UDC: 612.015.1:616.65:616-007.61

Background. Benign prostatic hyperplasia (BPH), which is mostly prevalent in older men, is associated with compression of the prostatic urethra and manifests as lower urinary tract symptoms. Its pathological characteristics include abnormal proliferation of stromal and glandular epithelial cells, leading to prostate enlargement. Current data highlight additional factors in the pathogenesis of this disease, notably oxidative stress and chronic inflammation.
Materials and Methods. Prostate tissue was obtained from 35 patients aged 58–72 years via transurethral resection. Prostate tissue from three patient groups was utilized. Group 1 consisted of patients with BPH (n = 7) weighing up to 40 grams (control group); Group 2 included patients with BPH (n = 14) weighing 45–98 grams; Group 3 comprised patients with benign prostatic hyperplasia and chronic inflammation (adenoprostatitis) weighing 45–98 grams (n = 14). The levels of malondialdehyde and reduced glutathione, as well as the activities of glutathione peroxidase and glutathione reductase, were determined in the tissues.
Results. In large-scale prostate hyperplasia and prostate hyperplasia associated with prostatitis, lipid peroxidation processes escalate in prostate cells, as indicated by an increase in malondialdehyde concentration. The elevation in lipid peroxidation levels is accompanied by a decrease in the activity of antioxidant defense enzymes glutathione peroxidase and glutathione reductase, alongside a reduction in the concentration of reduced glutathione. The balance within the pro-/antioxidant system is more significantly disrupted in cases of prostate hyperplasia associated with prostatitis.
Conclusion. In large-scale prostate hyperplasia and hyperplasia associated with histologically confirmed prostatitis, lipid peroxidation processes intensify within the cells, which is confirmed by rising levels of malondialdehyde. The increase in lipid peroxidation is accompanied by a decline in glutathione peroxidase and glutathione reductase activities, as well as a decrease in the concentration of reduced glutathione. In prostate hyperplasia accompanied by adenoprostatitis, the balance in the pro-/antioxidant system is disrupted to a greater extent.

УДК: 612.014.484:012.015.1]-078.73-037-092.9

Introduction. Priapismisafrequentpainfulerectionthatlastsmorethan4hoursandisnotcaused bysexualstimulation,occurswhenbloodisblockedinthepenisandcannotleaveit.Itisbelieved thattheincreaseinthefrequencyofpriapismdirectlydependsontheprevalenceofintracavernous injectionsofvasoactivesubstancesinthetreatmentoferectiledysfunction.
Aim. Toevaluatethepathogeneticfeaturesofthedevelopmentofpriapism,asoneoftheforms
ofsexualdysfunction,inmeninjuredasaresultofcombatoperations(combattrauma)andto
optimizetreatmentmethods.
Materials and methods. Thestudy included14priapismpatientswhowere treatedat the
urologyclinicin2022‑2024.Priapismasacomplicationdevelopedin2(4.4%)of45patientsafter
intracavernousinjectionof20μgofprostaglandinE1(PGE1)(group1),in1(10%)of10patientsafter
sequentialinjectionof20μgofPGE1and0,5mgofphentolamine(group2),in3(20%)of15patients
afterinjectionof2%solutionpapaverine(group3).In5patients,priapismoccurredagainstthe
backgroundofsystematicuseofanticoagulants(lowmolecularweightheparin)inthetreatmentof
severevascularpathology(phlebothrombosis,thrombophlebitis)(group4).Inanother3patients,
thecausethatledtopriapismwasnotfound,sotheidiopathicformwasestablished(group5).
Results. Itwasshownthatin3cases,thedurationofpriapisminpatientswithpsychogenicEDwas
insignificant,sinceallpatientswerewarnedaboutthepossibledevelopmentofpriapismbefore
theinjectionofthevasoactivedrugandrecommendedtoseekmedicalhelpimmediatelyincaseof
itsoccurrence.Threeoutofthreepatientswithapreviousdiagnosisofmixederectiledysfunction
(withanorganicvascularcomponent)failedtorestoreerectilefunctionaftershunting.Threeout
offourpatientsdiagnosedwithidiopathicpriapismreportedtheabsenceoferectionsduring
severalmonthsofpostoperativefollow‑up.Innocasewastherearecurrenceofpriapisminthe
postoperativeperiod.
Conclusions. TheobtaineddataallowustorecommendprostaglandinE1asthedrugofchoice
amongvasoactivesubstancesforintracavernoususeduetoitshighestsafety.Unilateraltranscaputal
punctureofthecavernousbody(Wintershunt)inpatientswithischemicpriapismmadeitpossible
toachievedetumescencein100%ofcaseswithoutsubsequentrecurrenceandrestoreerectile
functionin40%ofpatients.
Keywords: priapism, erectile dysfunction, combat trauma, treatment, vasoactive drugs

УДК: 612.014.484:012.015.1]-078.73-037-092.9

Aim: To study the spectrum of antibiotic resistance of causative agents of wound infection in wounded men at the stage of specialized medical care.
Materials and Methods: Retrospective analysis of the results of culture of wound secretions on chromogenic media. The research involved 113 samples of biomaterial from 85 wounded. Sensitivity of antibiotics was studied by the Kirby-Bauer method.
Results: Analysis of the microflora of the wound surface made it possible to determine the dominance of gram-negative bacteria, they were isolated in 80% of cases. The microbial spectrum of gram-negative bacteria is represented by Pseudomonas aeruginosa – 31 isolates, Acinetobacter baumannii – 29 isolates, 
Enterobacter aerogenes – 21 isolates, Proteus vulgaris – 13 isolates, Escherichia coli – 7 isolates, Enterobacter cloacae – 5 isolates, Klebsiella pneumoniae – 7 isolates and gram-positive bacteria Staphylococcus aureus – 5 isolates, Enterococcus fecalis – 32 isolates. Among all tested isolates of gram-negative non-fermenting 
bacteria and enterobacteria, the highest sensitivity was observed to colomycin and polymyxin B, from 60 to 80%. When analyzing of antibiotic sensitivity of Klebsiella pneumoniae and Acinetobacter baumannii, it was found that these pathogens retain 80-100% of their actual antibiotic sensitivity to polymyxins.
Conclusions: Gram-negative strains isolated from wound infection are sensitive to antibiotics: 70% to polymyxins (colistin), 30% to aminoglycosides (amikacin), 24-16% to cephalosporins (cefoperazone-sulbactam/cefoperazone-avibactam).
KEY WORDS: combat trauma, microbiome, antibiotic resistance

УДК: 612.014.484:012.015.1]-078.73-037-092.9

Aim: To evaluate the effectiveness of selective serotonin reuptake inhibitors (SSRIs) to the treatment of patients with premature ejaculation who have been affected by combat actions.
Materials and Methods: Results of an examination of 50 men injured as a result of hostilities, with sexual dysfunction and complaints of premature ejaculation. 
Patients were divided into smaller subgroups depending on the selected serotonin reuptake inhibitors, which they received for at least 1.5 months: sertraline (n=14), paroxetine (n=12), citalopram (n=12), venlafaxine (n=12).
Results: After treatment with all serotonin reuptake inhibitors, reactive and personal anxiety symptoms, as assessed by the Spielberger-Hanan scale, were objectively reduced in men. Only treatment with paroxetine and citalopram resulted in a likely reduction in depressive symptoms in men with premature ejaculation, Paroxetine and sertraline appeared to be relatively balanced drugs with moderate efficacy but relatively few side effects. The lack of a «gold 
standard» among serotonin reuptake inhibitor drugs for the treatment of premature ejaculation on the Ukrainian market necessitates the search for new, more effective drugs with the possibility of flexible use.
Conclusions: The study demonstrates that the neurotransmitter serotonin plays a key role in the modulation of ejaculation, as the use of reuptake inhibitors increases the intravaginal latency to ejaculation. Among the selective serotonin reuptake inhibitors, venlafaxine was found to be the most effective

UDC: 612.616.2:612.015.1]-07

Background. One of the most important antioxidant defence mechanism in spermatozoa is the gluthatione system which includes glutathione peroxidase (GPx), glutathione reductase (GR), glutathione S-transferase (GST) and reduced glutathione (GSH). It is promising to use ROC analysis, which allows to assessing the diagnostic sensitivity and specificity of indicators.
Materials and methods. Infertile men were divided into 3 groups: patients with oligozoospermia (n = 30), asthenozoospermia (n = 34), and oligoasthenozoospermia (n = 22). To assess the diagnostic sensitivity and specificity of indicators, the values of the biomarkers were tested using the receiver operating characteristic (ROC) curve, and the area under it (AUC), the standard error (SE) and the 95% confidence interval (CI 95%) were calculated.
Results. The ROC analysis showed that GP activity was characterized by excellent diagnostic significance for diagnosing both oligozoospermia and asthenozoospermia (the sensitivity was 100%, and specificity – 100%). The GR activity has moderate diagnostic significance, since the AUC is 0.654 (95% CI from 0.503 to 0.785, P = 0.0645) for oligozoospermic, the AUC is 0.612 (95% CI from 0.454 to 0.7555, P = 0.1979) for asthenozoospermic men. The analysis of the ROC curve revealed a good diagnostic value of GsT activity in sperm samples for the diagnosis of pathospermia (sensitivity of 75% and specificity of 80%). Simultaneously, it was shown that GSH content could not serve as valuable biomarkers for distinguishing patients with pathospermia from healthy controls, with an AUC of 0.615, corresponding to moderate diagnostic significance for oligozoospermia.
Conclusion. The results of this study show that the cut-off points for the biomar­kers glutathione peroxidase and glutathione-S-transferase can be used to distinguish between patients with pathospermia and normozoospermia, and the parameters themselves can serve as valuable diagnostic biomarkers to distinguish patients with pathospermia from healthy controls, regardless of the causes of pathospermia. The value of these indicators below the cut-off point indicates the probable presence of pathology. Indicators of GR activity and GSH content have a low diagnostic value, which makes them unsuitable for use as laboratory tests for the diagnosis of male infertility.