Rashad SHOLAN, Seymur KARIMOV, Yegana ABBASOVA, Narmin MAMMADOVA
Experimental and Clinical Transplantation - 2026;24(7):528-534
Objectives: Erectile dysfunction is highly prevalent in men with end-stage renal disease and substantially impairs quality of life. Although kidney transplant can mitigate systemic complications, its effect on erectile dysfunction varies. Here, we evaluated 1-year changes in erectile function following living donor kidney transplant in Azerbaijani men and identified clinical predictors of postoperative improvement. Materials and Methods: This retrospective observational study included 121 male patients undergoing living donor kidney transplant between 2017 and 2024. Erectile function was evaluated with the 5-item International Index of Erectile Function preoperatively and at 6 and 12 months postoperatively. We used multivariate linear regression to identify independent predictors of improvement. Results: All patients (mean age: 35.9 +/- 11.7 y) had erectile dysfunction at baseline, predominantly mild-to-moderate (42.1%) or moderate (28.9%). Mean 5-item International Index of Erectile Function scores increased significantly from 11.0 +/- 3.8 at baseline to 12.2 +/- 4.1 at 6 months and to 14.0 +/- 4.8 at 12 months (both P < .001). At 1 year, 97.5% of patients demonstrated improvement in score, with a mean increase of 3.0 +/- 1.6 points. Univariate analysis linked older age, smoking, regular sexual partnerships, and mild baseline erectile dysfunction with greater increase in score. However, multivariate analysis established the baseline score as the sole independent predictor of 1-year erectile function improvement (P < .001). Conclusions: Living donor kidney transplant was associated with significant and progressive improvement in erectile function over 1 year in men with end-stage renal disease. Baseline erectile function was the key determinant of recovery, underscoring the importance of early evaluation and management.
