scholarly journals Modern Methods of Treating Erectile Dysfunction in Young Men

Health of Man ◽  
2021 ◽  
pp. 49-58
Author(s):  
Oleksandr Knigavko ◽  
Viktoriia Dorina
Keyword(s):  
Erectile Dysfunction ◽  
Surgical Treatment ◽  
Chronic Prostatitis ◽  
Young Patients ◽  
Young Men ◽  
Sexual Life ◽  
Modern World ◽  
Subjective Data ◽  
Results Of Treatment ◽  
Number Of Patients

Traditionally, the incidence of erectile dysfunction (ED) increases with the age of a man, evolutionarily protecting him from passing on old, defective genes to his offspring by limiting his participation in sexual activity. Nevertheless, in the modern world, only 1 % of sexual contacts are carried out for the purpose of reproduction, the rest – with a recreational and social purpose. In addition, there has been an increasing number of cases of ED in young men lately. The problem of treating ED in young patients (up to 45 years old) requires an etiological approach. The objective: to determine the effectiveness of etiological non-surgical (treatment of prostatitis, psychotherapy) or minimally invasive (Marmara operation, veno-occlusive surgery, PRP-therapy) treatment of young men with ED. Materials and methods. On the basis of the Kharkiv Regional Medical Clinical Center for Urology and Nephrology named after V.I. Shapoval and on the basis of the P. Mogila Black Sea National University (Nikolaev) during 2014–2020. a comprehensive examination and treatment of 563 patients was carried out, which were divided into three supergroups (A, B and C) according to the prevailing factor: 156 patients with venoocclusive erectile dysfunction – supergroup A, 353 patients with chronic prostatitis – supergroup B and 54 patients with predominant psychoneurological disorders and the absence of organic pathology - supergroup C. Results. The effectiveness of surgical treatment in supergroup A according to subjective data after 2 months was almost equal in groups and subgroups, but after 18 months it was significantly higher in subgroups 1b and 2b (65.4 % and 83.7 %) according to ICEF results, and according to objective data after 18 months – 73.4 % and 91.4 %, respectively. After 1 and 7 months, the effectiveness of treatment in supergroup B was determined by the indices of satisfaction with sexual intercourse on the IIEF scale, the number of patients satisfied with the results of treatment, the absence of prostatic complaints and the eradication of infectious agents. Convincing results were obtained when assessing the quality of life of patients in supergroup C. Conclusion. Chronic prostatitis is the most common cause of erectile dysfunction ED in young men. Three-week antibacterial etiological treatment demonstrates the highest rates of infection eradication and ICEF recovery in patients with prostatitis. Operation Marmara reduces venous hyperemia of the prostate, lowers the IPSS score, and improves erectile function in patients with comorbid pathology. The use of an etiological approach allows to improve the sexual function of young patients, returning them to a normal sexual life, creating an alternative to falloprosthetics.

scholarly journals Dermatological manifestations of psychic ailments

2020 ◽  
Vol 11 (6) ◽  
pp. 55-62
Author(s):  
Grigorii V. Prutyan ◽  
Alexander S. Zhukov ◽  
Nikanor V. Lavrov ◽  
Vladislav R. Khairutdinov ◽  
Alexey V. Samtsov
Keyword(s):  
Young Patients ◽  
Sensory Information ◽  
Modern Medicine ◽  
The Body ◽  
Modern World ◽  
Hormonal Changes ◽  
Obsessive Compulsive ◽  
Number Of Patients ◽  
Inner World ◽  
Family And Marriage

An increase in the number of patients with psychodermatological manifestations and the identification of a certain comorbidity during the course of diseases in patients with a dermatological profile makes us take a fresh look at this problem. Psychodermatology is one of the relevant and, at the same time, the least studied areas of modern medicine, which is at the junction of psychiatry and dermatovenereology. Psychiatry and psychotherapy studies the inner world of a person; Dermatovenerology deals with the diagnosis and treatment of diseases of the human skin and its appendages, and psychodermatology combines these two sections of medicine. In the modern world, as a result of increasing the amount of incoming sensory information, accelerating the rhythm of life, the action of harmful environmental factors, a person can be subjected to excessive psycho-emotional stress, leading to the development of mental disorders. Often it is skin rashes that are an objective manifestation of such disorders. Early diagnosis of psychodermatosis and signs of obsessive-compulsive pathology in sick people contributes to the timely identification of the category of people at risk of psychotic reactions and mental illness. This is especially true for young patients. Against the background of hormonal changes in the body, the crisis of adolescence, the increased educational load on them at school, the destroyed institute of family and marriage, an overabundance of sensory information and physical inactivity, the incidence of psychodermatosis throughout the world, including in our country, is increasing.

Results of open and endoscopy-guided removal of hypertensive intracerebral hematomas

2018 ◽  
Vol 20 (2) ◽  
pp. 50-57
Author(s):  
Ya. A. Shesterikov ◽  
К. G. Petrosyan ◽  
E. N. Pospelov ◽  
Е. G. Melidi ◽  
S. V. Tsilina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Death Rate ◽  
Surgical Navigation ◽  
Outer Diameter ◽  
Endoscopic Intervention ◽  
Results Of Treatment ◽  
Surgical Navigation System ◽  
Group I ◽  
Number Of Patients ◽  
Luminal Area

The objectiveis to compare the effectiveness of surgical treatment of the patients with hypertensive intracerebral hematomas (ICH) using endoscopic aspiration and craniotomy removal.Materials and methods.Analysis of the results of surgical treatment of 132 patients with ICH. Patients of group I (n = 72) underwent craniotomy removal of ICH, group II (n = 60) underwent endoscopic intervention. Endoscopic ICH aspiration was performed using surgical navigation system and ventriculoscope (outer diameter – 6.5 mm, operating length – 13 cm, luminal area of the working channel – 20 mm2), with a high light-transmitting capacity.Results.Death rate in the patients over the age of 71 after endoscopic intervention was significantly lower than after craniotomy removal (45.4 and 86 %, respectively). In patients with soporose condition, death rate after open removal was 86.4 %, and after endoscopic aspiration – 44 %; in patients with wakefulness reduced to coma this indicator was 100 and 75 %, respectively. Death rate in the patients with thalamic ICH was 20 % after endoscopic intervention and 83.3 % after open surgery, with putaminal ICH – 39.5 and 50 %, respectively, with subcortical ICH – 22.7 and 0 %. Among patients with a hematoma with volume of up to 40 ml, death rate was 17.2 and 4.7 % in the groups I and II, respectively, with volume from 61 to 100 ml – 81.8 and 66.7 %.Conclusion. After endoscopy-guided removal of ICH the number of patients with good recovery increased 3-fold, and the post-operative mortality decreased by 19 %. The use of endoscopic technique in the treatment of hypertensive ICH under the control of neuronavigation (in comparison with open craniotomy removal and microsurgical ICH evacuation) improved the results of treatment due to decreasing of mortality rate and improvement of functional outcomes of the disease.

scholarly journals ECONOMIC INDICATORS OF SURGICAL TREATMENT OF ATHEROSCLEROSIS OF THE FEMORAL-POPLITEAL SEGMENT IN PATIENTS FOR CRITICAL LIMB ISHEMIA

2021 ◽  
Vol 4 (18) ◽  
pp. 51-57
Author(s):  
O.A. Holyachenko ◽  
Y.M. Gupalo ◽  
O.I. Nabolotnuy ◽  
B.L. Kulikovskuy ◽  
A.V. Shamrai-Sas ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lower Extremity ◽  
Bypass Surgery ◽  
Transluminal Angioplasty ◽  
Economic Indicators ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Patients With Diabetes ◽  
Average Patient

Introduction: is to analyze the economic indicators of different types of surgical treatment of atherosclerosis of the femoral-popliteal segment of the lower extremity in patients for сritacal limb ishemia. Materials and methods. were analyzed 173 cases of atherosclerosis of the femoral-popliteal segment of the lower extremity in patients for сritacal limb ishemia, of which 93 underwent arterial percutaneous transluminal angioplasty and 80 bypass surgery of the affected vessels. For this an original model of determining the value of medical care was used. It included the determination of costs that was given as a payment for medical workers, material and technical costs, the surgical interventions costs, the drugs that were used, additional examinations, and etc. Results. Economic analysis of costs per average patient that underwent PTA was UAH 5025.85, and bypass surgery UAH 4351.1. However,analyzing the results of treatment showed that there are small differences between the two methods, in particular a larger number of patients with diabetes. Conclusions. Both methods of treatment gave almost the same result in terms of the cost of treatment, which requires consideration of other factors, especially the clinical course of the disease.

scholarly journals CRIO-INFLUENCE IN SURGICAL TREATMENT OF BENIGN TUMOURS OF FOOT BONES

2010 ◽  
Vol 16 (3) ◽  
pp. 74-78
Author(s):  
S. V. Dianov ◽  
K. M. Halagummaev
Keyword(s):  
Surgical Treatment ◽  
Bone Cyst ◽  
Border Line ◽  
Foot Bones ◽  
Solitary Bone Cyst ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Benign Tumours ◽  
Pathological Focus ◽  
Positive Results

The material of investigation was the results of treatment of 131 patients with foot bones tumours. The largest number of patients referred, to age interval from 11 to 30 years (69,6%). More than half of cases were osteochondromas (54%), then solitary bone cyst (14,5%) and chondromas (13%). Other nosologic forms were met significantly seldom. Two groups of patients were examined: the main group (with crio-influence) - 44 patients and group of comparison (without crio-influence) - 87 patients. The plot of operation was in flat, border-line, intrafocusal or segmental resection of damaged section, crio-instillation or contact curio-processing of bone and auto- or allopathic of respected defect. The results of treatment were estimated in a year after operation. After usage of curio-surgical method there were observed positive results in 41 patients, satisfactory - in 2 and unsatisfactory - in 1. The results of treatment with traditional method were positive in 79 cases, satisfactory - in 2, unsatisfactory - in 6. The worked-out method of curio-surgical treatment of foot bone tumours includes resection of pathological focus, itraoperative crio-influence on bone tissue and bone plastic transplantation of resected, defect. The analysis of criosurgical operations of foot gave the foundation to consider such interventions significant and perspective in treatment of patients with tumours and tumour similar damages of foot bone.

Erectile dysfunction

2017 ◽  
Author(s):  
Carlo Bettocchi ◽  
Marco Spilotros
Keyword(s):  
Erectile Dysfunction ◽  
Young Patients ◽  
Penile Prosthesis ◽  
Pharmacological Therapy ◽  
Internal Pudendal Artery ◽  
Arterial Revascularization ◽  
Vacuum Device ◽  
Number Of Patients ◽  
Prosthetic Surgery ◽  
Venous Leakage

Pharmacological therapy and vacuum device don't provide satisfactory results or can be contraindicated in a limited number of patients with erectile dysfunction (ED). The sole available option to treat their condition is represented by surgery. Penile prosthetic surgery is the most common surgical approach to restore erectile function but within the other options available, venous ligation and penile arterial revascularization should be considered in selected patients. Penile prosthesis implant is recommended in patients with organ failure who don't respond to medical therapy, in case of severe corporal fibrosis due to priapism, or when both ED and Peyronie’s disease are diagnosed. In relatively young patients not affected by severe vascular disease and diabetes with a documented stenosis of the internal pudendal artery, penile arterial revascularization can be considered. In case of congenital venous leakage, a further surgical treatment is represented by venous ligation that can provide satisfactory results in young patients.

Acupuncture and phototherapy efficiency for correction оf erectile dysfunction in the patients with neurotic depression

10.12737/6446 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Дмитриенко ◽  
G. Dmitrienko ◽  
Баисова ◽  
E. Baisova ◽  
Череващенко ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Depressive Disorders ◽  
Antisocial Behaviour ◽  
Sexual Life ◽  
Sexual Disorders ◽  
Results Of Treatment ◽  
End Of Treatment ◽  
Combined Use ◽  
Vascular Origin ◽  
The Stability

Sexual dysfunction in men, limiting their reproductive capabilities, prevent the achievement of marital and sexual life as a couple, break the stability of marriage, adversely affect mental health, lead to the development of neurotic and depressive disorders, alcohol abuse and antisocial behaviour. In recent years, interest in the problem of vasculogenic erectile dysfunction has increased worldwide. But, despite this, many researchers believe that erectile dysfunction of vascular origin ranks second in frequency after disorders due to psychogenic factors. Therapy of sexual disorders with neurotic depression has a number of obstacles due to absence of system-structural approach to sexopathologist syndromes. It is necessary to search new possibilities of correction of sexual disorders in patients with neurotic depression. The purpose of this study was to develop and to justify pathogenetically the method of combined use of phototherapy and acupuncture for the correction of sexual disorders to improve the effect of treatment in men with neurotic depression. 80 patients with neurotic depression and erectile dysfunction prior to the application of medical facilities and at the end of treatment were examined. The results of treatment were: restoration of sexual function, decrease or disappearance of neurasthenic complaints (irritability, fatigue, headaches, dyssomnia, psycho-emotional, vegetative-vascular disorders, and others), normalization of libido and paraclinical data (psychological testing, electrophysiological parameters).

scholarly journals ESTIMATION OF RESERVES FOR IMPROVING THE RESULTS OF PATIENTS WITH MULTIPRESISTANT PULMONARY TUBERCULOSIS IN THE APPLICATION OF SURGICAL METHODS BASED ON ANALYSIS OF THE EFFICIENCY OF CONSERVATIVE TREATMENT OF A SPECIFIED COHORT

2018 ◽  
Vol 5 ◽  
pp. 33-39
Author(s):  
Oleg Khmel ◽  
Igor Kalabukha ◽  
Vladimir Ivashchenko
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Pulmonary Tuberculosis ◽  
Surgical Intervention ◽  
Cohort Analysis ◽  
Multidrug Resistant ◽  
Complete Cure ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Surgical Methods

In order to improve the results of treatment of patients with multi-resistant pulmonary tuberculosis with the use of surgical methods, the effectiveness estimation of conservative treatment of 176 patients with this form of tuberculosis according to cohort analysis data in two districts of Kyiv were done. In the list were included following parameters: type of the tuberculosis, its clinical-radiological form and the prevalence of the process, the results of conservative treatment in patients who completely finished the course of anti-TB chemotherapy and the results of conservative treatment of 81 patients who had indications for surgical treatment but had not been operated. Processing of the materials of the study was carried out with the use of licensed software products included in the Microsoft Office Professional 2007 package. The predicted results of treatment were calculated on the condition of surgical intervention. Out of the total sample of patients, 31.3 % of the patients completed treatment. Mortality was 16.5 %, transferred to palliative care 11.9 %. More than one in three patients (35.2 %) stopped treatment at different times from the start. According to the clinic of thoracic surgery SU "National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky NAMS of Ukraine ", the overall effectiveness of treatment for patients with limited multidrug-resistant tuberculosis with the use of surgical intervention is about 95 % in the absence of mortality. We have modelled the potential results of treatment of the selected cohort in case of the surgical stage is fully and timely applied in a complex of therapeutic treatment. If all 81 patients with indications for surgical treatment used that way, then, with the above efficiency, a complete cure could be predicted in 77 patients (44.5 % of the total number of observations), which in turn would allow predicting the achievement completion of treatment at 64.2 % with complete cure for 60.6 % of patients. Thus, it is established that the positive result of surgical treatment in the general complex of treatment measures in patients with multidrug-resistant pulmonary tuberculosis is able to improve the results of treatment of this contingent more than twice, reduce the mortality almost by three times, reduce the need for repeated courses of treatment from 7.4 % to 1.7 %, as well as to reduce the epidemiological reservoir of infection due to a significant decrease in the number of patients with failure to treat tuberculosis, interrupted and palliative treatment.

scholarly journals Operative treatment of prolactinomas: indications and results in a current consecutive series of 212 patients

2008 ◽  
Vol 158 (1) ◽  
pp. 11-18 ◽  
Author(s):  
J Kreutzer ◽  
R Buslei ◽  
H Wallaschofski ◽  
B Hofmann ◽  
C Nimsky ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Transsphenoidal Surgery ◽  
Remission Rate ◽  
Young Patients ◽  
Primary Treatment ◽  
Consecutive Series ◽  
Surgical Indications ◽  
Cystic Tumors ◽  
Number Of Patients ◽  
Remission Rates

ObjectiveMedical therapy with dopamine agonists (DA) is the primary treatment of choice in most patients with prolactinomas. ‘Classical’ surgical indications are intolerance or lack of efficiency of DA therapy. Focusing on a possible shift of recent indications, we retrospectively analyzed our results of surgical treatment in prolactinomas.Patients and methodsBetween 1990 and 2005, we have operated on 212 consecutive patients with prolactinomas. Surgical indications were divided into ‘classical’ indications and ‘modern’ indications defined as cystic prolactinomas or patients with microprolactinomas who individually decided on a primary surgical treatment.ResultsInitial overall remission was accomplished in 53.2% including giant prolactinomas. However, in microadenomas, the remission rate was significantly higher with 91.3%. Overall remission at the latest follow-up was 42.7%, but 72.5% in intrasellar tumors, 80% in cystic prolactinomas, and 84.8% in microprolactinomas. The overall recurrence rate was 18.7%. Relapse of hyperprolactinemia in microprolactinomas was 7.1%. In our series, continually less patients were surgically treated for ‘classical’ indications. By contrast, the number of patients who individually decided on a primary surgical therapy has increased considerably.ConclusionRemission rates after surgical treatment of prolactinomas remain excellent, particularly in microadenoma and intrasellar macroadenomas, whereas morbidity of transsphenoidal surgery is low in the hands of experienced pituitary surgeons. Our remission rates not only confirm the already interdisciplinarily accepted surgical indications, but also emphasize the value of primary transsphenoidal surgery as a discussion-worthy alternative to dopaminergic therapy in young patients with microprolactinomas or cystic tumors.

scholarly journals Comparison of tamsulosin vs tamsulosin/sildenafil effectiveness in the treatment of erectile dysfunction in patients affected by type III chronic prostatitis

2013 ◽  
Vol 85 (3) ◽  
pp. 109 ◽  
Author(s):  
Ubaldo Cantoro ◽  
Francesco Catanzariti ◽  
Vito Lacetera ◽  
Luigi Quaresima ◽  
Giovanni Muzzonigro ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Combination Therapy ◽  
Symptom Score ◽  
Chronic Prostatitis ◽  
Young Patients ◽  
Medical Examination ◽  
Symptom Index ◽  
Type Iii ◽  
Significant Difference ◽  
Phosphodiesterase Type

Aim: We evaluated the effectiveness of tamsulosin monotherapy versus tamsulosin plus sildenafil combination therapy on erectile dysfunction (ED) in young patients with type III chronic prostatitis and ED by using symptom score scales. Materials and methods: 44 male patients were divided into 2 groups: the first group (20 patients) was treated with tamsulosin 0,4 mg monotherapy and the second one 24 patients) was treated with tamsulosin 0,4 mg plus sildenafil 50 mg combination therapy. “International Prostate Symptom Score” (IPSS), “National Institute of Health Chronic Prostatitis Symptom Index” (NIH-CPSI) and “International Index of Erectile Function” (IIEF-5) were inves- tigated in each group of patients, and scores calculated during the first medical examination. Both groups were treated with tamsulosin once daily for 60 days, while sildenafil 50 mg was given on demand (at least 2 times per week) for 60 days. During the second medical examination IPSS, NIH-CPSI and IIEF-5 scores were analyzed once more. Afterwards, the alterations of scores among medical examinations in each group and between both groups were statistically compared. Results: The age average of the 44 cases included was 32.04 ± 3.15 years. Both groups present a statistically significant decrease, between the first and the second medical examination, in IPSS, NIH-CPSI scores and statistically significant increase in IIEF-5 score. In addition, there is no sta- tistically significant difference, in all scores, between mono and combination therapy. Conclusions: tamsulosin monotherapy, as well as a combination therapy (tamsulosin plus silde-nafil) has an improving effect on symptoms and on ED in patients with type III prostatitis. In the near future alpha-blockers monotherapy could be used in the treatment of chronic prostatitis and ED cases instead of phosphodiesterase type 5 (PDE-5) inhibitors combination therapy.

scholarly journals X-ray endovascular methods for the treatment of veno-occlusive erectile dysfunction

2021 ◽  
Vol 22 (2) ◽  
pp. 24-34
Author(s):  
O. B. Zhukov ◽  
V. E. Sinitsyn ◽  
A. E. Vasiliev ◽  
P. M. Klimenko
Keyword(s):  
Erectile Dysfunction ◽  
Surgical Treatment ◽  
Clinical Signs ◽  
Young Patients ◽  
Surgical Techniques ◽  
Venous Drainage ◽  
Simultaneous Treatment ◽  
X Ray ◽  
Venous Surgery ◽  
Arterial Insufficiency

The results of surgical treatment of 59 patients with veno-occlusive erectile dysfunction and follow-up of 8 years are presented. The age of patients is 18-48 years old (average age is 29.3 ± 7.6). Five of them had hemodynamic and clinical signs of arteriovenous erectile dysfunction in the stage of subcompensation, 16 patients underwent simultaneous treatment in the form of sclerotherapy of testicular veins in connection with the secretory type of male infertility, 5 underwent simultaneous surgical treatment to eliminate veno-occlusive and arterial insufficiency of the cavernous bodies of the penis by stenting of the internal iliac or pudendal arteries, 2 patients underwent delayed stenting of the iliac veins due to May-Turner syndrome, the remaining patients underwent surgical treatment aimed at eliminating venous erectile dysfunction. The diagnosis was established on the basis of a clinical and urological examination, including physical examination and questioning according to the IIEF-5 (International Index of Erectile Function), ultrasound Doppler examination of the cavernous bodies of the penis with intracavernous pharmacotest, dynamic computer pharmacocavernosography with 3D reconstruction, with veno-occlusive arteries with suspected arteries, or computer tomography arterial insufficiency of the cavernous bodies of the penis. All types of endovascular and hybrid operations on the venous collectors of the penis were analyzed. Priority surgical techniques for the treatment of pathological venous drainage have been identified, which are 75 % effective in the long-term postoperative period. Based on the presented experience of the authors and analysis of foreign literature, the expediency of revising the European and Russian recommendations for venous surgery of the penis towards the priority use at the first stage of minimally invasive X-ray surgical treatment in a category of young patients has been proved.

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