TITLE:
Erectile Dysfunction in Chronic Hemodialysis Patients at the University Hospital Center of Point-G in Mali
AUTHORS:
Seydou Sy, Magara Samaké, Hamadoun Yattara, Moctar Coulibaly, Ibrahima Koné, Aboubacar Sidiki Fofana, Djénèba Diallo, Atabieme Kodio, Modi Sidibé, Nouhoum Coulibaly, Alkaya Touré, Djibril Sy, Moustapha Tangara, Saharé Fongoro
KEYWORDS:
Erectile Dysfunction, Renal Failure, Dialysis, Mali
JOURNAL NAME:
Open Journal of Clinical Diagnostics,
Vol.10 No.1,
February
14,
2020
ABSTRACT:
Introduction: Erectile Dysfunction (ED) is defined as the inability to achieve or
maintain an erection sufficient for sexual intercourse. The frequency of erectile
dysfunction in patients with kidney failure is estimated at 50% to 70%. The
objective of this work was to determine the frequency of sexual dysfunction in
chronic hemodialysis patients, to evaluate the psycho-social impact and to describe
hormonal disturbances. Patients and Methods: This was a descriptive
prospective study carried out from 3 April to 31 August 2017 in the nephrology
and haemodialysis department of the Point G University Hospital. She has been
interested in men over the age of 18 who have been on chronic hemodialysis for
more than a year. Sexual dysfunction was assessed using the questionnaire:
International Index of Erectile Function (IIEF-5). Results: Sixty-five
patients were included. Forty-six (70.8%) had severe (30.8%), moderate (13.8%)
and mild (26.2%) ED. 56.9%
of patients had libido disorders, with decreased sexual desire (38.5%); absent
sexual desire (18.5%). Sexual desire was normal in 43.1% of patients. Sexual
activity was absent in 20 patients (30.8%). Sexual rigidity was reduced in 28
patients (43.1%) and normal in 24 patients (36.9%). The mean age of our
patients was 42.55 years with a median age of 40 years and extremes of 23 and
74 years. Eighty percent were married. Nine patients (13.8%) were using
sildenafil-based
medications. Antihypertensives were prescribed in 93.9% and erythropoietin in
30.8% of patients. The main impact groups were anxiety (53.8%), fear of failure
(27.7%), insomnia (7.7%) and anxiety (6.1%). And defence mechanisms included:
understanding (54.7%); isolation (24.6%); repression (7.7%); quarrel (7.7%);
and divorce in 1 case (1.5%). The occurrence of ED was related to
hypotestosterolemia (p = 0.030), and between low libido and testosterone (p = 0.001).
Nutritional status was satisfactory in 78.4% of our patients. Moderate and at
and severe undernutrition was found in equal proportions (10.8%) in our
patients with a statistically significant relationship with the occurrence of
erectile dysfunction (p = 0.015). There was no correlation between ED and
duration of dialysis (p = 0.715), the existence of inflammatory syndrome (p = 0.870),
age (p = 0.249) and diabetes, hypertension, smoking (p = 0.442). Sexual
activity was decreased in 41 patients with Hb 10 g/dl (p = 0.340). Conclusion: Sexual disorders are common in hemodialysis
patients. Psychological support of the patient is essential throughout the therapeutic sequence of erectile dysfunction,
whatever the molecule or physical means considered.