Nephrology Dialysis Transplantation, Vol 12, Issue 12 2654-2663, Copyright © 1997 by Oxford University Press
A Toorians, E Janssen, E Laan, L Gooren, E Giltay, P Oe, A Donker and W Everaerd
Background: Sexual dysfunctions are common among
patients with chronic renal failure. The prevalence was assessed in a
population of 281 patients (20-60 years), and it was attempted to determine
whether their mode of treatment (haemodialysis, peritoneal dialysis, or
kidney transplantation), or biochemical and endocrine variables and
neuropathy affect sexual functioning. Patients with rheumatoid arthritis
served as a comparison group. Methods: Assessment
included clinical history, physical and laboratory examinations,
questionnaires measuring erotosexual dysfunctions, and a
psycho-physiological test procedure. The latter is a laboratory method
which measures, in a waking state, subjective and physiological sexual
arousal. Results: Men on haemodialysis or peritoneal
dialysis suffered significantly more often from 'Hypoactive Sexual Desire
Disorder', 'Sexual Aversion Disorder' and 'Inhibited Male Orgasm' than men
with kidney transplantation or rheumatoid arthritis. Interestingly, the
prevalence of 'Male Erectile Disorder' did not differ significantly between
the four groups and ranged between 17 and 43%. Of the women, transplanted
patients suffered significantly less from 'Hypoactive Sexual Desire
Disorder' than the other three groups; the prevalence of other sexual
dysfunctions did not differ between the groups. Although 'Male Erectile
Disorder' and Female Sexual Arousal Disorder' had a relatively high
prevalence there were no differences in the four groups of patients in
genital responses during psychophysiological testing. Genital responses
during psychophysiological assessment had no relationship to the duration
of renal replacement treatment, biochemical/endocrine variables, or the
presence/absence of neuropathy. Conclusion: The
prevalence of sexual dysfunction was high. Sexual dysfunction in men on
haemodialysis or peritoneal dialysis was not so much due to erectile
failure but largely to loss of sexual interest, subjectively ascribed to
fatigue. The latter was also found in women on haemodialysis or peritoneal
dialysis. Key words: chronic renal failure;
prevalence; biochemical variables; psychophysiology; sexual dysfunctions
ORIGINAL ARTICLES
Chronic renal failure and sexual functioning: clinical status versus objectively assessed sexual response
Departments of Nephrology and Endocrinology, University Hospital Vrije Universiteit, PO Box 7057, 1007 MB Amsterdam The Netherlands; Faculty of Psychology, Universiteit van Amsterdam, The Netherlands; Corresponding author
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