Effect of kidney transplantation on sexual dysfunction in patients with end stage renal disease: A systematic review

Table 1 Summary of included studies

Ref.	Country	Population	Tool for EF assessment	No. of participants	No. of living donor RTRs	Type of renal transplant anastomosis	Age ± SD	Months of dialysis before RT ± SD	Time point of EF assessment (months after RT)	No. of patients with smoking	No. of patients with hypertension	No. of patients with diabetes	Testosterone prior to RT (ng/dL)
Gontero et al[18]	Italy	Adult males on HD undergoing RT	EF domain of IIEF-15	22	NA	End-to-side external iliac artery	51 ± 10.5	11.5 ± 5.5	3	NA	NA	NA	410 ± 182
Mirone et al[19]	Italy	Adult males on HD undergoing RT	EF domain of IIEF-15	78	0	Internal or external iliac artery	NA	NA	3	NA	NA	NA	NA
Nanjappa et al[27]	India	Adult males on HD undergoing RT	IIEF-5	NA	NA	NA	NA	NA	NA	37	63	NA	NA
Nassir[20]	Saudi Arabia	Adult males with sexual partners on HD or dialysis	EF domain of IIEF-15	25	NA	NA	49.2 ± 11.4	22 ± 18.8	NA	NA	NA	NA	NA
Pourmand et al[21]	Iran	Adult males on HD undergoing RT	IIEF-5	64	NA	Common iliac artery: 8	41.1 ± 8.7	41.8 ± 31.9	NA	NA	NA	NA	NA
Pyrgidis et al[28]	Egypt	Hepatitis C virus+ adult males on dialysis	IIEF-5	64	0	NA	50.1 ± 6.1	12.8 ± 20.5	NA	NA	NA	NA	307 ± 94
Teng et al[22]	China	Adult males on dialysis undergoing RT	EF domain of IIEF-15	24	NA	Internal iliac artery	44.7 ± 9.8	NA	NA	NA	NA	NA	NA
Javid et al[23]	Iran	Sexually active adult males on MHD		NA	NA	Internal and external iliac artery	43.24 ± 8.73		12
Pan et al[24]	China	Adult males on maintenance hemodialysis undergoing Ktx who suffered from SARS-COV-2 infection		NA	NA	NA	40.2 ± 9.7	32.5 ± 35.3	6
El hennawy et al[25]	Saudi Arabia	Adult males on maintenance hemodialysis undergoing Ktx		68	NA	NA	48.96+/-12.9		12
Mondal et al[26]	India	Adult males on maintenance hemodialysis undergoing Ktx		NA	NA	NA	40.9 ± 9.9	13.6 ± 0.43

EF: Erectile function; RTRs: Renal transplant recipients; RT: Renal transplantation; HD: Hemodialysis; IIEF: International Index of Erectile Function; NA: Not available.

Table 2 Study parameters for meta-analysis

Ref.	No. of patients with SexDys before Ktx	No. of patients with SexDys after Ktx	MEAN IIEF difference with 95%CI	Smoking	HTN	Diabetes	Testosterone prior Ktx		RR	Upper limit RR	Lower limit RR	Weight age for SexDys before and after transplant (565)	Weight age for mean IIEF difference	Pre-KTX IIEF	Post-KTX IIEF
Gontero et al[18]	65/87	42/87	-4.4 (-6.67, -2.13)	13	19	1	410 ± 182	419 ± 129	2.18	1.2	3.95	0.0389	0.035889	22.5 ± 7.09	18.09 ± 6.33
Mirone et al[19]	68/78	71/78	0.9 (-1.53, -.27)	16	69	7	NA	NA	0.67	0.24	1.86	0.138	0.12724	42.46	39.97
Nanjappa et al[27]	12/16	7/16	8.00 (4.75, 11.25)	NA	NA	NA	NA	NA	3.86	0.86	17.32	0.02831
Nassir[20]	96/127	71/127	1.8 (1.17, 2.43)	NA	NA	NA	805 ± 170	942 ± 216	2.44	1.43	4.17	0.22477	0.207177	17.47 ± 4.3	19.26 ± 4.41
Pourmand et al[21]			5.6 (3.68, 7.52)	NA	NA	NA	NA	NA	NA	NA	Na	Na	0.104405	13.59	19.16
Pyrgidis et al[28]			4.8 (3.22, 6.38)	NA	NA	NA	NA	NA	NA	NA	NA	Na
Teng et al[22]	21/24	11/24	7.3 (5.22, 9.38)	NA	NA	0	307 ± 94	654 ± 314	8.27	1.94	35.34	0.04247	0.039152	12.46 ± 8.88	19.75 ± 5.93
Javid et al[23]				NA	72	32
Pan et al[24]	191/230	142/230	2 ± 13.6	NA		167			3.04	1.96	4.69	0.407079	0.375204	19 ± 7.41	21 ± 6.21
El hennawy et al[25]	63/68	39/68	8.7						9.37	3.35	26.24	0.120354	0.11093	46.8 ± 12.9	55.5 ± 13
Mondal et al[26]	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA

SexDys: Sexual dysfunction; Ktx: Kidney transplantation; IIEF: International Index of Erectile Function; HTN: Hypertension; NA: Not available.