Impact Of Different Age Groups Of Living Renal Donors On Male Sexual Dysfunction In Renal Transplanted Recipients

Objective To explore the impact of various ages of living renal donors on male sexual dysfunction in recipients.Methods68cases of married male recipients, which were selected and analyzed retrospectively, were undergoing living-related renal transplantations in the Organ Transplantation Center of the First Affiliated Hospital of Kunming Medical University from January2009to June2012. In all of those living renal donors(LRD), all male recipients were divided into two groups according to the ages of LRD:Group A,40recipients, the average age of this group was28years, while the average age of LRD was below55. Group B,28recipients, the average age of the group was30years old, however, the average of LRD was older than55years. All of the68recipients sexual function was investigated and assessed by International Index of Erectile function(IIEF-5) and Chinese Index of Sexual Function for Premature Ejaculation(CIPE)in preoperation and postoperation. Meanwhile, their erection, vibration perception threshold(VPT) and level of sexual hormones were evaluated and analyzed. All early grafts’ function was measured by serum creatinine and average daily urinary volume on the1st、3rd and7th postoperative day.Results1. Two groups of sexual function:the prevalence of sexual function was better in the postoperative than in the preoperative transplantation (P<0.05).2.There was statistically significant difference in scores of IIEF-5between the preoperation and the postoperation in the6th month within two groups, but show no statistical differences between6months and9months after transplantation. There were no differences in IIEF-5score between two groups pre-transplanted(P>0.05), while significant differences were presented between two groups in the6th month and the9th month after transplantation(P<0.05). Compare to the preoperation, the score of Q3and Q4in both groups increased rapidly after transplantation in the6th month and the9thmonth(P<0.05).3. The pattern of CIPE score was same as the IIEF-5:differences were presented between pretransplantation and6months after transplantation within two groups, but show no differences between6months and9months after transplantation. There were no differences in CIPE score between two groups pretransplantation(P>0.05), but statistically significant differences occurred in the6month and the9month after transplantation(P<0.05).3. Sex hormone levels:there was obvious differences in the level of PRL and T before and6months after transplantation in two groups(P<0.05). However, obvious differences occurred in the level of PRL between6months and9months after transplantation in Group B(P<0.05). Compare to the level of T preoperation, which rised rapidly, the level of PRL in both groups decreased rapidly after operation in the6th month and the9th month(P<0.05). The difference of pretransplantation donor renal GFR was statistically significant between two groups(P<0.05). There was no significant difference in the percentage of decreased serum creatinine level between two groups on the7th day after transplantation (P>0.05), while significant differences were shown on the1st and the3rd day after transplantation(P<0.05). The percentage of decreased serum creatinine in group B was significantly lower than in group A(P<0.05). Urine volume in group A was significant more than group B at the early stage after transplantation (P<0.05).Conclusions1. The incidence of PE and ED after renal transplantation obviously decreased compared with pre-transplantation, and the incidence of PE and ED of group A was significantly lower than in group B.2. IIEF-5score and CIPE score after renal transplantation was better than pre-transplantation. Moreover, the effect of group A was better than group B.3. Sex hormone levels of pre-transplantation was abnormal and then restored to normal range after renal transplantation, especially in group A.4. Many factors associated with sexual function after transplantation:normal and stable graft function, immunosuppressants, prevention of complications, attention to psychological counseling, choosing reasonable medication. It is a good way to acquire satisfactory quality of sex life.