ED Tied to Total Kidney Removal

Total nephrectomy may increase erectile dysfunction risk

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Kidney removal is a serious surgery that comes with some long-term risks, including chronic kidney disease. Now researchers have found it may have an impact on men's sex lives.

Total nephrectomy (the complete removal of the kidney) may increase the risk of erectile dysfunction (when a man cannot get or keep an erection hard enough for sex).

"Ask your doctor about the risks of kidney removal."

Total nephrectomy is most often performed to treat kidney cancer or to remove a severely damaged kidney. Not all patients need their entire kidney removed, a partial nephrectomy may be enough to remove a tumor or damaged section of kidney while preserving the filtering function of the kidney.

"This is the first study in medical literature to suggest that surgery for kidney removal can negatively impact erectile function while partial kidney removal can protect sexual function," said the study's senior author Ithaar Derweesh, MD, of the University of California San Diego Health System.

Study results showed that, about six years after surgery, male patients who had their entire kidney removed were 3.5 times more likely to develop erectile dysfunction, compared to those who had kidney reconstruction.

"What we are seeing is a dramatic yet delayed effect," said Dr. Derweesh.

"The primary argument for kidney-sparing surgery over total kidney removal has been to preserve the kidney filtration function," said Ryan Kopp, MD, of the UC San Diego School of Medicine and lead author of the study.

"However, we are also beginning to understand that total kidney removal may also increase the risk of metabolic diseases and significantly decrease quality of life," he said.

According to Dr. Derweesh, this study is the most recent to suggest that saving part of the kidney may be beneficial to patients.

Dr. Derweesh's past research has shown that partial kidney removal can lower the risk of osteoporosis and kidney failure.

For their study, the researchers looked at 432 male patients who underwent surgery for renal cell carcinoma (a type of kidney cancer). A portion of these patients underwent total nephrectomy while another portion underwent kidney-sparing surgery. The researchers measured the men's sexual function before and after surgery using the International Index of Erectile Function, a sexual health questionnaire.

More research is needed to protect patients from erectile dysfunction and to figure out ways to predict the development of the condition.

The study was funded by the Sexual Medicine Society of North America Scholars in Sexuality Research Grant.

The research was published in the British Journal of Urology International.

Reviewed by: 
Review Date: 
July 31, 2012
Last Updated:
April 18, 2013