Testicular cancer is the most common malignancy in young men, with early and accurate diagnosis being critical for effective management and prognosis. Traditionally, the diagnostic approach relies on scrotal ultrasound and serum tumor markers, which, while effective, have limitations in characterizing complex lesions and detecting small, non- palpable tumors or metastatic disease. Recent advancements in imaging technology have introduced multiparametric MRI (mpMRI) as a promising tool in the diagnostic armamentarium for testicular cancer. MpMRI combines multiple imaging sequences, including T2-weighted imaging, diffusion-weighted imaging (DWI), and dynamic contrast- enhanced MRI (DCE-MRI), providing detailed anatomical and functional information about testicular lesions. This systematic review consolidates and evaluates current evidence regarding the role of mpMRI in the diagnosis, staging, and follow-up of testicular cancer. 
Key findings from the literature suggest that mpMRI offers superior sensitivity and specificity compared to conventional imaging techniques, particularly in distinguishing between benign and malignant lesions. It is also highly effective in the precise localization and staging of tumors, including the detection of small lymph node metastases, which are often missed by ultrasound or CT. This review highlights the potential of mpMRI to enhance diagnostic precision and influence treatment strategies in testicular cancer, while also identifying areas for further research, such as the optimization of imaging protocols and the assessment of mpMRI's impact on long-term clinical outcomes. The review underscores the importance of mpMRI as a non-invasive, highly informative imaging modality that could lead to more personalized and effective management of testicular cancer. 

Abstract

Androgen deprivation therapy (ADT) remains a cornerstone in the treatment of prostate cancer, but patient responses vary significantly. 
This systematic review evaluates the role and application of genomic and transcriptomic markers in assessing ADT efficacy and resistance. 
We analyzed 40 studies focusing on key markers such as AR-V7, TMPRSS2-ERG, RNA expression profiles, and the 23-gene signature. 
Our findings highlight the potential of these markers to personalize ADT, improve patient stratification, and guide treatment decisions. 
Despite promising results, challenges remain in standardization, cost, and clinical integration. 
Corresponding author. Mytsyk Yulian, Regional Specialist Hospital, Wroclaw, Poland, mytsyk.yulian@gmail.com 

UDC 577.151.042:616.72-002.772:616.72-007.274

Summary
Introduction. Identification of microorganisms that colonize combat wounds and cause wound infection is of primary importance for the subsequent successful treatment of the patient. The resistance of microorganisms to antimicrobial drugs makes the efforts of modern medicine in the fight against infectious agents ineffective. The problem of infertility is closely related to combat injuries, their infection, stress, and neurotic disorders.
Aim. Obtaining and summarizing data on microbial colonization of mine-blast wounds of pelvic organs and the microbiome of the genitourinary system of combatants.
Materials and methods. 84 smears were taken from 56 wounds of 36 patients with injuries of the pelvic organs who were being treated. 73 patients with injuries were examined for the presence of mycoflora in the urogenital tract. Isolation of pure bacterial cultures was carried out by inoculating the studied material using meat-peptone agar, blood agar, chromogenic agars. For the diagnosis of urogenital or other infections by the PCR method, a scraping from the back wall of the urethra was taken from the patients.
Results. Predominant microorganisms in positive cultures of smears were non-fermenting gram- negative rods, which in 28 % of cultures belonged to the genus Acinetobacter, in 26 % to the genus Pseudomonas. As for associated infections, 20 % of them consisted of the genus Acinetobacter, 32 % – Enterobacter, 4 % – Klebsiella and 29 % – Pseudomonas. Gram-positive cocci were isolated in 37 % of positive smear cultures. The frequency of isolation of the genus Streptococcus in monoinfection was 2.5 %, followed by the genus Clostridium – 2 %, Bacillus – 3 %, Enterococcus – 4 % and Actynomycceas – 4 %. In associated infections, the frequency of isolation of the genus Streptococcus was 4 %, followed by the genus Clostridium – 2 %, Bacillus – 4 %, Enterococcus – 3 % and Actynomycceas – 5 %. When analyzing the microflora of the genitourinary system, it was found that the priority role belongs to the combined infection, when there are associations of specific pathogens such as Ureaplasma spp., Mycoplasma spp., Chlamidia spp., Neisseria gonorrhoeae, Trichomonas vaginalis, Streptococcus spp., Enterococcus faecalis, which is 80 % of the entire microbiome.
Conclusions. Acinetobacter baumanii and Klebsiella pneumoniae are the dominant microflora complicating the course of combat wounds during almost two years of Russia’s full-scale war against Ukraine. Probably, the duration of hostilities, the large number of wounded, and the forced mass unsystematic use of various antibiotics lead to rapid changes in the spectrum of pathogens of combat wounds. Combat wounds and their infection, stress, and nervous disorders lead to an imbalance of microflora, in particular microflora of the genitourinary system, which can be one of the causes of infertility. Chlamydia and Ureaplasma are the most common microorganisms that colonize the urogenital tract of men injured as a result of hostilities.
Keywords: sombat wound, microbial flora, genitourinary system, infertility

 616.69-008.6(079.5)

Сучасне наукове розуміння еректильної дисфункції вказує на переважну вторинність сексуальних розладів стосовно захворювань, що їх спричиняють. Це значною мірою стосується чоловіків, постраждалих внаслідок бойових дій. Основою роботи стали результати анкетування 298 чоловіків, постраждалих внаслідок бойових дій (осколкові та кульові поранення) з використанням анкет Міжнародного індексу еректильної функції-5 (МІЕФ-5). Дослідна група була розділена на дві: чоловіки віком 20–39 років (група 1) і чоловіки віком 40–53 роки (група 2). До контрольної групи увійшли 48 практично здорових чоловіків без скарг на сексуальну дисфункцію чи кардіологічну, неврологічну або ж ендокринологічну патологію. Серед чоловіків контрольної групи – 30 чоловіків віком 20–39 років (група 3) і 18 чоловіків віком 40–60 років (група 4). Показано, що у 196 чоловіків 1-ї групи віком 20–39 років спостерігається легка форма ЕД – сумарний бал – 19,57 ± 0,44. У 102 чоловіків 2-ї групи віком 40–53 роки теж наявна легка форма ЕД, однак сумарний бал значно нижчий – 17,94 ± 0,41. Показники окремих 5 компонентів статевої функції чоловіків і шкала твердості ерекції також були нижчими в пацієнтів 2-ї групи. Найбільш показово знижується домен ЕД-МІЕФ-5 зі ступенем тяжкості ЕД. Усі домени МІЕФ достовірно знижуються при ЕД порівняно зі здоровою групою респондентів, проте диференціація за тяжкістю ЕД відсутня. Тобто, при ЕД будь-якої вираженості одночасно страждають всі інші сексуальні функції – сексуальне бажання, впевненість в ерекції, твердість та підтримання ерекції, задоволення від статевого акту та статевого життя.

Erectile dysfunction and the associated quality of life are a pressing social and medical problem for millions of people. The basis of
the work was the results of a survey of 298 men injured as a result of combat operations (shrapnel and bullet wounds) using the questionnaires of the International Index of Erectile Function-5 (IIEF-5) and the SF-36 Health Status Survey (SF-36) questionnaire to characterize the quality of life. The research group was divided into two: men aged 20-39 years (group 1) and men aged 40-53 years (group 2). The control group consisted of 48 clinically healthy men without complaints of sexual dysfunction or cardiac, neurological or endocrinological pathology. It is shown that men aged 20-39 years have a mild form of ED where the total score is 19.57 ± 0.44. Men of the 2nd group aged 40-53 years also have a mild form of ED, but the total score is much lower and is 17.74 ± 0.41. Patients of both age groups affected by hostilities suffer from both mental and physical health components. Indicators such as general health, role functioning due to physical condition, and pain intensity have probably lower values compared to the contol group. Lower indicators of role functioning due to physical condition indicate limitations in everyday life due to unsatisfactory physical condition. The decrease in the physical functioning index has statistically significant differences only in patients of the 2nd observed group. Thus, a mild form of erectile dysfunction is observed in men injured as a result of hostilities. No significant differences in the severity of erectile dysfunction were found betweenmale war victims of two age groups. All IIEF-5 domains were significantly reduced in men affected by combat operations. It has been proven that the physical and mental components of health suffer in victims of hostilities. Against the background of a decrease in all indicators on the scales of the physical component of health, general health and role functioning caused by physical condition lag behind the most. In the psychological domain, the most pronounced changes are recorded in such components as mental health, vital activity and social functioning. Сorrelation analysis revealed the significant correlation between physical functioning and role functioning caused by emotional state (r =+0.64; P < 0.05).
Keywords: men with shrapnel and bullet wounds; erectile dysfunction; quality of life;SF-3