Kidney-Pancreas transplantation Is associated with near-normal sexual function in uremic type 1 diabetic patients

Background. Sexual function is altered in patients with type 1 diabetes (T1D) and end-stage renal disease (ESRD), thus affecting quality of life. The present study aimed to analyze sexual function in patients with T1D and ESRD (T1D + ESRD) who received a simultaneous kidney-pancreas (KP) or kidney-alone (KD) transplantation. Methods. Ten KP, 10 KD, 9 T1D + ESRD patients and 11 healthy control subjects were evaluated according to the following parameters: (1) medical/sexual history and physical examination; (2) International Index of Erectile Function; (3) Beck's inventory for depression; (4) assessment of hormonal profile; (5) quantitative sensory testing of both hand and penile sensory thresholds; and (6) hemodynamic penile assessment. Results. Controls and KP patients showed a higher rate of self-reported satisfactory erectile function as compared with KD and T1D + ESRD patients. Circulating androgens level resulted lower in both groups of transplanted patients and in patients with T1D + ESRD compared with healthy controls, albeit a relatively better profile was observed in KP. Both transplanted and T1D + ESRD patients showed peripheral hyposensitivity; however, healthy controls and KP showed better penile hemodynamic parameters compared with KD and T1D + ESRD. Conclusions. Our study demonstrates that sexual function, circulating sex steroids milieu, penile sensitivity, and hemodynamics are near-normalized for the most part in KP transplantation. Further studies are needed to assess the beneficial role and the overall impact of KP transplantation on sexual function in a long-term setting and a larger cohort of patients.