Health of Man https://health-man.com.ua/ <p><strong>About Journal </strong></p> <p>All-Ukrainian Scientific and Practical Journal</p> <p>«HEALTH of MAN»</p> <p>Year of establishment: 2002 as a leading publication publishing articles on all aspects of andrology, urology, sexology including original and review articles, commentaries, and problem articles in which the discussion was the most relevant current topics in basic, molecular, and clinical research.</p> <p>Until 2022, it was published under the title «Здоров'я чоловіка. Здоровье мужчины. Zdorovʹe mužčiny» (ISSN 2307-5090 (Print) ISSN 2412-5547 (Online) <a href="https://health-man.com.ua/2412-5547/issue/archive">archive of numbers</a></p> <p><strong>Updated ISSN 2786-7323 (Print), ISSN 2786-7315 (Online)</strong></p> <p>Website: https://health-man.com.ua/2412-5547/index</p> <p>DOI: https://doi.org/10.30841/2307-5090</p> <p>UDC: 613.97-055.1+616-055.1](05)</p> <p>Frequency: 4 times a year</p> <p>Publication language: Ukrainian, English</p> <p>Founders and Publishers:</p> <ul> <li>Shupyk National University of Health Care of Ukraine</li> <li>State institution «Institute of Urology acad. O.F. Vozianov of the National Academy of Medical Sciences of Ukraine»</li> <li>Public organization. «All-Ukrainian Association for Continuing Professional Education of Doctors and Pharmacists»</li> <li>All-Ukrainian public organization «Association of Sexologists and Andrologists of Ukraine»</li> </ul> <p>Registration number in the Register of Media Subjects of the National Council of Ukraine on Television and Radio Broadcasting - R 30-03216</p> <p>Entry into the <a title="категорія А" href="https://nfv.ukrintei.ua/view/5b1925e27847426a2d0ab3cd">List of Scientific and Professional Publications of Ukraine from category «А»</a> in the field of medical sciences Specialty: 222 (12/28/2019)</p> <p>The journal «HEALTH of MAN» provides open access (open access).</p> <p>The journal is indexed and presented in the <strong><a href="https://www.scopus.com/sourceid/21101186196">SCOPUS</a> </strong>international scientometric database, as well as in the catalogs of scientific libraries, databases, and search systems of the <strong><a href="http://www.irbis-nbuv.gov.ua/cgi-bin/irbis_nbuv/cgiirbis_64.exe?Z21ID=&amp;I21DBN=UJRN&amp;P21DBN=UJRN&amp;S21STN=1&amp;S21REF=10&amp;S21FMT=juu_all&amp;C21COM=S&amp;S21CNR=20&amp;S21P01=0&amp;S21P02=0&amp;S21P03=PREF=&amp;S21COLORTERMS=0&amp;S21STR=Zdmu">National Library of Ukraine named after V.I. Vernadsky</a>,<a title="OUCI" href="https://ouci.dntb.gov.ua/editions/3lDk3rDE/"> OUCI,</a><a href="https://www.ebsco.com/products/ebscohost-research-platform"> EBSCO</a>, <a href="https://index.pkp.sfu.ca/index.php/browse/index/8711">PKP Index,</a> <a href="https://hinari.summon.serialssolutions.com/#!/search?ho=f&amp;include.ft.matches=f&amp;l=en&amp;q=(ISSN:(2307-5090)">Research4Life</a></strong><a href="https://health-man.com.ua/2412-5547/journalindexing"> (full list presented)</a></p> <p>Chief editor: <strong>Igor Gorpynchenko</strong></p> <p>Contact Information</p> <p>03039, Kyiv, JSC No. 4, Ukraine</p> <p>(044) 257-27-27</p> <p><a href="mailto:alexandra@professional-event.com">yevheniia.semak@professional-event.com</a></p> <p>Yevheniia Semak</p> <p>Circulation - 3, 000 copies</p> <p>Subscription index - 01666</p> uk-UA <p>Authors retain the copyright and grant the journal the first publication of original scientific articles under the <a href="https://creativecommons.org/licenses/by/4.0/" rel="license">Creative Commons Attribution 4.0 International License</a>, which allows others to distribute work with acknowledgment of authorship and first publication in this journal.</p> alexandra@professional-event.com (Alexandra Popylniuk) alexandra@zdr.kiev.ua (Попильнюк Александра (Попільнюк Олександра)) Mon, 18 Aug 2025 10:31:35 +0000 OJS 3.2.1.2 http://blogs.law.harvard.edu/tech/rss 60 Long-term Oncological Outcomes of Neoadjuvant Androgen-deprivation Therapy Prior to Radical Prostatectomy https://health-man.com.ua/article/view/337324 <p>Prostate cancer (PCa) is the second most frequently diagnosed malignancy among men and the fifth leading cause of cancer death in the world. PC remains a heterogeneous disease with an unpredictable course, ranging from indolent forms that may never progress, to initially high and very-high risk of progression, where the mortality associated with PCa remains significant despite optimal treatment.</p> <p><strong>The objective:</strong> to evaluate the impact of neoadjuvant androgen-deprivation therapy (NADT) prior to radical prostatectomy (RP) on biochemical recurrence-free, overall, and cancer-specific survival, considering the duration, type, and intensity of NADT, National Comprehensive Cancer Network (NCCN) risk stratification, and the role of adjuvant or salvage external beam radiation therapy (EBRT).</p> <p><strong>Materials and methods.</strong> This study included 175 PCa patients who underwent RP between 2015 and 2021. Among them, 84 received NADT and 91 did not. Patients were stratified by NCCN risk groups and EBRT status. Oncological outcomes included biochemical recurrence-free survival (BCRFS), overall survival (OS), cancer-specific survival (CSS), and EBRT-free survival (EBRTFS). Kaplan–Meier and Cox regression analyses were performed.</p> <p><strong>Results.</strong> NADT significantly improved BCRFS (hazard ratio = 0.45; p &lt; 0.001), especially in patients who received maximal androgen blockade for ≥ 3 months. The combination of NADT and EBRT showed the most favorable OS and CSS. Patients without NADT or EBRT had the poorest outcomes. NADT was also associated with significantly longer EBRTFS (39 vs 12 months; p &lt; 0.001). Multivariable analysis identified NCCN risk group and EBRT as independent predictors of survival.</p> <p><strong>Conclusions.</strong> NADT prior to RP improves BCRFS and potentially enhances long-term oncological outcomes when combined with EBRT. Treatment duration and intensity are key factors in optimizing patient outcomes, especially in high-risk PCa.</p> Yevhenii Afanasiev, Rostyslav Danylets, Viacheslav Hryhorenko, Oleksandr Shuliak, Andrii Bardin, Mykola Sosnin Copyright (c) 2025 Yevhenii Afanasiev, Rostyslav Danylets, Viacheslav Hryhorenko, Oleksandr Shuliak, Andrii Bardin, Mykola Sosnin https://creativecommons.org/licenses/by/4.0 https://health-man.com.ua/article/view/337324 Mon, 30 Jun 2025 00:00:00 +0000 Monitoring of Correlation of Diagnostic Markers of Acute Pyelonephritis and Diabetes Mellitus Under Experimental Conditions https://health-man.com.ua/article/view/337327 <p>Acute pyelonephritis (АР) complicated by concomitant diabetes mellitus (DM) is often accompanied by the development of significant renal complications. In predicting its course and monitoring the effectiveness of drug treatment, attention is paid to the study of informative markers of the nature of the course of pyelonephritis – leukocyte index indicators and the level of pro-inflammatory eicosanoids, which allows determining the degree of intoxication in acute infectious-inflammatory process in the kidneys, making it possible to predict the nature of the development of the pathological process and assess the effectiveness of therapeutic measures.</p> <p><strong>The objective:</strong> to investigate the relationship between АР and DM by monitoring their markers in an experiment.</p> <p><strong>Materials and methods</strong>. Experimental studies were conducted on Wistar rats weighing 200–300 g at the age of 8–9 months, simulating АР and hyperglycemic condition, which by the nature of the course reproduces DM. The prototype of DM was induced by intraperitoneal injection of streptozotocin, during the period of stable hyperglycemia in animals, АР was simulated. Rats were given a single rectal injection of <em>Escherichia coli</em> isolate. On the second day, the animals were subjected to cold stress at a temperature of 0–2 °C for 2 hours. Bacteriological and general laboratory analysis of urine showed pronounced bacteriuria and a significant increase in the number of leukocytes per high power field in the groups of animals studied. 4 days after the start of the АР simulation, etiotropic drug exposure or etiotropic-pathogenetic drug exposure was applied. After the completion of drug exposure, peripheral blood from the tail vein was examined. The intensity of the inflammatory process and the degree of intoxication were determined based on the calculation of leukocyte integrative indices, which were calculated based on the leukocyte formula of peripheral blood.</p> <p>In peripheral blood smears, the leukocyte formula was determined. According to its indicators, integrative hematological indices were calculated, on the basis of which the following were determined: the degree of endogenous intoxication by the leukocyte intoxication index (LII). Determination of the level of prostaglandin E<sub>2</sub> (PGE<sub>2</sub>) and leukotriene B<sub>4</sub> (LTB<sub>4</sub>) in blood plasma was performed using the enzyme-linked immunosorbent assay method. The analysis of the content of eicosanoids in blood plasma was performed using selective antibodies of the test system for quantitative determination of the level of PGE<sub>2</sub> and LTB<sub>4</sub> by enzyme immunoassay on the Stat Fax 2100 analyzer (Awareness Technology, USA).</p> <p>Data on the correlation dependence between the level of LII in peripheral blood and the level of pro-inflammatory eicosanoids in kidney tissue (PGE<sub>2</sub> and LTB<sub>4</sub>) are presented, as well as the influence of etiotropic and etiotropic-pathogenetic drug correction on the correlation dependence between the LII, pro-inflammatory eicosanoids and nephrospecific enzymes and proteins in АР and accompanying DM in an experiment.</p> <p><strong>Results.</strong> The obtained results of study confirm the pathogenetic significance of the established correlation between LII, pro-inflammatory eicosanoids and nephrospecific metabolic indicators, which allows determining the severity of intoxication in the pathology under study and allows predicting the nature of the development of the pathological process, as well as evaluating the effectiveness of experimental therapy measures. The presence of a pronounced positive correlation with markers of the inflammatory process both in the case of АР and in its combination with concomitant hyperglycaemic state was established.</p> <p>A correlation between the level of LII in peripheral blood, creatinine clearance and the content of β<sub>2</sub>-microglobulin in urine was also determined in the case of АР and the accompanying hyperglycemic condition, taking into account etiotropic and etiotropic-pathogenetic drug effects.</p> <p>When evaluating the dependence between the level of LII and the activity of N-acetyl-β-D-glucosaminidase (N-AG), β-D-glucosidase in kidney tissue and taking into account the results of both types of drug exposure, we obtained a reliably significant negative correlation dependence of medium and strong relationship.</p> <p><strong>Conclusions.</strong> The use of etiotropic medicinal effects caused a decrease in the correlation coefficient between indicators, a strong positive relationship between LII and the level of PGE<sub>2</sub> and between LII and the level of LTB<sub>4</sub> remained. When applying an etiotropic-pathogenetic drug effect in rats with АР and accompanying hypoglycemic state, the correlation coefficient between LII indicators and the level of PGE<sub>2</sub> and between LII and the level of LTB<sub>4</sub> decreased, which indicates the presence of an average positive relationship in terms of strength.</p> Serhii Borysov, Fedir Kostyev, Oleksandr Borysov, Serhii Bohatskyi, Serhii Kolomiichuk, Ruslan Savchuk Copyright (c) 2025 Serhii Borysov, Fedir Kostyev, Oleksandr Borysov, Serhii Bohatskyi, Serhii Kolomiichuk, Ruslan Savchuk https://creativecommons.org/licenses/by/4.0 https://health-man.com.ua/article/view/337327 Mon, 30 Jun 2025 00:00:00 +0000 Personalized Psychological and Wellness Support for Male Athletes with Infertility: a Typology of Emotional Responses to Diagnosis https://health-man.com.ua/article/view/337329 <p>Infertility in male athletes is a multifactorial issue encompassing physiological, psychological, and social dimensions. Despite significant advances in the diagnosis and treatment of reproductive disorders, psychological support for athletes remains underdeveloped – particularly in terms of integrating psychotherapeutic methods with physical wellness programs. Given the impact of stress, hormonal fluctuations, and the specific demands of professional sports, the development of personalized approaches to psychological and physical support is a relevant and timely challenge for modern medicine and sport psychology.</p> <p><strong>The objective:</strong> to develop a typology of emotional responses among male athletes diagnosed with infertility and to identify personalized psycho-wellness support strategies through the integration of psychotherapeutic methods and physical exercises.</p> <p><strong>Materials and methods.</strong> The study involved 100 male professional and amateur athletes (mean age M = 37.6; SD = 6.8) with a medically confirmed diagnosis of infertility. Psychodiagnostic tools included the Depression, Anxiety, and Stress Scale (DASS-21) to assess emotional distress, and the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) to evaluate emotional responses to the infertility diagnosis.</p> <p><strong>Results.</strong> Five primary psychological response types to an infertility diagnosis were identified:</p> <ol> <li>Active Implementer – responded well to cognitive-behavioral therapy combined with functional training to sustain motivation.</li> <li>Isolated Sufferer – benefited from group therapy and breathing exercises to reduce anxiety.</li> <li>Rigid Traditionalist – showed positive results from family counseling paired with rehabilitative exercise programs.</li> <li>Skeptical Rationalist – responded to educational sessions and body awareness practices, which improved treatment adherence.</li> <li>Destructive Denier – required deep psychotherapy and emotional self-regulation training.</li> </ol> <p>The developed typology is based on real psychological requests and consultations from men diagnosed with infertility. It serves as a practical tool for clinicians, helping to better understand the emotional patterns and coping strategies commonly observed in this patient group. The typology does not aim to replace medical treatment or present psychological support as an alternative to clinical reproductive therapy. Rather, its purpose is to complement biomedical care by offering a structured framework for integrating psycho-emotional understanding into patient-centered support.</p> <p>In contrast to previous studies focused primarily on physiological or biomedical aspects, our research highlights the importance of addressing the individual psychological needs of men with infertility and proposes ways to personalize support strategies accordingly.</p> <p><strong>Conclusions.</strong> We propose an original personalized typology of emotional responses in male athletes diagnosed with infertility, which may help them process the diagnosis more adaptively and guide tailored psychotherapeutic interventions. These findings can be implemented in clinical practice within reproductive health centers, by medical psychologists, and in wellness programs of sports organizations, in order to enhance the effectiveness of care for athletes living with infertility.</p> Olha Cherepiekhina, Vasyl Mazin, Valerii Bulanov, Olga Puchyna, Olena Zalevska, Volodymyr Rudchenko Copyright (c) 2025 Olha Cherepiekhina, Vasyl Mazin, Valerii Bulanov, Olga Puchyna, Olena Zalevska, Volodymyr Rudchenko https://creativecommons.org/licenses/by/4.0 https://health-man.com.ua/article/view/337329 Mon, 30 Jun 2025 00:00:00 +0000 Human Papillomavirus – the Etiological Factor of Giant Condyloma Buschke–Lowenstein (Clinical case) https://health-man.com.ua/article/view/337358 <p>Human papillomavirus (HPV) has more than 100 different genotypes, which are the cause of a significant number of diseases – benign, precancerous lesions and various types of cancer. One of the clinical manifestations of papillomavirus infection is giant condyloma acuminata, also called Buschke–Lowenshtein tumor. Of all reported penile tumors in the United States, giant condyloma Buschke-Lowenshtein (GCBL) accounts for approximately 5 to 24%. Despite its benign histology, GCBL is clinically malignant due to its locally destructive nature with extensive involvement of underlying tissue, high rate of local recurrence, and ability to spread to the pelvic organs, which will subsequently require surgical intervention.<br />A feature of this clinical case is that the patient had simultaneous infection with HPV types 11, 16 and 40, and the papillomavirus infection occurred in the form of GCBL. This diagnosis was confirmed by virology and pathomorphology. By the way, more than 9 months passed from the moment of the onset of the disease and the patient’s appeal to doctors for help to the verification of the diagnosis. During this time, the disease progressed, and the treatment tactics already required surgical intervention in several stages.<br />Different routes of infection, high contagiousness of HPV, oncogenic properties of the pathogen, lack of etiotropic medications dictate the need, along with the search for effective treatment methods, to actively introduce vaccine prophylaxis for this pathology. The use of the Gardasil 9-valent vaccine (provided that the vaccination schedule is followed) stimulates a strong humoral response, the production of type-specific virus-neutralizing antibodies and minimizes the risk of HPV infection and the oncological pathology caused by it. The description of this clinical case will increase the awareness of healthcare professionals about the course of papillomavirus infection and will contribute to the appointment of vaccination as the only means capable of protecting against HPV infection at the present stage.</p> Viktoriia Mishchenko, Marharyta Sliepchenko, Mykhailo Pushkar Copyright (c) 2025 Viktoriia Mishchenko, Marharyta Sliepchenko, Mykhailo Pushkar https://creativecommons.org/licenses/by/4.0 https://health-man.com.ua/article/view/337358 Mon, 30 Jun 2025 00:00:00 +0000 Zinner Syndrome: Modern Methods of Diagnosis and Treatment. Literature Review and Clinical Cases https://health-man.com.ua/article/view/337353 <p>Zinner syndrome (ZS) is a rare abnormality, described for the first time in 1914 by A. Zinner. The syndrome is caused by malformation of the ureteral bud at the early stages of embryogenesis, result in ipsilateral renal and the other structures anomalies originated from the mesonephric duct. In most patients (80.8%) it is diagnosed at the 2nd–4th decade of life, when the disorder manifests with various symptoms, in the others – it is asymptomatic and diagnosed accidentally or in dispensary medical examinations. Broad use of modern imaging methods, as ultrasound diagnostics, computed tomography, magnetic resonance іmaging (MRI), allows to diagnose this complex syndrome at the early stages, at a younger age and in previously asymptomatic patients. The clinical manifestation of the ZS is wide-ranging and non-specific for this pathology. The symptoms can be present in various diseases including non-urological. The treatment strategy depends on the disease severity, imaging data and consists of surveillance, conservative and surgical approaches.</p> <p><strong>The objective:</strong> to summarize the results of diagnostics and treatment methods of the ZS based on our clinical practice and literature review. </p> <p><strong>Materials and methods.</strong> From 2014 to 2020 in the SI “Academician O. F. Vozianov Institute of Urology of NAMS of Ukraine” eight patients with ZS, aged 22–39 years old, were examined and treated.</p> <p><strong>Results.</strong> All patients underwent different types of laparoscopic interventions depends on clinical presentation and imaging data. The outcomes of surgical interventions were favorable and without complications.</p> <p><strong>Conclusions.</strong> MRI currently remains the gold standard exam for diagnosis of ZS. Treatment of ZS depends on the results of imaging data, the presence or absence of symptoms, complications, and comorbidities. Today, radical laparoscopic intervention is the most justified treatment for this disease.</p> Mykola Sosnin, Oleksandr Shuliak, Vadym Slobodianiuk, Andrii Hrytsaiuk, Volodymyr Danylko Copyright (c) 2025 Mykola Sosnin, Oleksandr Shuliak, Vadym Slobodianiuk, Andrii Hrytsaiuk, Volodymyr Danylko https://creativecommons.org/licenses/by/4.0 https://health-man.com.ua/article/view/337353 Mon, 30 Jun 2025 00:00:00 +0000 Substantiation of the Importance of Rehabilitation for Children with Intestinal Obstruction in the Postoperative Period https://health-man.com.ua/article/view/337357 <p>In today’s world, more and more attention is being paid to children’s health and well-being, including the rehabilitation of patients in the postoperative period. Modern innovations in surgery and improved methods of treatment contribute to an increase in the number of surgeries in children, which emphasizes the importance of effective and safe rehabilitation in the postoperative period.</p> <p><strong>The objective:</strong> to scientifically substantiate the importance of rehabilitation intervention for children with intestinal obstruction in the postoperative period of rehabilitation treatment.</p> <p><strong>Materials and methods.</strong> Bibliosystematic and analytical methods were used when searching Internet electronic databases (ScienceDirect, Scopus, Web of Science, PubMed, Google Scholar, PEDro, Physiopedia Plus) to determine the importance of rehabilitation of children with intestinal obstruction in the postoperative period. The research methods were content analysis and structural and logical analysis. The study materials included professional publications, among others – legislative documents on the development of rehabilitation. These materials were analyzed.</p> <p><strong>Results.</strong> Rehabilitation of children with intestinal obstruction in the postoperative period is an important stage in their recovery after surgery. Modern approaches to rehabilitation interventions take into account not only physical activity but also psychosocial and cognitive characteristics of these children. Some studies show the importance of an individualized approach to rehabilitation and the involvement of a physical and rehabilitation physician and specialists working in a multidisciplinary team, where these professionals can develop a qualified individual rehabilitation program for the recovery period. Most studies show that high-quality rehabilitation of children with intestinal obstruction in the postoperative period has positive results. Modern rehabilitation in pediatric surgery and pediatrics is generally aimed at improving the functional capabilities of children with various health disorders. Physical therapists who are part of the multidisciplinary team use game and technological methods to engage children in the rehabilitation process, making it interesting and effective. It is worth noting that the rehabilitation process is an important and necessary component at every stage and period of rehabilitation, taking into account different modes of motor activity. For the rehabilitation of children with intestinal obstruction in the postoperative period, evidence-based physical therapy tools and methods are most often used to achieve maximum efficiency and rapid recovery.</p> <p><strong>Conclusions.</strong> Postoperative rehabilitation of children with intestinal obstruction is an important stage of health recovery aimed at improving the functional capabilities of the body. The analysis of literature sources emphasizes the need for an individual approach to each patient, taking into account the physical and psychosocial aspects of rehabilitation. Close cooperation with parents and caregivers is an important component of successful recovery. The involvement of physical therapists as part of a multidisciplinary team significantly increases the effectiveness of the rehabilitation process, helping to speed up recovery and improve the quality of life of children.</p> Ihor Krytskyi, Dariia Popovych, Volodymyr Dzhyvak, Valentyna Boiko, Uliana Hevko, Anastasiia Bai Copyright (c) 2025 Ihor Krytskyi, Dariia Popovych, Volodymyr Dzhyvak, Valentyna Boiko, Uliana Hevko, Anastasiia Bai https://creativecommons.org/licenses/by/4.0 https://health-man.com.ua/article/view/337357 Mon, 30 Jun 2025 00:00:00 +0000 Erectile Dysfunction: Terms, Definitions, Frequency https://health-man.com.ua/article/view/337342 <p>As clinicians have observed, erectile disorders occur more frequently than other sexual dysfunctions in males seeking medical advice. This article deals with the terms used for defining disturbances of erection. In the author’s opinion, a commonly used term “erectile dysfunction” (ED) is actually much wider than the states it defines. This is due to the fact that disturbances of erection can be manifested by not only its weakening (hypoerection) or absence (anerection), but increasing (hypererection that occurs in cases of priapism and pseudopriapism) as well. It is noted that the term “erectile dysfunction” replaced the term “impotence”, which with time acquired a derogative tint (impotence → impotent). Nevertheless, in order to define somatogenic hypo(an)erection ICD-10 still used the category “impotence of organic origin”, which is absent in ICD-11. The article also analyses such terms and concepts as <em>“impotentia coeundi”</em> (the collective name for all sexual dysfunctions) and <em>“impotentia generandi”</em> (inability to reproduce, sterility). It is noted that earlier the term “impotence” was used for defining various sexual dysfunctions in females too. Definitions and diagnostic criteria for hypo(an)erectile disturbances in international (ICD-9, ICD-10 and ICD-11) and American (DSM-4 and DSM-5) classifications are given and discussed. The author believes that, according to the latest classifications, the ability to diagnose a sexual dysfunction (including ED) only in case when this problem persists for a long period of time (a few months, six months) is not reasonable. If a person is not treated during this period, the quality of his life can significantly aggravate, and he can develop disorders of the neurotic level. Sometimes within this time period the dysfunction may be eliminated spontaneously. In case with a specialist in clinical sexology, who is sufficiently experienced, he will be able to make an appropriate diagnosis within a much shorter period than it is envisaged by the given diagnostic criterion. Another diagnostic criterion used in latest classifications is also worth discussing, according to which the diagnosis of any sexual dysfunction can be established in the presence of clinically significant distress. It is the author’s opinion that the use of the above diagnostic criterion can distort the diagnostic process. In particular, it should be noted that in some males the present ED or any other sexual dysfunction really сan not cause any clinically significant distress, but this fact does not cancel their presence and should not become the reason for which this dysfunction cannot be diagnosed. Otherwise, we can talk about subjectification of the situation and overstepping of the medical field boundaries by diagnostics. The article also contains different data on the prevalence of ED.</p> <p><strong>Conclusions.</strong> Special attention is paid to such criteria as the duration of the disorder (from several months to 6 months) and the mandatory presence of clinically significant distress. However, the requirement for a long course of sexual dysfunction is not justified, since during this time the patient’s quality of life can deteriorate significantly, and sometimes the disorder can disappear on its own. In some cases, the existing ED does not cause distress, but this should not be a reason for refusing to establish a diagnosis. The above statistics indicate a high prevalence of ED among men of different ages, which confirms the relevance of the problem and the need for its further study.</p> Garnik Kocharyan Copyright (c) 2025 Garnik Kocharyan https://creativecommons.org/licenses/by/4.0 https://health-man.com.ua/article/view/337342 Mon, 30 Jun 2025 00:00:00 +0000 The Effect of Obesity on Erectile Function in Men https://health-man.com.ua/article/view/337346 <p>Obesity is a chronic disease that is associated with the risk of developing various comorbid pathologies. Patients with metabolic syndrome and obesity have a 2.6-fold increased risk of erectile dysfunction (ED) compared to the general population.</p> <p><strong>The objective:</strong> to determine the frequency of detection of ED and the effect of incretins and their relationship with the development of ED in men with obesity and a body mass index (BMI) of 30–34.9 kg/m<sup>2</sup>.</p> <p>31 obese patients were included in the study, 29% of them had type 2 diabetes mellitus, 19.4% had prediabetes. The average age of patients was 46.19 ± 2.12 years, BMI – 36.37 ± 1.42 kg/m<sup>2</sup>. All men were divided into two groups with BMI 30–34.9 kg/m<sup>2</sup> (23 men) and BMI &gt; 40 kg/m<sup>2</sup> (8 men). The concentration of ghrelin, glucagon-like peptide-1 (GLP-1), thyroid-stimulating hormone, insulin, vitamin D and total testosterone, НOMA index, fasting blood glucose, glycated hemoglobin, total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides were determined in all patients on an empty stomach. Erectile function was assessed using the International Index of Erectile Function (IIEF) questionnaire. Statistical processing of the research results was carried out using IBM SPSS Statistics version 25 for Windows.</p> <p>In the group of patients with a BMI of 30–34.9 kg/m<sup>2</sup>, 30.4% had normal erectile function, 34.8% had mild ED, 21.7% had moderate ED, 13% had severe ED. Negative correlation was found between the total score of the IIEF questionnaire and age – B = –0.96; 95% confidence interval (CI) [–1.59; –0.32], p = 0.005, and the level of GLP-1 after 60 minutes after meal – B = –0.2; 95% CI [–0.37; –0.026], p = 0.026.</p> <p><strong>Conclusions.</strong> Negative relationship between the total score IIEF and age, the level of GLP-1 60 minutes after a meal was founded in obesity patients with BMI 30–34.9 kg/m<sup>2</sup>, which can lead to a worsening insulin resistance, the progression of obesity, which makes it difficult to achieve therapeutic goals in the treatment of ED.</p> Ivan Todurov, Olena Stepura, Svitlana Mazii, Nadiia Zherdova Copyright (c) 2025 Ivan Todurov, Olena Stepura, Svitlana Mazii, Nadiia Zherdova https://creativecommons.org/licenses/by/4.0 https://health-man.com.ua/article/view/337346 Mon, 30 Jun 2025 00:00:00 +0000 Features of the Intraoperative Period in Patients with Large-volume Benign Prostatic Hyperplasia Depending on the Method of Surgical Correction of Infravesical Obstruction https://health-man.com.ua/article/view/337334 <p>Benign prostatic hyperplasia (BPH) is a common condition among elderly men that significantly affects their quality of life. Although monopolar transurethral resection of the prostate (TURP) has long remained the gold standard for surgical treatment, advances in technology have led to the development of modern alternative approaches.</p> <p><strong>The objective:</strong> the aim of the study was to analyse the course of the intraoperative period inpatients with BPH of large and very large volumes, depending on the method of invasive intervention, taking into account anatomical features of vesicourethral segment.</p> <p><strong>Materials and methods.</strong> This retrospective single-center study included patients who underwent interventional procedures for BPH between 2019 and 2021. Depending on the surgical technique used, all patients were divided into four groups: the first group (n = 106) – mechanical methods of enucleation of hyperplastic prostate tissue; the second group (n = 51) – monopolar TURP of the prostate; the third group (n = 302) – bipolar TURP of the prostate; and the fourth group (n = 104) – bipolar transurethral enucleoresection of the prostate.</p> <p><strong>Results.</strong> Studied groups did not differ significantly in age (H = 2.8, p = 0.380) or body weight (F = 1.7, p = 0.409). Patients in the fourth group had significantly shorter durations of surgical intervention compared to the first (p = 0.0001) and second groups (p = 0.029). The fourth group also showed a 6.8-fold lower (p = 0.0003) volume of intraoperative blood loss compared to the first group, 3.13 times lower (p = 0.0002) than the second group, and 2.79 times lower (p = 0.0011) than the third group. Thus, a clear correlation is observed between the chosen surgical method and the volume of intraoperative blood loss. The use of certain surgical techniques significantly reduced the need for transfusion therapy: patients in the fourth group required erythrocyte mass transfusions (χ<sup>2</sup> = 6.93, p = 0.032) and fresh frozen plasma transfusions (χ<sup>2</sup> = 17.5, p = 0.005) significantly less frequently compared to other groups. Patients in the fourth group also required a shorter duration of urethral bladder drainage (51 (156; 72) hours) compared to the other groups (H = 13.2, p = 0.0011). The postoperative hospitalization period was also shorter in the fourth group (5 (4; 6) days) compared to the first (8 (5; 14) days, p = 0.003), second (7 (4.25; 10) days, p = 0.0031), and third groups (7 (6; 9) days, p = 0.0012).</p> <p><strong>Conclusions.</strong> The highest efficacy of hyperplastic tissue removal was demonstrated in group of patients with bipolar enucleoresection of the prostate, characterized by lower intraoperative blood loss, shorter urethral drainage duration, and shorter hospitalization compared to groups with mechanical enucleation (adenomectomia), monopolar and bipolar TURP.</p> Sergiy Shamrayev, Yaroslav Melnychuk Copyright (c) 2025 Sergiy Shamrayev, Yaroslav Melnychuk https://creativecommons.org/licenses/by/4.0 https://health-man.com.ua/article/view/337334 Mon, 30 Jun 2025 00:00:00 +0000 Elderly Men with an Overactive Bladder in Combination with Infravesicular Obstruction (Literature review) https://health-man.com.ua/article/view/337338 <p>Overactive bladder (OAB) combined with infravesicular obstruction (IVO) is one of the most common causes of lower urinary tract symptoms (LUTS).</p> <p>Benign prostatic hyperplasia (BPH), as the main cause of IVO in elderly men, is one of the most common urological diseases, causing urinary problems in every second man aged 60 years and older.</p> <p>According to many authors, the incidence of OAB increases from 3% in men aged 40–44 years to 42% in men over 75 years.</p> <p>LUTS in BPH are usually divided into: storage symptoms, voiding symptoms and post- voiding symptoms. Although voiding symptoms are somewhat more common, storage symptoms are significantly more bothersome to patients, which directly correlates with their quality of life. In such conditions, adjusting the strategy and tactics of managing this category of patients is justified.</p> <p>Given the widespread prevalence of combined urological pathology among the male population due to its rapid aging in our country, achieving the desired health improvement requires new approaches and principles in diagnosis and treatment.</p> <p>Urodynamic study (UDS) is the only method of examination that allows reliable diagnosis of IVO and OAB. Including the results of the “pressure-flow” study in the general preoperative examination algorithm significantly reduces the frequency of subjective failures compared to the past, when patient selection for surgical treatment was carried out without considering urodynamic parameters.</p> <p>A review of the literature indicates that there are currently a number of questions that arise when attempting to predict treatment effectiveness. Most previous methods and studies used univariate analysis, which considered a single factor independently of other variables. However, in modern conditions, it is necessary to take into account a set of parameters that can significantly affect predictions (severity and duration of bladder storage and voiding symptoms, UDS data, OAB questionnaire data, etc.). Some of these factors can only be studied under experimental conditions. This includes the degree of OAB, the type of overactivity, the severity of IVO, and the effectiveness of medical and surgical treatment. This situation dictates the need to create a universal methodology that would provide positive treatment results with a high degree of probability.</p> Oleh Melymuka, Andriy Boyko Copyright (c) 2025 Oleh Melymuka, Andriy Boyko https://creativecommons.org/licenses/by/4.0 https://health-man.com.ua/article/view/337338 Mon, 30 Jun 2025 00:00:00 +0000 Greetings on the Occasion of the 60th Anniversary of the Institute of Urology Named After Academician O. F. Vozianov of the National Academy of Medical Sciences of Ukraine https://health-man.com.ua/article/view/337323 <p>Державна установа «Інститут урології імені академіка О. Ф. Возіанова Національної академії медичних наук України» заснована 22 червня 1965 р. як науково-дослідний заклад МОЗ України – Київський науково-дослідний інститут захворювань нирок та сечовивідних шляхів (урології). З 1982 р. він був перейменований на Київський науково-дослідний інститут урології та нефрології. Згідно з Постановою Кабінету Міністрів України № 211 від 22 березня 1993 р. Інститут переданий у підпорядкування Академії медичних наук України. За наказом Академії медичних наук України № 12 від 29 вересня 1993 р. затверджена назва установи – Інститут урології та нефрології Академії медичних наук України. З 2021 року Інститут носить ім’я Президента Національної академії медичних наук, академіка О. Ф. Возіанова.</p> <p>У попередні роки Інститут очолювали професори: Ю. Г. Єдиний (1965–1968), П. М. Федорченко (1968–1969), В. С. Карпенко (1969–1987). З 1987 р. Інститутом керував академік НАН та НАМН України, Герой України О. Ф. Возіанов, а з 2011 року його очолює академік НАМН С. О. Возіанов.</p> Copyright (c) 2025 Serhii Vozianov https://creativecommons.org/licenses/by/4.0 https://health-man.com.ua/article/view/337323 Mon, 30 Jun 2025 00:00:00 +0000