|
Asian Journal of Andrology (2012) 14, 621-625; doi:10.1038/aja.2011.115; published online 26 December 2011
Does kidney transplantation onto the external iliac artery affect the haemodynamic parameters of the cavernosal arteries?
Paolo Gontero1, Marco Oderda1, Claudia Filippini2, Francesco Fontana3, Elisa Lazzarich4, Piero Stratta4, Ernesto Turello4, Alessandro Tizzani1 and Bruno Frea5
1 Department of Urology-1, A.O.U.S. Giovanni Battista, University of Turin, Turin 10126, Italy
2 Department of Anesthesiology, A.O.U.S. Giovanni Battista, University of Turin, Turin 10126, Italy
3 Department of Urology, Vercelli Hospital, Vercelli 13100, Italy
4 Department of Nephrology and Kidney Transplant, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara 28100, Italy
5 Department of Urology, University of Udine, Udine 33100, Italy
Correspondence: Dr P Gontero, (paolo.gontero@unito.it)
Received 9 March 2011; Revised 27 May 2011; Accepted 27 June 2011
Advance online publication 26 December 2011.
| Abstract |
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 iliac 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 iliac 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=0.01). 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 iliac 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.
Keywords: cavernosal arteries; Doppler; erectile dysfunction; external iliac artery; kidney transplant |
|
