Profile of Sexual Disorders in Chronic Hemodialysis Patients at the Boubacar Diallo National Hospital in Niamey (Niger)

Abstract

Introduction: Hemodialysis has favorably improved the prognosis of patients with end-stage renal failure. However, this heavy therapy is accompanied by an imbalance in various aspects of these patients’ lives. Sexuality is one of the most affected areas. Aim: To study the epidemiological, clinical and biological profile of chronic hemodialysis patients with sexual dysfunction in the Nephrology department of the Amirou Boubacar Diallo National Hospital in Niamey (HNABD). Method: This was a prospective, cross-sectional, analytical study of 100 cases collected over a period of six months from February to July 2023. Results: The frequency of sexual disorders was 98%; male gender represents 80% of cases. The mean age of our patients was 44.2 ± 1.2 years. AVF was used in 90% of cases. 98% of cases had two four-hour sessions per week. Hypertension was the comorbidity found in 67% of patients. Chronic glomerulonephritis was the etiology of end-stage chronic renal failure in more than half of the patients in 52% of cases. Functionally, libido disorder represented 87% of cases, sexual asthenia 68%, orgasm disorder 54%, ejaculation disorder 41%, menstrual disorder in 8% of cases, and sterility 2%. According to the IIEF5, erectile dysfunction was severe in 28%, moderate in 33%, and mild in 30%. According to the FSFI, 95.6% of female patients had sexual dysfunction. More than a quarter of patients (36% or n = 36) had hypogonadism in men. Almost all patients (92% or n = 92) had a hemoglobin level below 11 g/dl. Severe and moderate sexual dysfunction were positively correlated in patients over 60 years of age (p = 0.009 and p = 0.02), but also in hypertensive patients with mild sexual dysfunction and those whose IIEF was uninterpretable (p = 0.03 and p = 0.04). This association was also statistically significant in male diabetic patients with severe and moderate disorders (p = 0.02 and p = 0.04), but also in anemic patients (p = 0.05). Conclusion: Sexual disorders must be considered as a major factor affecting patients’ quality of life, and their management must be included in the therapeutic strategies of these patients.