(882) Changes in Erectile Function and Concordance Between Subjective and Objective Assessments in Male Uremic Patients After Kidney Transplantation

Introduction Patients with uremia frequently experience erectile dysfunction (ED) due to chronic metabolic and endocrine disturbances. Renal transplantation can improve general health, but its effect on sexual function recovery remains controversial, and discrepancies often exist between patients’ self-perception and objective questionnaire assessments. Objective To examine changes in erectile function before and after renal transplantation in men with uremia, compare self-reported ED with IIEF-15 assessments Methods This study included 64 male renal transplant recipients who attended follow-up visits at the Department of Urology, Peking University Third Hospital, between January 1 and December 24, 2024. Data on age, BMI, postoperative duration, and self-reported ED status before uremia, during uremia, and after transplantation were collected. Patients with psychogenic or other organic causes of ED were excluded. Postoperative erectile function was assessed using the International Index of Erectile Function (IIEF-15). Changes in self-reported ED were analyzed using McNemar’s test, and agreement between self-reported and IIEF-based ED classifications was evaluated with Cohen’s Kappa. Results Mean age was 43.11 ± 9.72 years, mean BMI 25.60 ± 7.57 kg/m2, and mean postoperative duration 4.42 ± 4.72 years. Self-reported ED: before uremia, 53/64 (82.8%) reported no ED; during uremia, 24/64 (37.5%) reported ED, a significant increase compared with pre-uremia (P = 0.00195); after transplantation, 52/64 (81.2%) reported no ED, a significant improvement from the uremic stage (P = 0.00596), and no significant difference compared with pre-uremia (P = 1.00). Postoperative IIEF-15 results show a total score of 53.78 ± 16.71; erectile function domain 23.00 ± 7.53; intercourse satisfaction 8.58 ± 4.06; sexual desire 7.22 ± 1.69; orgasmic function 7.33 ± 3.21; overall satisfaction 7.66 ± 1.90. According to IIEF grading: 29/64 (45.3%) normal, 26/64 (40.6%) mild ED, 2/64 (3.1%) moderate ED, and 7/64 (10.9%) severe ED. Agreement between self-report and IIEF-based classification was low: overall agreement 54.7%, Cohen’s Kappa = 0.144. Conclusions Renal transplantation appears to partially restore erectile function as judged by patient self-report, but objective IIEF-15 assessment indicates a persistent burden of ED in a substantial subset. Low concordance between self-report and standardized assessment suggests that postoperative evaluation should combine both subjective reports and objective questionnaires to better characterize sexual recovery and guide management. Disclosure No