In recent years, the requirements for the level of the life quality have increased significantly; an integral part of it is the sexual harmony, which in men largely depends on sexual desire and erectile function. According to the results of modern scientific studies, there is no doubt that erectile dysfunction in men is closely connected with the cardiovascular diseases, obesity, diabetes mellitus and other comorbidities. This problem can also be caused by systematic psycho-emotional overload, deterioration of the environmental conditions, harmful factors of production, uncontrolled use of medicines, inflammatory processes in the genital organs, the growth of somatic diseases. The vast majority of works concerning “male menopause” is reduced to the effectiveness of hormone-replacement therapy in erectile dysfunction, while only few research works are devoted to the study of the connection between somatic pathology and androgen deficiency. There is a negative correlation between total testosterone level and systolic blood pressure. According to the research results of some scientists, it was found that 38% of patients with arterial hypertension had androgen deficiency, confirmed in the laboratory, which is significantly higher than in patients of the same age category with normal blood pressure. These dominant factors exert and increase the influence on each other, which must be taken into account in modern therapeutic practice. The study of the formation of comorbid conditions in men with low levels of androgens is of particular importance, as the knowledge of pathophysiological mechanisms can prevent their development and progression. The aim of this investigation was to study the state of penile vascular blood flow in men with arterial hypertension with erectile dysfunction, using color Doppler imaging with pharmacological induction of erection. The indicators of daily monitoring of arterial pressure and arterial stiffness in men with arterial hypertension of the II degree against the background of androgen deficiency or at normal testosterone levels and ways of correction of erectile dysfunction in these patients were also evaluated.
The objective: to determine the effect of photoselective laser vaporization (FVP) on individual IIEF domains (sexual activity, libido, erection, ejaculation, ograzm, satisfaction with intercourse) in sexually active men with BPO, as well as the factors on which this effect depends. Materials and methods. 95 sexually active patients with benign prostatic obstruction (BPO) (prostate volume >40 cm3, maximum urinary flow rate Qmax <10 ml/s; QoL≥4) at the age of 45 to 60 years underwent FP (GreenLight XPS, MoxyFiber) ... Sexual function (IIEF), urination parameters (PSS/QoL, PVR, Qmax), prostate volume, intravesical prostate protrusion, PSA were assessed before the intervention and 3 months after. Results. PVP had a statistically significant and clinically significant effect on micturition parameters characterizing obstruction, prostate size and QoL. The median IPSSobstructive decreased by 6 (4–7) points (W=7.6; P<0.01), PVR by 48 (38–60) ml (W=6.2; P<0.01), IPP by 0.9 (0.5–1.5) cm (W=9.4; P<0.01) Vprostate at 31 (22–42) cm3 (W=8.5; P<0.01), QoL by 3 (2–4) points (W=11.2; P<0.01). The median Qmax increased by 23 (15–29) ml/s (W=13.3; P<0.01). The median values of the IPSSirritative and IPSSnocturia domains did not change significantly (P<0.8 and P<0.6, respectively). At 3 months after PVP, 84 (94.6 %) patients restored sexual activity. In 33 (39.28 %) of them, an improvement in erection and 15 (17.85 %) deterioration were found. 61 (72.26 %) lost emission. Conclusions. The most significant effect of PVP on ejaculatory function is the loss of emission. The effect of PVP on erection is multidirectional and manifests itself in its improvement and deterioration. Further research is needed to determine the mechanisms by which PVP affects erection and ejaculation in order to prevent negative effects.
Thesis for searching of the degree in Medical Sciences on specialty 14.01.06-Urology.-State Institution "Institute of Urology of the National Academy of Medical Sciences ofUkraine",-Kyiv, 2015. The Dissertation is devoted to solving the current issues in urologyimproving diagnosis and treatment efficacy sexual disorders in men with hypertension by correction of complex changes with regard to health. This paper analyzes the comprehensive examination and treatment of 120 patients with sexual disorders on the background AG. Patients were divided into 4 groups: I group (30 patients)-treated with phosphodiesterase-5 inhibitor such as sildenafil "on demand"; II group (30 patients)-received sildenafil 50 mg a day; III group (30 patients)-sildenafil 50 mg a day plus arginine; IV group (30 patients)-sildenafil + Arginine + LNP-therapy (local negative pressure therapy with electrical fotovacuum stimulation on the machine "Lodap"). The study proved and proposed new medical diagnostic algorithm based on the method of combination therapy sildenafil + arginine + LNP-fotovacuum electrical stimulation therapy to correct sexual disorders in men suffering from hypertension. The use of sildenafil, arginine and local negative pressure therapy with fotovacuum electrical stimulation in patients with sexual disorders on a background of hypertension leads to an improvement of the disease, is safe, affordable and not accompanied by side effects.
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