Erectile function in men with end-stage liver disease improves after living donor liver transplantation

BACKGROUND: Impaired liver function in men can result in erectile dysfunction or hypogonadism or both. We investigated whether living donor liver transplantation (LDLT) results in improvement in male sexual function. METHODS: A total of 58 patients with end-stage liver disease (ESLD) were included in this prospective, cross-sectional study. Erectile function was measured before and after LDLT using a five-item modified version of the International Index of Erectile Function scale (IIEF-5) and hypogonadism was evaluated before and after LDLT using the Androgen Deficiency in the Aging Male (ADAM) questionnaire. Differences in mean values from the questionnaires before and after the operation were than evaluated to determine whether there is an association between LDLT and improvement in sexual function. RESULTS: We found that mean IIEF-5 scores significantly increased after LDLT (from 11.7 ± 7.7 before LDLT to 14.7 ± 7.5 after LDLT, p <0.01), indicating that the operation played a role in improving erectile function. In addition, the prevalence of hypogonadism among the patients with ESLD decreased markedly after liver transplantation (hypogonadism before LDLT, n = 41 versus hypogonadism after LDLT, n = 31, p = 0.03). Patients with hypogonadism reported a higher prevalence of erectile dysfunction after LDLT than patients without hypogonadism (p <0.01). CONCLUSIONS: LDLT results in improvement in erectile function. In addition, improvement in erectile function is associated with self-reported absence of hypogonadism.