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Dialyse aktuell 2012; 16(3): 170-178
DOI: 10.1055/s-0032-1311831
Nephrologie
© Georg Thieme Verlag Stuttgart · New York

Sexualität – Wie ist die Situation bei chronischer Niereninsuffizienz und nach Nierentransplantation?

Sexuality – How is the situation regarding chronic renal insufficiency and after renal transplantation?
Markus Giessing
1   Universitätsklinik für Urologie, Heinrich Heine Universität Düsseldorf (Direktor: Prof. Dr. Peter Albers)
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Publication Date:
04 April 2012 (online)

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An der Dialyse besteht für Männer im Vergleich zur Normalbevölkerung eine signifikant erhöhte Prävalenz einer erektilen Dysfunktion. Ebenso finden sich Testosteronmangel und Libidoverlust häufiger. Diagnostik und Therapie des männlichen Dialysepatienten mit Erektionsstörungen unterscheiden sich nicht von derjenigen bei der Normalbevölkerung. Sie beinhalten neben der Anwendung von Hilfsmitteln medikamentöse und operative Therapieformen. Auch bei weiblichen Dialysepatienten besteht eine signifikant erhöhte Prävalenz einer sexuellen Dysfunktion. Während die Art der Dialyse (Hämo- vs. Peritonealdialyse) keinen Einfluss auf die Prävalenz der männlichen sexuellen Dysfunktion hat, ist die Peritonealdialyse für Frauen in Bezug auf die sexuelle Funktion besser (relatives Risiko sexuelle Dysfunktion Hämodialyse vs. Peritonealdialyse 5). Nach der Nierentransplantation bessert sich bei beiden Geschlechtern die sexuelle Funktion signifikant. Eine Schwangerschaft nach Nierentransplantation ist immer eine Risikoschwangerschaft und bedarf einer engmaschigen Anbindung an entsprechend ausgebildete Zentren. Sexualität bedeutet Lebensqualität – die betreuenden Ärzte sollten deshalb aktiv diesen Bereich bei ihren Patienten ansprechen.

Compared to normal population, male dialysis patients have a significantly higher prevalence of reduced libido, reduced testosterone level and increased erectile dysfunction. Diagnostic approach and therapy of a male dialysis patient with erectile function do not differ from male patients of the normal population. They include medication, supportive tools or an operative approach. Female patients with end-stage renal disease also have a significantly higher prevalence of sexual dysfunction. Interestingly, while for male dialysis patients the kind of dialysis (hemo vs. peritoneal) does not affect sexual dysfunction, women on hemodialysis have a 5-fold higher prevalence of sexual dysfunction compared to peritoneal dialysis. For both genders renal transplantation significantly improves sexual function. Pregnancy following renal transplantation is feasible but should always be handled as a high-risk pregnancy, requiring close cooperation between patient and transplant center. As sexuality is of utmost importance for quality of life, doctors involved in the care for dialysis patients and transplant recipients should always offer their patients full support in this field.

Key words

renal transplantation - dialysis - sexuality - erectile function
 

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