CHRONIC-RENAL-FAILURE AND SEXUAL FUNCTIONING - CLINICAL STATUS VERSUSOBJECTIVELY ASSESSED SEXUAL-RESPONSE

Background. Sexual dysfunctions are common among patients with chronic renal failure. The prevalence was assessed in a population of 281 pat ients (20-60 years), and it was attempted to determine whether their m ode of treatment (haemodialysis, peritoneal dialysis, or kidney transp lantation), or biochemical and endocrine variables and neuropathy affe ct sexual functioning. Patients with rheumatoid arthritis served as a comparison group. Methods. Assessment included clinical history, physi cal and laboratory examinations, questionnaires measuring erotosexual dysfunctions, and a psychophysiological lest procedure. The latter is a laboratory method which measures, in a waking state, subjective and physiological sexual arousal. Results. Men on haemodialysis or periton eal dialysis suffered significantly more often from 'Hypoactive Sexual Desire Disorder', 'Sexual Aversion Disorder' and 'Inhibited Male Orga sm' than men with kidney transplantation or rheumatoid arthritis. Inte restingly, the prevalence of 'Male Erectile Disorder' did not differ s ignificantly between the four groups and ranged between 17 and 43%. Of the women, transplanted patients suffered significantly less from 'Hy poactive Sexual Desire Disorder' than the other three groups; the prev alence of other sexual dysfunctions did not differ between the groups. Although 'Male Erectile Disorder' and 'Female Sexual Arousal Disorder ' had a relatively high prevalence there were no differences in the fo ur groups of patients in genital responses during psychophysiological testing. Genital responses during psychophysiological assessment had n o relationship to the duration of renal replacement treatment, biochem ical/endocrine variables, or the presence/absence of neuropathy.Conclu sion. The prevalence of sexual dysfunction was high. Sexual dysfunctio n in men on haemodialysis or peritoneal dialysis was not so much due t o erectile failure but largely to loss of sexual interest, subjectivel y ascribed to fatigue. The latter was also found in women on haemodial ysis or peritoneal dialysis.