Total removal of a kidney during cancer treatment increases the risk of developing erectile dysfunction nearly four-fold compared with patients who have only a partial removal, researchers reported Tuesday. In light of other research, which shows that partial removal (known as partial nephrectomy) is at least as effective and probably more effective than complete removal (radical nephrectomy), it now seems reasonable that radical nephrectomy should be reserved as a last resort.
Dr. Ithaar Derweesh, a urologic surgeon at the UC San Diego Health System, and his colleagues studied 264 patients who underwent a radical nephrectomy and 168 who underwent a partial nephrectomy at either the UC San Diego Medical Center or the University of Tennessee Health Science Center in Memphis between January 1988 and December 2007. The team assessed the patients’ sexual health and activity before the surgery and at least six months afterward.
The researchers reported in the British Journal of Urology International that the patients who had radical nephrectomies had larger tumors and were more likely to have erectile dysfunction before cancer surgery. At six months after the surgery or later, 29.5% of those with a radical nephrectomy had newly developed erectile dysfunction, compared with 9.5% of those who underwent a partial nephrectomy. Taking other factors into consideration as well, the team calculated that those who underwent a radical nephrectomy had 3.56 times the risk of developing erectile dysfunction.
“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 erectile function,” Derweesh said.
Prior research by Derweesh has also shown that partial nephrectomy can reduce the risk of osteoporosis and chronic kidney insufficiency, which can lead to heart attacks and metabolic disturbances.
The study was funded by the Sexual Medicine Society of North America.