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In this study we determine the sexual problems and the prevalence of erectile dysfunction (ED) in male hemodialysis patients by means of the International Index of Erectile Function (IIEF). A total of 187 male patients were included in the study. All of the patients who underwent hemodialysis were asked to complete the IIEF questionnaire. The IIEF domain scores were calculated and erectile dysfunction grading was determined on erectile function domain. Patients were also asked to report whether they had disclosed their sexual problems to physicians or not. The mean age was 49.3 ± 13.2 y and the duration of hemodialysis was 38.1 ± 8.4 months. By means of the IIEF, the prevalence of erectile dysfunction of any degree was 80.7%. The prevalence of any ED for the patients < 50 y and ≥ 50 y was 74.5% and 86.6%, respectively. The prevalence and the severity of ED was significantly higher in patients ≥50 y. The frequency of intercourse attempts during the last four weeks was 1 - 2 in 130 (69.5%) of patients. Only 1% of patients disclosed their erectile problems and sought medical assistance prior to our study. Erectile dysfunction is highly prevalent in hemodialysis patients. The prevalence and the severity of ED increased with age. Evaluations for ED should be included in routine assessment of hemodialysis patients. [ABSTRACT FROM AUTHOR]