Efficacy and Safety of Different Modalities for Treatment of Erectile Dysfunction on Chronic Renal Failure Patients

Abstract

exual dysfunction is a set of disorders characterized by physical and psychological changes that result in the inability to perform satisfactory sexual activities. The condition has been found to be significantly more common in men and women with chronic kidney disease (CKD) than in the general population. Men with CKD frequently suffer from reduced libido, erectile dysfunction and difficulty reaching orgasm. Approximately 50% of male predialysis CKD patients and 80% of male dialysis patients have erectile dysfunction. Penile erection during sexual stimulation is caused by increased penile blood flow resulting from the relaxation of penile arteries and the smooth muscle of the corpus cavernosum. This response is mediated by the release of nitric oxide (NO) from nerve terminals and endothelial cells, which stimulates the synthesis of cyclic guanosine monophosphate (more commonly known as cyclic GMP or cGMP) in smooth muscle cells. cGMP relaxes smooth muscle and increases blood flow to the corpus cavernosum. Our study about the safety and efficacy of different modalities of treatment of erectile dysfunction in CKD patients using sildenafil, vardenafil, tadalafil and alprostadil.