УДК: 612.014.484:012.015.1]-078.73-037-092.9
Abstract. Military personnel who have received combat injuries experience long-term consequences of severe injuries that have a significant impact on
quality of life and sexual function. There is growing evidence that post-trau matic stress disorder, which develops secondary to injury, is associated with
higher rates of erectile dysfunction, decreased sexual desire, and premature ejaculation. Combat-related injuries may also have significant consequences for male fertility, as they typically serve during their peak sexual activity years.
The aim of the work was to comparative analysis of the International Index of Erectile Function and quality of life indicators in men with combat injuries
and sexual dysfunction accompanied by chronic pelvic pain and premature ejaculation, before and after treatment.
Methods. The study was based on the results of a questionnaire survey of 76 men aged 20–53 years, injured as a result of combat operations (mostly as a result of polytraumatic injuries) before and after treatment using the Interna tional Index of Erectile Function-5 questionnaire and the SF-36 questionnaire to assess the quality of life. After establishing the appropriate diagnoses, the patients were divided into two groups. Group 1 incluted patients with erectile dysfunction of mixed genesis, accompanied by chronic pelvic pain, included combat participants with endothelial dysfunction, metabolic syndrome, dyslipid emia, hypertension, coronary artery disease, late hypogonadism (n = 48); Group 2 incluted patients with erectile dysfunction of mixed genesis and premature ejaculation combatants with endothelial dysfunction, metabolic syndrome, dyslipidemia, hypertension, coronary heart disease, late hypogonadism (n = 28).
Results. It was shown that the elimination of pelvic pain after successful etiotropic therapy of patients in group 1, along with multifaceted treatment of
ED (pathogenetic therapy), leads to a significant improvement in the indicators of general health, role-physical functioning, role-emotional functioning, life activity, mental health, and the absence of pain. Elimination of the cause of erectile function through psychotherapy with potentiation of the effect by takng sildenafil leads to a significant increase in the average score of all MIEF-5 domains, and therefore an improvement in sexual function as a whole. After treatment of patients in group 2, a significant increase in the average score of the absence of pain from 84,9 to 95,1 is observed. The average score for vital activity significantly increased from 63,9 to 70,2 (p < 0,05), and there was also a trend towards improvement in the mental health domain from 68,1 to 74,3.
Conclusions. The results of the study indicate a significant prevalence of mixed forms of erectile dysfunction, accompanied by chronic pelvic pain or premature ejaculation, which bothers men after suffering combat injuries. As a result of the treatment of erectile dysfunction of mixed genesis with chronic pelvic pain, indicators of general health, role-physical functioning, role-emo tional functioning, life activity, mental health, absence of pain sensation and sexual function in general improve. After comprehensive treatment of men with erectile dysfunction of mixed genesis and premature ejaculation, indicators of pain sensation, life activity, satisfaction from sexual intercourse and sexual life significantly improve, and there is also a tendency to improve mental health.
Key words: combat trauma, erectile dysfunction, quality of life, MIEF-5 questionnaire, SF-36 questionnaire.