Does kidney transplantation onto the external iliac artery affect the haemodynamic parameters of the cavernosal arteries

Reduced cavernosal arterial inflow has been hypothesized to be the likely cause of erectile dysfunction after kidney transplants in recipients revascularized through end-to-end anastomosis to the internal lilac artery, suggesting that end-to-side anastomosis at the external iliac artery is preferabl...

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Bibliographic Details
Published in:Asian journal of andrology 2012-07, Vol.14 (4), p.621-625
Main Authors: Gontero, Paolo, Oderda, Marco, Filippini, Claudia, Fontana, Francesco, Lazzarich, Elisa, Stratta, Piero, Turello, Ernesto, Tizzani, Alessandro, Frea, Bruno
Format: Article
Language:English
Subjects:
Adult
Aged
Anastomosis, Surgical - adverse effects
Anastomosis, Surgical - methods
Blood Flow Velocity
Erectile Dysfunction - etiology
Erectile Dysfunction - physiopathology
Humans
Iliac Artery - surgery
Kidney Transplantation - adverse effects
Kidney Transplantation - methods
Male
Middle Aged
Multivariate Analysis
Original
Penis - blood supply
Penis - diagnostic imaging
Postoperative Period
Preoperative Period
Prospective Studies
Severity of Illness Index
Ultrasonography, Doppler, Color
Young Adult
动力学参数
动脉
勃起功能障碍
睾丸激素
肾移植
肾脏
血流量
阴茎海绵体
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Summary:Reduced cavernosal arterial inflow has been hypothesized to be the likely cause of erectile dysfunction after kidney transplants in recipients revascularized through end-to-end anastomosis to the internal lilac artery, suggesting that end-to-side anastomosis at the external iliac artery is preferable. The aim of this study was to prospectively evaluate the effect of the use of the external iliac artery on erectile function, hormone profiles and penile blood flow by evaluating changes in penile colour Doppler ultrasound parameters in a consecutive series of 22 recipients before and after end-to-side external lilac artery transplantation. The mean International Index of Erectile Function-Erectile Function （IIEF-EF） domain score decreased significantly 3 months after transplant （18.09±6.33 vs. 22.50±7.09, P=O.01）. The reduction in peak systolic velocity （PSV） was significant for the cavernous artery homolateral to the side of transplant （42.60±18.77 vs. 52.01±19.91, P=0.01）. The mean postoperative end diastolic velocity （EDV） did not differ significantly from the preoperative value （P=0.74）. No statistical differences were found in the serum levels of testosterone or prolactin. Kidney grafts anastomosed at the external lilac artery produced significant （P=0.01） reductions in arterial inflow at the homolateral cavernosal artery that remained above the normal threshold. Whether these haemodynamic changes can explain the worsening of postoperative erectile function remains to be proven.
ISSN:1008-682X
1745-7262
DOI:10.1038/aja.2011.115