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Response to Comment on: The impact of solid organ transplantation on sexual dysfunction and infertility in older men and women: a claims-based study

International Journal of Impotence Research (2025)Cite this article

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We would like to thank Basheer et al. for their insightful response to our findings on the impact of solid organ transplantation (SOT) on sexual function and fertility [1]. We agree that sexual function is often overlooked during patient counseling for SOT, although it is an essential factor for quality-of-life measures. As Basheer et al. pointed out, our study showed that sexual health improved and fertility improved modestly following SOT [2].

Our findings showed that heart (ARR 2.21%, p = 0.001) and kidney (ARR 1.42%, p < 0.001) transplantation had the greatest impact on sexual function [1, 2]. In addition to Basheer et al.’s observations, we would like to highlight that these findings can potentially be explained physiologically. Heart transplantation improves blood perfusion, which is necessary for erectile function and vaginal lubrication [3]. This, along with enhanced endurance capability to meet the physiological demands of sexual activity, may allow for improved sexual function [3]. In renal failure, uric acid accumulates, which is toxic to the hypothalamus and gonads [4]. Renal transplantation restores the HPG axis and gonadal function by decreasing uric acid, among other effects.

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Data availability

The data discussed here can be found in the following article: Obuekwe O, Clark H, Saffati G, Yatsenko T, Oscar‑Thompson L, Riveros C, et al. The impact of solid organ transplantation on sexual dysfunction and infertility in older men and women: a claims‑based study. Int J Impot Res. 2025. https://doi.org/10.1038/s41443-025-01127-1.

References

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  2. Obuekwe O, Clark H, Saffati G, Yatsenko T, Oscar-Thompson L, Riveros C, et al. The impact of solid organ transplantation on sexual dysfunction and infertility in older men and women: A claims-based study. Int J Impot Res [Internet]. 2025 July [cited 2025 Sept 29]; Available from: https://www.nature.com/articles/s41443-025-01127-1

  3. Hasin T, Jaarsma T, Murninkas D, Setareh-Shenas S, Yaari V, Bar-Yosef S, et al. Sexual function in patients supported with left ventricular assist device and with heart transplant. ESC Heart Fail. 2014;1:103–9.

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Authors and Affiliations

  1. Department of Urology, Houston Methodist Hospital, Houston, TX, USA

    Obinna Obuekwe, Tatyana Yatsenko, Carlos Riveros & Akhil Muthigi

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  1. Obinna Obuekwe
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  2. Tatyana Yatsenko
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  3. Carlos Riveros
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  4. Akhil Muthigi
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OO, TY, CR were responsible for writing the original manuscript. AM was responsible for supervision, review, and editing.

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Correspondence to Akhil Muthigi.

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The authors declare no competing interests.

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No new human data were collected or analyzed for this response. The original study on which this discussion is based utilized deidentified patient records and therefore did not require ethical approval.

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Obuekwe, O., Yatsenko, T., Riveros, C. et al. Response to Comment on: The impact of solid organ transplantation on sexual dysfunction and infertility in older men and women: a claims-based study. Int J Impot Res (2025). https://doi.org/10.1038/s41443-025-01204-5

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