HEART-TRANSPLANTATION AND ITS IMPACT ON S EXUAL LIFE - A RETROSPECTIVE INQUIRY IN 62 MALE-PATIENTS

119 adult male Austrian patients who had undergone heart transplantati on between January 1985 and December 1990 were questionned on sexual f unctional disorders pre- and postoperatively. Questions dealt with per ceived medication effects on sexual function and libido, fear of inter course, their worries about the sexual habits of the donor, perceived changes in sexual attractiveness and body image. They were also asked how they felt about discussing sexual matterns with their doctors. 62 patients returned fully completed questionnaires. 75% of the patients were more than 45 years old (45 to 67 years). Heart transplantation ha d been carried out at least once longest seven years before. The patie nts report ed a significant postoperative increase of libido accompani ed by a significant decrease of physical complaints at intercourse. Pr oblems with potency (impaired erectile rigidity) persisted, however (T able 4, Figure 1). 23% of the patients reported that since transplanta tion sexuality had become a problem for them. 42% wanted to undergo tr eatment if available. 29% stated that sexual matters had clearly impro ved. 31% suspected that medication adversely affected sexual functioni ng, and 23% stated that in their opinion it contributed to a lowered l ibido. 15% felt themselves much more sexually attractive after they ha d undergone surgery, and 13% were considered more sexually attractive by their spouses. Only four patients reported avoiding intercourse for health reasons. One patient confirmed that he was fantasizing about t he sexual habits of the unknown donor of his heart. It seems that phys icians often neglect to talk about sexual matters with their heart tra nsplant patients, though the patients consider it a very important top ic (Figure 2). The complete questionnaire is reproduced in Table 2. Ne ither the age of the patients nor the time since the transplantation h ad any statistically significant influence on the response to the ques tions asked. When comparing the groups ''minimal medication'' (n = 12) and ''maximal medication'' (n = 12), statistically significant differ ences were found: patients on more medication were more likely to have erectile dysfunction and were more likely to blame medication for the ir sexual problems. They were also more afraid of physical exertion du ring sexual intercourse, considered sexuality a personal problem, and said that they were thinking of consulting a sexual therapy clinic. It remains to be seen, however, whether sexual dysfunction is primarily due to adverse drug effects, psychological strain or pre-existing mult imorbidity. Since complaints were subjective self-reports, their actua l validity remains uncertain, but clearly the symptoms were bothersome enough not to be denied.