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SEXUAL COMPLICATION
Clinical complications of chronic
kidney
failure
The
clinical complications of chronic
kidney failure are
widespread
such as:
Sexual Functions
Males
A
combination of loss of libido and erectile impotence
are experienced by about half the men on dialysis.
Loss of libido will be a consequence of ill health
and depression and is improved when well being is
restored. Impotence has many causes, including
pelvic vascular disease, venous leakage because of
neuropathy, and drugs (for example, thiazides or
a-blockers). Treatment of impotence with vacuum
devices, intracavernosal injection of phentolamine,
or oral sildanefil may be effective. Low sperm
counts and motility that are not improved by
hormonal treatment account for the lower fertility
of uraemic men. In vitro fertilization is an option.
Priapism is a rare complication of haemodialysis
treatment. Gynaecomastia is common.
Females
Most
women with severe renal failure develop amenorrhoea
or irregular menses due to hypothalamopituitary
dysregulation. Oestrogen levels are low, accounting
for atrophic vaginitis and contributing to
osteoporosis. Women with severe uraemia are usually
infertile and the rare pregnancies almost always end
in miscarriage. Patients with mild to moderate renal
failure do become pregnant, when the risk of an
accelerating decline in function and chance of a
successful outcome are related to the severity of
preconception renal dysfunction, proteinuria, and
blood pressure.
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