CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Temos por objetivo avaliar a funÃÃo sexual e testicular (endÃcrina e espermÃtica) de homens em hemodiÃlise e transplantados renais. O estudo compreende 22 pacientes renais crÃnicos em hemodiÃlise e 21 pacientes transplantados renais acompanhados no ambulatÃrio de prà e pÃs-transplante do Hospital UniversitÃrio Walter CantÃdio, UFC. Os pacientes foram submetidos a anamnese, exame fÃsico e avaliados atravÃs de questionÃrio de avaliaÃÃo sexual. A avaliaÃÃo endÃcrina foi feita atravÃs dos seguintes hormÃnios: FSH, LH, Prolactina e Testosterona. AnÃlise seminal (espermograma) e testes de funÃÃo espermÃtica (teste hipo-osmÃtico, teste de estabilizaÃÃo da cromatina nuclear e swim-up) foram realizados. As medianas dos escores dos grupos controle, hemodiÃlise, transplante, foram, respectivamente, na funÃÃo erÃtil 29/27, 5/28; funÃÃo orgÃstica 10/10/10, funÃÃo desejo sexual 10/8/9, satisfaÃÃo com a relaÃÃo sexual 13/11/12, satisfaÃÃo com a vida sexual 10/10/9, evidenciando que nÃo houve diferenÃa estatisticamente significante entre os grupos, exceto no componente desejo sexual em que o grupo hemodiÃlise foi maior que o controle (P = 0,0004). As medianas das concentraÃÃes hormonais, no grupo hemodiÃlise e transplante, foram, respectivamente, prolactina 17,27/11,4; testoterona 5,25/4,78; FSH 3,65/4,11; LH 7,02/5,9; nÃo sendo constatada diferenÃa estatisticamente significante, exceto pelas dosagens de prolactina que foram maiores no grupo hemodiÃlise (P = 0,0035). As mÃdias e desvio-padrÃo dos parÃmetros seminais e testes de funÃÃo espermÃtica nos grupos hemodiÃlise e transplante, foram respectivamente, volume 1,86Â0,85/3Â1,9; pH 8Â0/8,14Â0,24; concentraÃÃo 25,57Â25,7/36,6Â37,5; motilidade progressiva 30,29Â27,5/33Â9,67; vitalidade 40Â16,7/52Â12,2; morfologia 10,14Â6,39/13,67Â11,02; estabilidade da cromatina nuclear (estÃvel) 80Â2,16/82Â3,9; estabilidade da membrana espermÃtica 59,71Â4,61/58,5Â4,76; motilidade progressiva pÃs-capacitaÃÃo 48,8Â25,19/40,33Â16,02; concentraÃÃo pÃs-capacitaÃÃo 3,42Â3,7/7,67Â4,18; evidenciando que nÃo houve diferenÃa estatisticamente significante. Conclui-se que o transplante renal nÃo melhora a funÃÃo sexual dos pacientes renais crÃnicos em hemodiÃlise. Houve pouca alteraÃÃo do eixo hipotÃlamo-hipÃfise-gÃnada, em ambos os grupos estudados, porÃm houve melhora dos nÃveis de prolactina sÃrica no grupo transplantado. NÃo hà melhora dos parÃmetros do espermograma padrÃo com o transplante renal, porÃm houve pouca alteraÃÃo nas provas de funÃÃo renal, em ambos os grupos, o que sugere boa previsÃo de fertilidade neste grupo de pacientes estudados. / Our goal is to evaluate the sexual and testicular (endocrine and spermatic) functions on men submitted to hemodialysis and kidney transplants. Our study is based on 22 patients with chronic kidney disease during hemodialysis and 21 kidney transplanted patients attended on a first aid station special for those cases of previous and post transplant at the Hospital UniversitÃrio Walter CantÃdio, UFC. The patients were submitted to anamnesis, physical exams and evaluated through a questionary about sexual performance. The endocrine evaluation was made considering the following hormones: FSH, LH, Prolactin and Testosterone. Semen analysis (spermogram) and sperm functional tests (hypo-osmotic test, nuclear chromatin stabilization test and swim-up test) were made. The median scores of the control, hemodialysis and transplant group were respectively: at erectile function 29/27,5/28, at orgastic function 10/10/10, at sexual desire function 10/8/9, at intercourse satisfaction 13/11/12, at satisfaction related to sexual life 10/10/9 proving that there was no significant statistical difference between the groups â excepting the sexual desire component in which the hemodialysis group was bigger than the control group (P = 0.0004). The hormones concentration averages in the hemodialysis and transplant group were respectively: prolactin 17,27/11,4; testosterone 5,25/4,78; FSH 3,65/4,11; LH 7,02/5,9 and it was not verified any significant statistical difference â excepting the prolactin levels that were higher in the hemodialysis group (P = 0,0035). The average and standard deviation from the semen parameter and sperm functional tests on the hemodialysis and transplant group were respectively: volume 1,86Â0,85/3Â1,9; pH 8Â0/8,14Â0,24; concentration 25,57Â25,7/36,6Â37,5; progressive motility 30,29Â27,5/33Â9,67; vitality 40Â16,7/52Â12,2; morphology 10,14Â6,39/13,67Â11,02; stability of nuclear chromatin (stable) 80Â2,16/82Â3,9; stability of the sperm membrane 59,71Â4,61/58,5Â4,76; progressive motility after capacitation 48,8Â25,19/40,33Â16,02; concentration after capacitation 3,42Â3,7/7,67Â4,18 showing that there was no significant statistical difference. Thus, we can conclude that kidney transplants do not improve the sexual function of patients with cronic kidney disease submitted to hemodialysis. The alteration in hypothalamus-hypophysis-gonad was not significant in both groups studied. However, there was an improvement of the seric prolactin levels on the transplanted group. There was no improvement of the standard spermogram parameter related to kidney transplant, but it was observed a slight alteration concerning the sperm functional tests in both groups that suggests a good forecast of fertility in the group of patients studied.
| Identifer | oai:union.ndltd.org:IBICT/oai:www.teses.ufc.br:1657 |
| Date | 31 July 2007 |
| Creators | LeocÃcio Venicius de Sousa Barroso |
| Contributors | Francisco das Chagas Medeiros, LÃcio FlÃvio Gonzaga Silva, Maria Angelina da Silva Medeiros |
| Publisher | Universidade Federal do CearÃ, Programa de PÃs-GraduaÃÃo em Tocoginecologia, UFC, BR |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da UFC, instname:Universidade Federal do Ceará, instacron:UFC |
| Rights | info:eu-repo/semantics/openAccess |
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