| Abstract: |
Genitourinary complications commonly affect the kidney transplant population. This chapter on erectile dysfunction (ED) and other urological issues in kidney transplant recipients is from a textbook on the medical management of kidney transplant patients. The authors discuss the epidemiology of ED, erectile anatomy and physiology, the etiology of ED in the transplant patient (vasculogenic, neurogenic, endocrinologic causes, as well as chronic disease), and the evaluation of ED in the transplant patient, including the history and physical, laboratory studies, the process of care model, endocrine evaluation, treatment of hypogonadism, psychiatric factors of sexual dysfunction, phosphodiesterase type 5 inhibitors, vacuum constriction devices, transurethral alprostadil, intracavernosal injection, and penile prostheses. The final sections consider preoperative urological issues, including indications for native nephrectomy and history of urological malignancy; and postoperative urological issues, including hematuria, hydronephrosis and obstruction, urinary tract infections, prostate cancer screening, urolithiasis (urinary tract stones), and bladder dysfunction. The authors conclude that a thorough understanding of the urological issues involved and the diagnostic and treatment options available enables an effective multidisciplinary approach to the transplant patient. 14 figures. 7 tables. 138 references. |