types. These findings suggest SOT may improve sexual health, particularly in men, though effects on infertility remain limited.
实体器官移植（SOT）可恢复器官功能并延长生存期，但对性功能障碍和不孕症的影响尚未得到充分研究。本研究评估了不同器官类型移植前后这些疾病患病率的变化。我们使用TriNetX进行了一项回顾性队列研究，纳入了64932名美国成年人（≥18岁），他们在过去20年内接受了心脏、肾脏、肝脏、肺或胰腺移植。使用国际疾病分类第十版（ICD - 10）编码识别性功能障碍（如勃起功能障碍、性交困难）和不孕症。前后分析评估了相对和绝对风险降低率（ARR）。分析按性别和器官类型分层。SOT与性功能障碍（ARR 1.40%，p < 0.001）和不孕症（ARR 0.10%，p = 0.013）的风险降低相关。男性性功能障碍的降低幅度（ARR 2.11%，p < 0.001）大于女性（ARR 0.20%，p = 0.035）。心脏移植（ARR 2.21%，p = 0.001）、肾脏移植（ARR 1.42%，p < 0.001）、肺移植（ARR 1.24%，p = 0.042）和肝脏移植（ARR 0.74%，p = 0.003）后性功能障碍有所下降。胰腺移植后未见差异，不同类型SOT的不孕症患病率也无差异。这些发现表明SOT可能改善性健康，尤其是对男性，尽管对不孕症的影响仍然有限。
