Sexual dysfunction in the male patient with uremia: A reappraisal

Sexual dysfunction in the male patient with uremia: A reappraisal. Partial or complete impotence is common in uremia. It is not clear whether the impotence is organic or psychogenic in nature and whether uremia itself or the state of chronic illness is responsible for it. We examined these questions, by psychiatric interviews and nocturnal penile tumescence (NPT), in 50 normal subjects, 48 patients with chronic uremia, including 23 patients treated with maintenance dialysis, and 22 patients with chronic illness and normal renal function. About 40 to 50% of patients with uremia, but not those with chronic illness and normal renal function, complained of erectile dysfunction and reported a significant decrease in frequency of intercourse. There were no significant differences between patients with uremia prior to initiation of therapy and those treated with maintenance hemodialysis. NPT declines after 40 years of age. In all age groups, NPT was significantly (P < 0.01) lower in uremics than in normals or those with chronic illness. There was no correlation between erectile complaints, frequency of intercourse or NPT, and the presence or absence of depression. The frequency of intercourse correlated significantly (r = 0.68, P < 0.01) with NPT in patients with uremia. Data indicate that 50% of male patients with uremia have partial or complete impotence, which is most probably organic in nature and is related to uremia or its metabolic or hormonal consequences rather than to the state of chronic illness. Disfonctionnement sexuel chez le malade urémique de sexe masculin: Une réévaluation. L'impuissance partielle ou totale est fréquente au cours de l'urémie. La nature organique ou psychogénique de l'impuissance n'est pas claire et il n'est pas non plus établi si l'urémie par elle même ou la maladie chronique en sont responsables. Nous avons étudié ces prodromes chez 50 sujets normaux, 48 malades atteints d'urémie chronique, parmi lesquels 23 étaient traités par hémodialyse itérative., et 22 malades atteints d'affections chroniques, mais avec des fonctions rénales normales au moyen des interrogatoires psychiatriques et des érections nocturnes. Quarante à cinquante pour cent des malades urémiques, mais non pas ceux atteints de maladies chroniques avec des fonctions rénales normales, se sont plaint d'anomalies de l'érection et d'une diminution significative de la fréquence des rapports sexuels. Il n'a pas été observé de différence significative entre les malades ur