Skip to main content
SpringerLink
Log in

Impotence in Uremia

Preliminary Results of a Combined Medical and Psychiatric Investigation

  • Chapter
Psychonephrology 2

Abstract

End-stage renal disease (ESRD) is a very stressful illness with many possible complications. One of the most disruptive of these potential complications for both males and females is sexual dysfunction. ESRD patients must make many sacrifices and they are required to give up many things. Assaults on their self-esteem are ubiquitous for these individuals. The loss of sexual functioning can deprive the patient of one of the key areas of gratification in his or her life. In this day and age, with so much emphasis on sexuality, the loss of the ability to perform sexually can be devastating to one’s self-esteem. While sexual dysfunction had been sporadically mentioned over the course of many years and in numerous reports as a sequela of ESRD,1,2 it wasn’t until Levy’s study that a large-scale, systematic analysis of this problem was presented.3 Basically, Levy performed a national questionnaire survey of the membership of an organization of patients with ESRD of varying degrees. A total of over 500 patients on hemodialysis and with renal transplants were assessed. He found that a high percentage of male patients with ESRD suffered from erectile disturbances while a substantial number of women with ESRD complained of failure to experience arousal and achieve orgasm. A large number of both men and women reported declines in libido. The frequency of intercourse declined appreciably in most of these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Kaplan De-Nour, A. Some notes on the psychological significance of urination. Journal of Nervous and Mental Disease, 1969, 148, 615–623.

    Article  PubMed  CAS  Google Scholar 

  2. Friedman, E. A., Goodwin, N. J., and Chaudhry, L. Psychosocial adjustment of family to maintenance hemodialysis. Part II. New York State Journal Medicine, 1970, 70, 767–774.

    CAS  Google Scholar 

  3. Levy, N. B. Sexual adjustment of maintenance hemodialysis and renal transplantation: National survey by questionnaire: Preliminary report. Transactions of the American Society of Artificial Internal Organs, 1973, 19, 138–143.

    Article  CAS  Google Scholar 

  4. Foster, F. G., Cohn, G. L., and McKegney, F. P. Psychological factors and individual survival on chronic renal hemodialysis—a two year follow up: Part I. Psychosomatic Medicine, 1973, 35, 64–82.

    PubMed  CAS  Google Scholar 

  5. Salvatierra, O., Fortmann, J. L., and Belzer, F. O. Sexual function in males before and after renal transplantation. Urology, 1975, 5, 64–66.

    Article  PubMed  Google Scholar 

  6. Abram, H. S., Hester, L. R., and Sheridan, W. F. Sexual functioning in patients with chronic renal failure. Journal of Nervous and Mental diseases, 1975, 160, 220–226.

    Article  CAS  Google Scholar 

  7. Thurm, J. Sexual potency of patients on chronic hemodialysis. Urology, 1975, 5, 60–62.

    Article  PubMed  CAS  Google Scholar 

  8. Sherman, F. P. Impotence in patients with chronic renal failure on dialysis: Its frequency and etiology. Fertility and Sterility, 1975, 26, 221–223.

    PubMed  CAS  Google Scholar 

  9. Bommer, J., Tschope, W., and Ritz, E. Sexual behavior of hemodialyzed patients. Clinical Nephrology, 1976, 6, 315–318.

    PubMed  CAS  Google Scholar 

  10. Steele, T. E., Finkelstein, S. M., and Finkelstein, F. O. Hemodialysis patients and spouses: Marital discord, sexual problems and depression. Journal of Nervous and Mental Disease, 1976, 162, 225–237.

    Article  PubMed  CAS  Google Scholar 

  11. Bergstein, E., Asaba, H., and Bergstrom, J. A study of patients on chronic hemodialysis. Scandanavian Journal of Social Medicine, 1977, 11, 1–31.

    Google Scholar 

  12. Milne, J. F., Golden, J. S., and Fibus, L. Sexual dysfunction in renal failure: A survey of chronic hemodialysis patients. International Journal of Psychiatry in Medicine, 1977/78, 8, 335–345.

    Article  PubMed  Google Scholar 

  13. Kaplan De-Nour, A. Hemodialysis: Sexual functioning. Psychosomatics, 1978, 19, 229–235.

    Article  Google Scholar 

  14. Procci, W. R., Hoffman, K. I., and Chatterjee, S. N. Sexual functioning of renal transplant recipients, Journal of Nervous and Mental Disease, 1978, 166, 402–407.

    Article  PubMed  CAS  Google Scholar 

  15. Holdsworth, S. R., de Kretser, D. M., and Atkins, R. C. A comparison of hemodialysis and transplantation in reversing the uremic disturbance in male reproductive function. Clinical Nephrology, 1978, 10, 146–150.

    PubMed  CAS  Google Scholar 

  16. Procci, W. R., Goldstein, D. A., and Adelstein, J. Sexual dysfunction in the male uremic patient: A reappraisal. Kidney International, 1982, 19, 317–323.

    Article  Google Scholar 

  17. Guevara, A., Vidt, D., and Halberg, M. C. Serum gonadotropin and testosterone levels in uremic males undergoing intermittent dialysis. Metabolism, 1969, 12, 1062–1066.

    Article  Google Scholar 

  18. Chen, J. C., Vidt, D. G., and Zorn, E. M. Pituitary-Leydig cell function in uremic males. Journal of Clinical Endocrinology and Metabolism, 1970, 31, 14–17.

    Article  PubMed  CAS  Google Scholar 

  19. Bailey, G. L., Rosen, S., and Weintraub, B. Serum testosterone and gonadotrophins in uremic males before and after hemodialysis. Proceedings of the American Society of Nephrology, 1970, 4, 5.

    Google Scholar 

  20. Frantz, A. G., Kleinberg, D. L., Noel, G. L. Studies on prolactin in man. Recent Progress in Hormonal Research, 1972, 28, 527–590.

    CAS  Google Scholar 

  21. Nagel, T. C., Freinkel, N., and Bell, R. H. Gynecomastia, prolactin, and other peptide hormones in patients undergoing chronic hemodialysis. Journal of Clinical Endocrinology and Metabolism, 1973, 36, 428–432.

    Article  PubMed  CAS  Google Scholar 

  22. Sawin, C. T., Longscope, C., and Schmitt, G. W. Blood levels of gonadotropins and gonadal hormones in gynecomastia associated with chronic hemodialysis. Journal of Clinical Endocrinology and Metabolism, 1973, 36, 988–990.

    Article  PubMed  CAS  Google Scholar 

  23. stewart-Bently, M., Gans, D., and Horton R. Regulation of gonadal function in uremia. Metabolism, 1974, 23, 1065–1072.

    Article  Google Scholar 

  24. Distiller, L. A., Morley, J. E., and Sagel, J. Pituitary-gonadal function in chronic renal failure. The effect of luteinizing hormone-releasing hormone and the influence of dialysis. Metabolism, 1975, 24, 711–720.

    Article  PubMed  CAS  Google Scholar 

  25. Lim, V. S., and Fang, V. S. Gonadal dysfunction in uremic men. A study of the hypothalamic-pituitary-testicular axis before and after transplantation. American Journal of Medicine, 1975, 58, 655–662.

    Article  PubMed  CAS  Google Scholar 

  26. Hagen, C., Olgaard, K., and McNeilly, A. S. Prolactin and the pituitary-gonadal axis in male uremic patients on regular dialysis. Acta Endocrinologica Copenhagena, 1976, 82, 29–38.

    CAS  Google Scholar 

  27. Holdsworth, S. R., Atkins, R. C., and de Kretser, D. M. The pituitary-testicular axis in men with chronic renal failure. New England Journal of Medicine, 1977, 296, 1245–1249.

    Article  PubMed  CAS  Google Scholar 

  28. Perez, R. J., Lipner, M., and Abdulla, N. Menstrual dysfunction of patients undergoing chronic hemodialysis. Obstetrics and Gynecology, 1978, 51, 552–555.

    Article  PubMed  CAS  Google Scholar 

  29. Beck, A. T. The diagnosis and management of depression. Philadelphia: University of Pennsylvania Press, 1973.

    Google Scholar 

  30. Bryan, F. A. The national dialysis registry. Development of a medical registry of patients on chronic dialysis. 7th Annual Progress Report, No. AK-7-7-1387, Artificial Kidney-Chronic Uremia Program, National Institute of Arthritis, Metabolism, and Digestive Diseases, National Institute of Health, October, 1975.

    Google Scholar 

  31. Karacan, I. A simple and inexpensive transducer for quantitative measurements of penile erection during sleep. Behavioral Research Methods and Instruments, 1969, 1, 251–252.

    Article  Google Scholar 

  32. Feighner, J. R., Robbins, E., and Guze, S. B. Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 1972, 26, 57–63.

    Article  PubMed  CAS  Google Scholar 

  33. Beck, A. T., Ward, C. H., and Mendelson, M. An inventory for measuring depression. Archives of General Psychiatry, 1961, 4, 561–571.

    Article  PubMed  CAS  Google Scholar 

  34. Raskin, A., Schulterbrand, J., and Reatig, N. Factors of psychopathology in interview, ward behavior, and self-report ratings of hospitalized depressives. Journal of Consultation Psychology, 1967, 31, 270–278.

    Article  CAS  Google Scholar 

  35. Karacan, I., Salis, P. J., and Ware, J. C. Nocturnal penile tumescence and diagnosis in diabetic impotence. American Journal of Psychiatry, 1978, 135, 191–198.

    PubMed  CAS  Google Scholar 

  36. Fisher, C., Schiavi, R. C., and Edwards, A. Evaluation of nocturnal penile tumescence in the differential diagnosis of sexual impotence: A quantitative study. Archives of General Psychiatry, 1979, 36, 431–37.

    Article  PubMed  CAS  Google Scholar 

  37. Franks, S., Jacobs, H. S., and Martin, N. Hyperprolactinaemia and impotence. Clinical Endocrinology, 1978, 8, 277–287.

    Article  PubMed  CAS  Google Scholar 

  38. Glassman, C. N., Rife, C. C., and Wilson, C. B. Prolactin—Added dimension in male genitosexual disorders. Urology, 1980, 15, 49–52.

    Article  PubMed  CAS  Google Scholar 

  39. Spark, R. F., White, R. A., and Connolly, P. B. Impotence is not always psycho-genic: Newer insights into hypothalamic-pituitary-gonadal dysfunction. Journal of the American Medical Association, 1980, 243, 750–755.

    Article  PubMed  CAS  Google Scholar 

  40. Nagulesparen, M., Ang, V., and Jenkins, J. S. Bromocriptine treatment of males with pituitary tumors, hyperprolactinaemia, and hypogonadism. Clinical Endocrinology, 1978, 9, 73–79.

    Article  PubMed  CAS  Google Scholar 

  41. Bommer, J., del Pozo, E., and Ritz, E. Improved sexual function in male hemodialysis patients on bromocriptine. Lancet, 1979, 2, 496–497.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Residency Education in Psychiatry, Harbor-UCLA Medical Center, Torrance, California, USA

    Warren R. Procci M.D. (Director, Visiting Professor of Psychiatry and the Biobehavioral Sciences)

  2. School of Medicine, University of California at Los Angeles, Los Angeles, California, USA

    Warren R. Procci M.D. (Director, Visiting Professor of Psychiatry and the Biobehavioral Sciences)

  3. University of Southern California School of Medicine, Los Angeles, California, USA

    David A. Goldstein M.D. (Associate Professor of Medicine), Oscar A. Kletzky M.D. (Associate Professor of Obstetrics and Gynecology), Vito M. Campese M.D. (Associate Professor of Medicine) & Shaul G. Massry M.D. (Professor of Medicine)

Authors
  1. Warren R. Procci M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David A. Goldstein M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Oscar A. Kletzky M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vito M. Campese M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shaul G. Massry M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. New York Medical College, Valhalla, New York, USA

    Norman B. Levy M.D. (Professor of Psychiatry, Medicine and Surgery) (Professor of Psychiatry, Medicine and Surgery)

  2. University of North Carolina, Chapel Hill, North Carolina, USA

    William Mattern M.D. (Associate Professor of Medicine) (Associate Professor of Medicine)

  3. Department of Psychiatry and Behavioral Science, New York Medical College, Valhalla, New York, USA

    Alfred M. Freedman M.D. (Professor and Chairman) (Professor and Chairman)

Rights and permissions

Reprints and permissions

Copyright information

© 1983 Springer Science+Business Media New York

About this chapter

Cite this chapter

Procci, W.R., Goldstein, D.A., Kletzky, O.A., Campese, V.M., Massry, S.G. (1983). Impotence in Uremia. In: Levy, N.B., Mattern, W., Freedman, A.M. (eds) Psychonephrology 2. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-6669-8_20

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-6669-8_20

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-6671-1

  • Online ISBN: 978-1-4899-6669-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation