title: Persistent sexual dysfunction impairs quality of life after cardiac transplantation.
abstract: BACKGROUND
  The impact of sexual dysfunction (SD) on mental and physical health after heart transplantation (HTx) has not been established.
  
  
  OBJECTIVE
  We investigated the relationship of SD on quality of life (QoL), physical and mental health, and depressive symptoms after HTx.
  
  
  METHODS
  We evaluated SD according to the International Index of Erectile Dysfunction and the Female Sexual Function Index. QoL, physical and mental health were assessed using: 1) Short Form 12 Health Survey Questionnaire, 2) Quality of Life Enjoyment and Satisfaction Questionnaire--Short Form, and two depressive symptoms questionnaires: 1) Beck Depression Inventory-II and 2) Quick Inventory Depressive Symptomatology-Self Report.
  
  
  METHODS
  We enrolled patients who were greater than 6 months post HTx. Patients unable to read English, had pelvic surgery or trauma, urogenital abnormalities, or sexually inactive were excluded.
  
  
  RESULTS
  Out of 79 subjects that were screened, 33 men and 6 women participated (mean age 61.4 + 1.4). Response rates were at least 82% for all questionnaires. Overall prevalence of SD was 61%, with 78% of men being affected and 50% of women. There was no significant difference in measures between genders. HTx recipients with SD reported significantly worse QoL on measures of physical health when compared to those without SD. After HTx, patients suffering from SD had significantly worse general health (P = 0.02) and physical health (P = 0.02), including physical functioning (P = 0.01) and physical role limitation (P = 0.01). In contrast, mental health and depressive symptoms after HTx were not significantly different between those with and without SD.
  
  
  CONCLUSIONS
  After HTx a high prevalence of SD remains among both men and women. Patients with SD had worse general and physical health but not depressive symptoms when compared to those without SD. The contributing factors may be more related to physical rather than psychological causes.
authors.affiliation: Cedars-Sinai Medical Center, Cedars Sinai Heart Institute, Division of Cardiology, Los Angeles, CA, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Phan
authors.forename: Waguih William
authors.initials: WW
authors.lastname: Ishak
authors.forename: Biing-Jiun
authors.initials: BJ
authors.lastname: Shen
authors.forename: Justin
authors.initials: J
authors.lastname: Fuess
authors.forename: Kiran
authors.initials: K
authors.lastname: Philip
authors.forename: Catherine
authors.initials: C
authors.lastname: Bresee
authors.forename: Lawrence
authors.initials: L
authors.lastname: Czer
authors.forename: Ernst R
authors.initials: ER
authors.lastname: Schwarz
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D016027:Heart Transplantation / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires