STUDY ON IMPOTENCE IN PATIENTS TREATED WITH CHRONIC HEMODIALYSIS

Abstract

Psychiatric, neurological, and endocrinological studies on impotence in 61 patients who had been treated by chronic dialysis were carried out, and Testosterone (T) substitution therapy was performed, obtaining the following results concerning hormonal movement and therapeutic efficacy.
1) According to the questionnaires on the effects of chronic dialysis on impotence, sexual desire, erection, and ejaculation were all reduced as compared to normal in many patients after the institution of dialysis, suggesting a close relationship between chronic dialysis and impotence.
2) In MAS, the patients showed an anxiety tendency which, however, was not ralated to impotence. In Y-G tests, the majority or 81% of the patients were classified into A, B and D types (extroversive and positive).
3) Bulbocavernosus reflex disappeared in 4 patients and anal reflex in 7, but there was no relationship between these findings and impotence.
4) Plasma LH, FSH, PRL, T, DHEA and DHEA-S were measured as endocrine function test, showing a rise in LH and PRL and a fall in T. In luteinizing hormone releasing hormone tolerance tests, both LH and FSH showed various degrees of response from none to excessive response with delayed fall.
5) PRL showed high values in the group of reduced sexual potency. T showed lowered basic values and reduction in response in HCG tolerance tests in the group of reduced sexual desire.
6) T substitution therapy with testosterone cypionate was carried out to study its effects on hormonal values and impotence. LH and FSH were controlled well from the early stage of treatment, suggesting the participation of negative feedback. Impotence was improved in 13 of 14 patients (93%), suggesting that low T values played an important role in the onset of impotence in the patients treated by chronic dialysis.