Erectile function after kidney transplantation: a meta-analysis

BACKGROUND: Erectile dysfunction (ED) is common in patients with end-stage renal disease (ESRD). Whether kidney transplantation can improve erectile function in patients with ESRD is still controversial. We conducted a meta-analysis on the relationship between kidney transplantation and erectile function. METHODS: A literature search was conducted on PubMed, Embase, Cochrane Library, and Web of Science until May 31, 2019. Primary outcomes were ED prevalence and each domain score of the International Index of Erectile Function (IIEF) questionnaire. We used age-matched dialysis patients or patients before kidney transplantation as a control group and compared them to kidney transplant recipients. RESULTS: A total of 9 articles were finally enrolled in the study. Compared with the control group, the kidney transplantation group had a lower prevalence of ED (OR 0.49, 95% CI: 0.28–0.86) and higher domain scores for erectile function (SMD 0.53, 95% CI: 0.12–0.94) and sexual desire (SMD 1.19, 95% CI: 0.11–2.27). While there were no significant variations in domain scores for orgasmic function (SMD 0.27, 95% CI: −0.10–0.63), intercourse satisfaction (SMD 0.26, 95% CI: −0.10–0.61), and overall satisfaction (SMD 0.17, 95% CI: −0.21–0.56). Patients in the kidney transplantation group had higher serum testosterone (SMD 1.20, 95% CI: 0.86–1.54) and lower prolactin (SMD −1.46, 95% CI: −2.22 to −0.69) and luteinizing hormone (SMD −0.97, 95% CI: −1.39 to −0.55). CONCLUSIONS: Kidney transplantation may be associated with improved erectile function in patients with ESRD. This may be attributable to the correction of endocrine hormone disorders in patients after kidney transplantation.