The purpose of dialysis is to improve the patients quality of life. While there are many indices of quality of life one of the most common complaints from my patients relates to adequacy of male sexual function. The exact incidence of erectile dyfunction among patients on dialysis is unknown. However studies among the subset of patients on hemodialysis show an 82 percent incidence as published in Kidney International.
Unfortunately patients that require dialysis usually carry a high burden of disease affecting the heart, brain and circulatory systems. This results in damage to these systems that commences years before the need for dialysis. The process of hemodialysis is also known to stress these very systems that were previously damaged before the need for dialysis even arose. The unfortunate result of this is a high incidence of erectile dysfunction.
What can be done about it?
Firstly erectile dysfunction can be a complex subject that ties together desire for sexual intercourse known as libido with ability to gain and maintain an erection when appropriately stimulated. Treatment for this problem therefore starts with a detailed look at each individual case with a care provider that you are comfortable with.
In the majority of cases patients will ask me directly if they can have viagra. My response is it depends..
First of all viagra has indeed been shown to be effective in erectile dysfunction among patients on dialysis. All previously understood cautions are still advised, patients who are on a class of drugs such as nitrates have to be particularly careful as it may cause a sudden drop in blood pressure. Viagra therefore should not be taken on dialysis days as there have been reports of a fall in blood pressure on dialysis in patients that do so. Viagra also did not increase the desire for sex in any way. The loss of libido that dialysis patients frequently experience is more directly treated by ensuring adequate blood counts be maintained as well as adequate dialysis obtained.
So is viagra right for you? if you are on dialysis with no liver problems or heart problems with stable blood pressure and no need for nitrates then yes schedule an appointment and discuss it with your physician.
[...] one of the primary causes of erectile dysfunction in chronic kidney disease is decreased relaxation this treats the cause directly in the majority of patients with good [...]
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