Men who have a radical nephrectomy (complete kidney removal) are about 3.5 times more likely to develop erectile dysfunction (ED) than men who undergo partial nephrectomy (partial kidney removal), according to American researchers.
The retrospective study, published online in July in the British Journal of Urology International, followed two groups of men who had surgery for renal tumors between January 1998 and December 2007.
A total of 432 men participated in the study. One group of 264 men had a radical nephrectomy; the remaining 168 men had a partial nephrectomy. The two groups had similar demographics and comorbidities. The mean age of the men was 58 years.
Before and after each surgery, the researchers used the International Index of Erectile Function, a self-reported questionnaire, to assess the men’s erectile function. The men’s progress was followed for at least six months, with a mean of 5.8 years.
Almost 30% of the men who had a radical nephrectomy developed de novo cases of ED. About 10% of the men who had a partial nephrectomy developed new cases of ED after the surgery.
Phosphodiesterase inhibitors, oral medications commonly prescribed for ED, helped 63% of the men who developed ED, regardless of the type of surgery they had.
In a press release, senior author Dr. Ithaar Derweesh said, “This is the first study in medical literature to suggest that surgery for kidney removal can negatively impact erectile function while partial kidney removal can protect sexual function.” Dr. Derweesh is an associate professor of surgery at the University of California, San Diego School of Medicine and a urologic surgeon at UC San Diego Health System.
His colleague, lead author Ryan Kopp, MD added, “The primary argument for kidney-sparing surgery over total kidney removal has been to preserve the kidney filtration function. However, we are also beginning to understand that total kidney removal may also increase the risk of metabolic diseases and significantly decrease quality of life.” Dr. Kopp is the chief resident of the Division of Urology at the UC San Diego School of Medicine.
Researchers were affiliated with the University of California San Diego Medical Center, Alvarado Hospital in San Diego, and the University of Tennessee Health Science Center in Memphis.
Kopp, Ryan P., et al.
“Does radical nephrectomy increase the risk of erectile dysfunction compared with partial nephrectomy? A cohort analysis”
(Abstract. First published online: July 3, 2012)
The Guardian (University of California, San Diego)
“UCSD Researchers Connect Kidney Removal, Erectile Dysfunction”
(October 4, 2012)
Los Angeles Times
Maugh, Thomas H., II
“Removing kidney increases risk of erectile dysfunction”
(July 31, 2012)
“Complete Kidney Removal Tied to Erectile Dysfunction”
(July 31, 2012)
University of California, San Diego
“Researchers identify link between kidney removal and erectile dysfunction”
(July 30, 2012)