Tabler J B, Frierson R L
Jewish Hospital Heart and Lung Institute, Louisville, Ky.
J Heart Transplant. 1990 Jul-Aug;9(4):397-403.
Sexual concerns after heart transplantation are commonly experienced yet seldom voiced. Forty-five patients approved for this procedure were surveyed regarding sexual issues. Twenty-one (47%) persons responded, of whom 16 had undergone heart transplantation, and five were waiting for a donor. Sexual dysfunction included impotence, ejaculation problems, altered libido, and avoidance of sexual opportunities. Contributing factors to these sexual difficulties were fear of death during coitus, effects of medication on interest and ability to function, body-image concerns, depression, uncertainty about the sexuality of the donor, and altered roles and responsibilities within the family. Recommendations for members of heart transplant teams include (1) obtaining a routine sexual history during the evaluation of candidates, (2) heightening awareness of the sexual concerns of these persons, (3) aggressively treating clinical depression, (4) establishing peer support groups for spouses of transplant patients, (5) presenting didactic material on sexual issues after transplant, (6) adjusting medications when sexual problems arise, and (7) addressing one's own level of comfort in discussing sex-related topics with transplant patients.
心脏移植术后的性问题很常见，但很少有人提及。对45名获批进行该手术的患者就性问题进行了调查。21人（47%）做出了回应，其中16人已经接受了心脏移植，5人正在等待供体。性功能障碍包括阳痿、射精问题、性欲改变以及回避性机会。导致这些性困难的因素包括性交时对死亡的恐惧、药物对性兴趣和性功能的影响、对身体形象的担忧、抑郁、对供体性别特征的不确定以及家庭中角色和责任的改变。对心脏移植团队成员的建议包括：（1）在评估候选人时获取常规性病史；（2）提高对这些人所关心的性问题的认识；（3）积极治疗临床抑郁症；（4）为移植患者的配偶建立同伴支持小组；（5）提供关于移植后性问题的教学材料；（6）出现性问题时调整药物；（7）明确自己在与移植患者讨论性相关话题时的舒适程度。
