UDC 616.69-008.1-06:616-001.45]-08

Participants in hostilities often face long-term effects of severe injuries, which can markedly impair both quality of life and sexual function.
The objective: to assess the effectiveness of treatment for mixed genesis erectile dysfunction (ED) accompanied by chronic pelvic pain (CPP) or premature ejaculation (PE) in men with combat injury.
Materials and methods. The examination of 60 men aged 20–53, participants in hostilities, with sexual dysfunction was performed. The main complaints were ED accompanied by CPP or PE. According to the form of ED, patients were divided into groups: Group 1 included patients with ED of mixed etiology associated with CPP (n = 32); Group 2 consisted of patients with ED of mixed origin accompanied by PE (n = 28).
Results. It has been demonstrated that lifestyle modification is an effective treatment method for ED, which is accompanied by CPP in men with a combat injury. 62.5% of patients have a significant improvement in erectile function, and 31.2% have a slight improvement. The efficacy of treatment of ED associated with PE is linked to serotonin reuptake inhibitors (SRIs), confirming the key role of the neurotransmitter serotonin in the modulation of ejaculation. Significant improvement in this group was observed in 53.6% of patients, and insignificant in 39.3%.
Conclusions. The most effective method of treatment is lifestyle modification for patients injured as a result of hostilities, with ED of mixed genesis, accompanied by the leading syndrome of CPP. This group demonstrated an improvement in International Index of Erectile Function (IIEF)-5 score from 13.5 ± 2.3 to 21.6 ± 2.1 (p < 0.05). Serotonin is a key neurotransmitter involved in the regulation of ejaculation in patients with ED and coexisting PE, as treatment with SRIs prolongs intravaginal ejaculatory latency. This group also demonstrated an improvement in IIEF-5 score from 13.8 ± 2.1 to 22.0 ± 1.9 (p < 0.05).
Keywords: erectile dysfunction, combatants, combat trauma, chronic pelvic pain, premature ejaculation, treatment.