Assessment of the treatment effectiveness of men with mild and medium degree of erectile dysfunction.

OBJECTIVE: . Aim: To assess the effectiveness of monotherapy and complex treatment of patients with erectile dysfunction depending on its severity. PATIENTS AND METHODS: Materials and Methods: Men with moderate and mild erectile dysfunction took part in the study, who, in turn, were divided into groups, depending on the treatment, with the evaluation of the results of the International Index of Erectile Function (MIEF-15), the state of cavernous hemodynamics and the function of the vascular endothelium before and after treatment. RESULTS: Results: In patients with an average degree of severity, who received complex treatment including a course of low-energy shock wave therapy, against the background of taking sildenafil and L-arginine, the best results were obtained in the quality of erection and increased cavernous blood flow, which positively affected satisfaction with sexual intercourse and overall satisfaction. It has also been proven that the function of the endothelium was improved in patients receiving L-arginine, due to which there was a probable decrease in endothelin-1. A probable improvement of erectile function was obtained in the group of patients with a mild degree who received L-arginine, and there was no statistical difference from the indicators in the group who received sildenafil, which was confirmed by the data of dopplerography. CONCLUSION: Conclusions: Patients with an average degree of erectile dysfunction require comprehensive treatment. The use of L-arginine can be an alternative to phosphodiesterase type 5 inhibitors in the treatment of mild erectile dysfunction.

EVALUATION OF EFFICACY OF EXTRACORPOREAL SHOCK WAVE THERAPY IN COMPLEX TREATMENT OF PATIENTS WITH CHRONIC NON-BACTERIAL PROSTATITIS / CHRONIC PELVIC PAIN SYNDROME.

OBJECTIVE: The aim: Study of hemodynamics of the prostate and evaluation of the ef f ectiveness of extracorporeal shock wave therapy (ESWT) in the complex treatment of patients with chronic prostatitis with non-inf l ammatory chronic pelvic pain syndrome (NCPPS), (NIH III B). PATIENTS AND METHODS: Materials and methods: There were 63 patients with NCPPS aged 29 to 45 years, with a disease duration of more than 3 years and low ef f i cacy of treatment against the background of standard therapy. All patients received standard therapy according to the clinical protocol. The main group (33 men - group II), against the background of standard therapy, received a course of ESWT, followed by a comparative assessment of clinical results regarding to the group of patients (30 men - group I) who received only standard therapy after the course, and after 3 and 6 months after treatment. RESULTS: Results: According to the results of transrectal ultrasonography in Doppler mode, a marked decrease in volumetric blood fl ow in the prostate gland of patients was observed. The use of ESWT against the background of standard treatment contributed to a longer and more stable clinical ef f ect, with a signif i cant improvement in hemodynamic parameters in the prostate unlike the results in the group of patients receiving only standard therapy. CONCLUSION: Conclusions: Signif i cant disorders of prostate hemodynamics were found in patients with NCPPS. Use on the background of standard treatment of ESWT in these patients is pathogenetically justif i ed with a lasting and stable clinical ef f ect.