Abstract
BackgroundImpaired 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.MethodsA 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.ResultsWe 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).ConclusionsLDLT results in improvement in erectile function. In addition, improvement in erectile function is associated with self-reported absence of hypogonadism.
Highlights
Impaired liver function in men can result in erectile dysfunction or hypogonadism or both
The five-item International Index of Erection Function (IIEF-5) questionnaire, designed to evaluate erectile dysfunction, Survey An introductory letter comprising a detailed description of the methodology of the study, the future consequences of the study, the name of the contact person of the study, and associated information was presented to each participant before living donor liver transplantation (LDLT)
Change in erectile dysfunction We found that mean Index of Erectile Function (IIEF)-5 scores significantly increased after LDLT, indicating that the operation played a role in improving erectile function
Summary
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. Liver transplantation is considered standard curative therapy for patients with advanced hepatocellular carcinoma and for patients with alcohol-related end-stage liver disease (ESLD). Improvements in surgical techniques as well as medical therapy have resulted in better long-term survival outcomes for patients who require liver transplantation. A component of quality of life, is a major concern for men with ESLD and for those who have received liver transplantation [1, 2]. Increased need for liver transplantation and a shortage of deceased donors led to the development of living donor liver transplantation (LDLT) as an alternative to OLT. Organ rejection rates, and rates of hepatitis C virus (HCV) recurrence have been shown to be more or less equal between LDLT and OLT, studies have shown that LDLT is associated with a shorter ischemic time, a lower mortality rate, and greater perioperative benefits than OLT [7]
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