Sexual Function in Renal Transplant Recipients with Internal versus External Iliac Artery Anastomosis: A Randomized Clinical Trial
Urology Journal,
Vol. 21 No. 02 (2024),
24 March 2024
,
Page 121-125
https://doi.org/10.22037/uj.v20i.7738
Abstract
Purpose: The choice between using the internal or external iliac arteries to supply a transplanted kidney poses
a dilemma during renal transplantation. As the internal iliac artery branches to the genital tract, cutting it could
potentially result in sexual dysfunction. The purpose of this study was to compare the effects of these two surgical
methods on sexual function.
Materials and Methods: 122 sexually active male patients under the age of sixty were randomly divided into two
groups: the internal iliac anastomosis group and the external iliac artery anastomosis group. Before surgery and one year after the procedure, patients completed the International Index of Erectile Function-15 questionnaire (IIEF-
15), and the difference in scores of each domain was measured.
Results: Statistically, kidney transplantation improved all domains of IIEF in both groups, except for erectile
function in patients who underwent internal iliac artery anastomosis group. Additionally, there were significant
differences between the two groups in the domains of erectile function (p-value=0.04) and overall satisfaction
(p-value = 0.002), while other domains such as orgasmic function, sexual desire, and intercourse satisfaction did
not show any statistically significant differences.
Conclusion: In conclusion, the choice between using the internal or external iliac artery for arterial anastomosis
during kidney transplantation does not significantly impact graft function. However, it may negatively affect erectile
function in patients who undergo internal iliac artery anastomosis.
- Keywords: kidney transplantation, sexual function, artery anastomosis, complication
How to Cite
References
Pal DK, Sanki PK, Roy S. Analysis of outcome of end-to-end and end-to-side internal iliac artery anastomosis in renal transplantation: Our initial experience with a case series. Urology Annals. 2017;9(2):166.
Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49(6):822-830.
Pakpour AH, Zeidi IM, Yekaninejad MS, Burri A. Validation of a translated and culturally adapted Iranian version of the International Index of Erectile Function. Journal of sex & marital therapy. 2014;40(6):541-551.
Moray G, Bilgin N, Karakayali H, Haberal M. Comparison of outcome in renal transplant recipients with respect to arterial anastomosis: the internal versus the external iliac artery. Paper presented at: Transplantation proceedings1999.
Daowd R, Al Ahmad A. Renal artery anastomosis to internal or external iliac artery in kidney transplant patients. Saudi Journal of Kidney Diseases and Transplantation. 2015;26(5):1009.
Assmy A, El-Bahnasawy M, Dawood A, et al. 14 Effect of the use of internal iliac artery for renal transplantation on penile vascularity and erectile function: A prospective study. European Urology Supplements. 2004;2(3):6.
Barroso LV, Miranda EP, Cruz NI, et al. Analysis of sexual function in kidney transplanted men. Transplantation proceedings. Dec 2008;40(10):3489-3491.
Khorrami M, Javid A, Moshtaghi D, Nourimahdavi K, Mortazavi A, Zia H. Sildenafil efficacy in erectile dysfunction secondary to spinal cord injury depends on the level of cord injuries. International journal of andrology. 2010;33(6):861-864.
Lorenzo AJ, Taylor K. Is there a functional disadvantage to using the external iliac vessels for vascular anastomosis in children and adolescents undergoing renal transplantation? Jun 2019;23(4):e13398.
Kara S, Korkut E, Aksungur N, Altundas N, Ozturk G, Demir ZY. External Iliac Artery Anastomosis and Internal Iliac Artery Anastomosis for Artery anastomosis in Deceased-donor Kidney Transplantation and Multifactorial Analysis of Graft Survival. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. Oct 2022;32(10):1313-1317.
Matheus WE, Reis LO, Ferreira U, et al. Kidney transplant anastomosis: internal or external iliac artery? Urology journal. Fall 2009;6(4):260-266.
Pyrgidis N, Mykoniatis I, Sokolakis I, et al. Renal Transplantation Improves Erectile Function in Patients with End-Stage Renal Disease: A Systematic Review and Meta-Analysis. The Journal of urology. Apr 2021;205(4):1009-1017.
Spirito L, Manfredi C, Carrano R, et al. Impact of kidney transplantation on male sexual function: results from a ten-year retrospective study. The Journal of Sexual Medicine. 2020;17(11):2191-2197.
Lessan‐Pezeshki M, Ghazizadeh S. Sexual and reproductive function in end‐stage renal disease and effect of kidney transplantation. Asian Journal of Andrology. 2008;10(3):441-446.
Kang J, Tian J, Lu Y, Song Y, Liu X. Erectile function after kidney transplantation: A meta-analysis. Translational Andrology and Urology. 2020;9(5):1967.
- Abstract Viewed: 338 times
- 7738/pdf Downloaded: 128 times