Document Detail

Does kidney transplantation onto the external iliac artery affect the haemodynamic parameters of the cavernosal arteries?
MedLine Citation:
PMID:  22198628     Owner:  NLM     Status:  MEDLINE    
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.
Paolo Gontero; Marco Oderda; Claudia Filippini; Francesco Fontana; Elisa Lazzarich; Piero Stratta; Ernesto Turello; Alessandro Tizzani; Bruno Frea
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Publication Detail:
Type:  Journal Article     Date:  2011-12-26
Journal Detail:
Title:  Asian journal of andrology     Volume:  14     ISSN:  1745-7262     ISO Abbreviation:  Asian J. Androl.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-03     Completed Date:  2012-12-21     Revised Date:  2013-09-17    
Medline Journal Info:
Nlm Unique ID:  100942132     Medline TA:  Asian J Androl     Country:  China    
Other Details:
Languages:  eng     Pagination:  621-5     Citation Subset:  IM    
Department of Urology-1, A.O.U.S. Giovanni Battista, University of Turin, Turin 10126, Italy.
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MeSH Terms
Anastomosis, Surgical / adverse effects,  methods
Blood Flow Velocity
Erectile Dysfunction / etiology*,  physiopathology*
Iliac Artery / surgery*
Kidney Transplantation / adverse effects*,  methods
Middle Aged
Multivariate Analysis
Penis / blood supply*,  ultrasonography
Postoperative Period
Preoperative Period
Prospective Studies
Severity of Illness Index
Ultrasonography, Doppler, Color
Young Adult

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