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Endocrine contribution to the sexual dysfunction in patients with advanced chronic kidney disease and the role of hyperprolactinemia
Authors:Haitham Elbardisi  Ahmad Majzoub  Christiana Daniel  Fadwa AlAli  Mohamed Elesnawi  Kareim Khalafalla  Ashok Agarwal  Ralf Henkel  Alia Alattar  Ibrahim Al-Emadi  Mohamed Arafa
Institution:1. Department of Urology, Hamad General Hospital, Doha, Qatar;2. Political Science and Biological Science, North Carolina State University, Raleigh, NC, USA;3. Department of Nephrology, Hamad General Hospital, Doha, Qatar;4. American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA;5. Women Wellness and Research Center, Hamad General Hospital, Doha, Qatar
Abstract:In this study, we investigated the prevalence of sexual dysfunction among males with advanced chronic kidney disease and the effect of treating hyperprolactinemia among these patients. In this prospective study, patients were assessed with history, physical examination, hormonal assessment, and two questionnaires, IIEF and AIPE. Patients with hyperprolactinemia received treatment with cabergoline 0.5 mg once per week for 6 months and were re-evaluated. A total of 102 patients were included in this study, 75 (73.53%) were on hemodialysis, 13 (12.75%) on peritoneal dialysis and 14 (13.73%) on medical treatment alone. Ninety (88.24%) patients had premature ejaculation, 85 (83.33%) had anything from mild-to-moderate-to-severe erectile dysfunction. The incidence of hypogonadism and hyperprolactinemia was 34.4%. Patients treated with cabergoline (n = 26) showed a significant increase in LH levels (p = .003) and a significant decrease in prolactin levels (p = .003). Testosterone levels and the incidence of erectile dysfunction or premature ejaculation did not improve significantly. There is a high incidence of sexual dysfunction among patients. Treatment of hyperprolactinemia is effective in correcting prolactin levels, but does not improve erectile dysfunction or premature ejaculation. Therefore, treating hyperprolactinemia is not an overall effective treatment for erectile dysfunction in these patients.
Keywords:end-stage renal disease  erectile dysfunction  hyperprolactinemia  hypogonadism  premature ejaculation
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