Document Type : Original Article
Authors
1
Nephrology and Transplantation Unit, Internal Medicine Department, Assiut University, Assiut, Egypt.
2
Internal Medicine and Endocrinology, Internal Medicine Department, Assiut University, Assiut, Egypt.
3
Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Abstract
Background: Despite the significance of these concerns, dialysis patients' follow-up care marginalizes sexual dysfunction (SD), and physicians' attention given to this problem remains scant.
Aim and Objectives: To investigate the prevalence of gonadal dysfunction and sexual dysfunction in male hemodialysis patients (18–60 years old; sexually active males) and how it relates to serum prolactin, free testosterone level, and semen analysis in Assiut University Hospitals.
Patients and Methods: All male patients with ESRD on chronic HD who were treated at the Assiut University Hospitals' Nephrology and Hemodialysis Unit, Internal Medicine Department, between November 2020 and November 2021. This was an observational cross-sectional study. There were 150 male patients in hemodialysis units overall; however, only 56 of them were included in this study, and the rest of them were excluded due to comorbidities such as DM, HTN, and cardiac diseases, which may affect the results.
Results: All patients showed decreased libido, and 71.4% of them had erectile dysfunction after starting HD. The IIEF score indicates a marked decline in sexual desire, erectile function, orgasmic function, and satisfaction during intercourse, and overall satisfaction. Semen analysis results showed reduced volume, total count, concentration, vitality, and total motility, presenting evidence that uremia affects spermatogenesis and total sperm quality, which consequently causes adverse effects on patient fertility.
Conclusion: Erectile dysfunction (ED) prevalence is very high among HD patients; the most common cause is an endocrinological disturbance that is mainly caused by uremia, leading to increased prolactin and a low testosterone level. Also, hormonal disturbances and uremia affect semen quality, which subsequently affects patient fertility.
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