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Erectile Dysfunction after Kidney Transplantation

Kidney and Transplantation Research Center, Department of Nephrology, Dialysis and Transplantation, Annunziata Hospital, 87100 Cosenza, Italy
Department of Experimental and Clinical Medicine, Magna Graecia University Catanzaro, 88100 Catanzaro, Italy
Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(6), 1991;
Received: 21 May 2020 / Revised: 12 June 2020 / Accepted: 22 June 2020 / Published: 25 June 2020
Patients with kidney transplantation often have a worse quality of life than the general population. One of the reasons for this, in male patients, is the high prevalence of erectile dysfunction. This is mainly due to the presence of comorbidities, surgery for kidney transplantation, adverse drug effects, psychological changes related to chronic disease, as well as hyperprolactinemia and hypogonadism. Whenever these endocrine dysfunctions occur after kidney transplantation, they must be corrected with appropriate treatment, i.e., testosterone replacement therapy. Administration of the phosphodiesterase-5 inhibitor (PDE5i) sildenafil at the recommended posology does not significantly alter the pharmacokinetics of the calcineurin inhibitors cyclosporin A or tacrolimus and does not impair kidney allograft function. Tacrolimus increases the peak concentration and prolongs the half-life of PDE5i in kidney transplant patients and, therefore, daily administration cannot be recommended due to the significant drop in blood pressure. Intracavernous injection or topical application of alprostadil can be a second-line option for the treatment of erectile dysfunction after kidney transplantation, which does not alter cyclosporine concentrations and does not deteriorate kidney function. Finally, penile prostheses can be successfully implanted following pelvic organ transplantation after eliminating the risk of infection associated with surgery. View Full-Text
Keywords: end-stage renal disease; hypogonadism; prolactin; intracavernous injection; phosphodiesterase type-5 inhibitors end-stage renal disease; hypogonadism; prolactin; intracavernous injection; phosphodiesterase type-5 inhibitors
MDPI and ACS Style

Perri, A.; Izzo, G.; Lofaro, D.; La Vignera, S.; Brunetti, A.; Calogero, A.E.; Aversa, A. Erectile Dysfunction after Kidney Transplantation. J. Clin. Med. 2020, 9, 1991.

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