Abstract
Background: Erectile dysfunction (ED) is a disorder that is frequently observed in people with chronic kidney disease who undergo hemodialysis (HD). In the context of evidence-based medicine, we aimed to investigate the effect of low-dose tadalafil on sexual function in patients undergoing HD.Methods: The medical records of 30 males (aged 29–65 years) with end-stage renal disease (ESRD) on a HD program, and who had received 5 mg tadalafil twice weekly, were retrospectively evaluated. Changes in erectile and ejaculatory function were evaluated using the International Erectile Function Index questionnaire, the Erection Hardness Scale (EHS), and the Male Sexual Health Questionnaire (MSHQ).Results: The mean age of the patients was 47.6 ± 10.1 years, their mean body mass index was 24.3 ± 4.2 kg/m2, their mean hemoglobin was 11.9 ± 0.9 g/dL, and their mean creatinine clearance was 5.8 ± 1.1 mL/min. At the third month of treatment, 36.6% of the patients had no ED, 40% had mild ED, 10% had mild-to-moderate ED, and 13.3% had moderate ED. The mean MSHQ scores (p < .05) and the mean EHS scores (p = .001) were significantly improved. There was no significant difference between Beck's Depression Inventory scores (p > .05), but Hamilton anxiety rate scores decreased significantly (p = .001). The quality-of-life score improved throughout the study period (p < .05).Conclusions: Tadalafil therapy is an effective therapeutic option in patients with ESRD who undergo HD, not only for the treatment of ED, but also for ejaculatory function, with acceptable adverse effects.
Highlights
The delicate balance between detumesence and erection is maintained by harmonious interaction of the sympathetic and parasympathetic nervous systems
We aimed to investigate the effect of 5 mg tadalafil, administered twice-weekly for three months, on sexual function in people with end-stage renal disease (ESRD) undergoing HD, using the International Index of Erectile Function questionnaire (IIEF) [16] and the Male Sexual Health Quality questionnaire (MSHQ) [17], in the context of evidence-based medicine
Only a limited number of studies have investigated the effects of low-dose tadalafil in people with ESRD and on HD, numerous studies have reported the effects of different sildenafil doses in such individuals
Summary
The delicate balance between detumesence and erection is maintained by harmonious interaction of the sympathetic and parasympathetic nervous systems. Parasympathetic stimulation results in neurogenic nitric oxide synthase (nNOS) expression, and nNOS uses molecular oxygen and L-arginine to produce nitric oxyde (NO). Erectile dysfunction (ED) is a disorder that is frequently observed with increasing prevalence in people with end-stage renal disease (ESRD) who undergo a hemodialysis (HD) program [3]. Erectile dysfunction (ED) is a disorder that is frequently observed in people with chronic kidney disease who undergo hemodialysis (HD). Methods: The medical records of 30 males (aged 29–65 years) with end-stage renal disease (ESRD) on a HD program, and who had received 5 mg tadalafil twice weekly, were retrospectively evaluated. Changes in erectile and ejaculatory function were evaluated using the International Erectile Function Index questionnaire, the Erection Hardness Scale (EHS), and the Male Sexual. At the third month of treatment, 36.6% of the patients had no ED, 40%
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