According to a multi-center study featured online in the British Journal of Urology International, California University’s San Diego School of Medicine researchers have found that patients undergoing a total nephrectomy, i.e. a complete removal of a kidney, have a higher chance of developing erectile dysfunction.

Senior author of the study, Ithaar Derweesh, MD, an associate professor of surgery at the UC San Diego School of Medicine and urologic surgeon at UC San Diego Health System, said: “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.”

The researchers evaluated two cohorts of men who underwent surgery for renal cell carcinoma in a retrospective study. The total number of patients involved in the study was 432. The patients were divided into those who had a complete nephrectomy and those who had kidney-preserving surgery. They assessed the patients’ sexual function before and after their surgery by using a sexual health questionnaire, known as the International Index of Erectile Function.

Derweesh said: “What we are seeing is a dramatic yet delayed effect. Approximately six years after surgery, patients who had a total nephrectomy were 3.5 times more likely to develop erectile dysfunction compared to those who had kidney reconstruction.”

Leading researcher Ryan Kopp, MD, who is a chief resident at UC San Diego School of Medicine’s Urology Division, explained:

“The primary argument for kidney-sparing surgery over total kidney removal has been to preserve the kidney filtration function. 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.”

Derweesh concluded that this is the latest research in a series of studies, which suggests that it is wiser to save a patient’s kidney whenever possible, rather than removing it. Earlier research led by Derweesh demonstrated that a partial nephrectomy could lower the risk of osteoporosis and chronic kidney insufficiency, which can potentially lead to cardiac events and metabolic disturbances. He continued saying that further research is required to predict the potential occurrence and to prevent erectile dysfunction in these patients.

Written by Petra Rattue