The third millennium marked an increase in interest in the quality of human life and well-being. Human sexual health has become an integral part of a harmonious life. Great interest in the problem of erectile dysfunction is due to the increase in the number of patients with this pathology in the world. Many scientific studies have made progress in understanding the physio logy of erection. Starting its development from an objective examination, questioning, assessment of psychological history, the diagnosis of erectile dysfunction has stepped to new heights, such as multislice dynamic pharmacocavernosography using 3D modeling and positron emission tomography in combination with visual sexual stimulation or erectogenic pharmacological stimuli. The article presents data on the historical aspects of the study of erectile dysfunction and trends in the development of its diagnosis from ancient times to the present day. The main instrumental research methods that are actively used to diagnose the disease at the present time are described.

Introduction. The problem of the pandemic caused by the COVID-19 virus is extremely relevant. It has been proven that SARS-CoV-2, which causes respiratory distress syndrome, is not only aggressive towards lung tissue, as was originally assumed. A promising direction in the study of the pathogenic properties of the pathogen is the effect on the male reproductive system. Materials and methods. The review authors searched the Pubmed and eLibrary databases for the keywords «COVID-19», 2 SARS-CoV-2», «male fertility», «reproductive health», «sperm», «erectile function», «erection». A total of 122 publications were found, of which 34 were selected for this review. Results. According to a review of scientific publications, coronavirus infection can negatively affect the reproductive system of men through a combination of ACE-2 receptors and cellular transmembrane serine protease 2 (TMPRSS2), due to the development of oxidative stress in testicular tissue, hyperthermia, secondary cytokine storm syndrome, side effects of medications taken, which leads to damage to the testicular tissue, a decrease in the quantity and quality of spermatozoa, and the development of various forms of pathospermia. The cascade of pathological processes in the body of a man, developing under the influence of the COVID-19 virus, leads to damage to the endothelium of the penile vessels, a decrease in nitric oxide level in the cavernous bodies, which is manifested by a decrease in erectile function. Conclusions. Due to the short duration of the studies performed, the heterogeneity of the observed groups of patients, and a limited sample, it is impossible to make final predictions of the severity of reproductive and sexual disorders after a new coronavirus infection, their relationship with the characteristics of the course of the disease and the degree of reversibility of pathological processes. Accumulated data during the pandemic period indicate the potential impact of SARS-CoV-2 on male fertility and erectile function, which requires further large-scale homogeneous observations.

Introduction. Erectile dysfunction (ED) is a multifaceted and widely prevalent problem in modern medicine. The problem of erectile dysfunction has not only medical but also social significance – the presence of erectile dysfunction in men has a deleterious effect on their quality of life. One of the few pathophysiologically substantiated surgical methods of treatment for vasculogenic erectile dysfunction is penile revascularization. Objective. To evaluate the effectiveness of antegrade extraperitoneoscopic penile revascularization in patients with vasculogenic erectile dysfunction, to develop an algorithm for selecting patients with vasculogenic ED suitable for penile revascularization surgery. Materials and methods. From 2015 to 2022, 65 penile revascularizations were performed in patients with vasculogenic ED. All patients were divided into 2 groups. In the main group, antegrade extraperitoneoscopic penile revascularization was performed in 34 patients, while in the control group, penile revascularization was performed in 31 patients according to the Virag-Kovalev method. To assess the results of the treatment, we used the scales and questionnaires IIEF-5, QoL, and the evaluation of penile rigidity on the Erection Hardness Score (EHS) scale. We also compared the duration of surgery and length of hospital stay. Results. The duration of surgery in the main group was significantly shorter (p <0.01) than in the control group. Additionally, the length of postoperative hospital stay was significantly shorter (p <0.05) in the main group. When comparing patients, there was a significant statistical difference in IIEF-5, EHS, and QoL scores. Conclusions. Penile revascularization, particularly the antegrade revascularization method, is an effective method for treating ED. The proposed methodology, based on the shortcomings of previous methods, is the most effective and least invasive of all the presented options. The success of penile revascularization surgery directly depends on careful patient selection and surgeon experience.

AIM:To assess the degree of changes in complaints, dynamics of biochemical parameters of lipid metabolism, penile hemodynamics in patients with ED during therapy with EDELIM in comparison with PDE-5 inhibitors. Assess the tolerability of the drug based on the analysis of reported adverse events. MATERIALS AND METHODS:The study was prospective comparative observational cohort. The study included 60 patients over 18 years old with complaints of persistent, at least 1 month, erectile dysfunction. The patients were divided into 2 groups: group 1 patients with ED received Edelim on a regular basis, one capsule 2 times daily for 3 months; group 2 patients with ED received generic tadalafil 5 mg daily for 1 month, then 1 month break, then 5 mg per day for 1 month. RESULTS:The mean age of the patients was 38.4 9.2 years. In group 1, significant differences were noted in the all hemodynamic and biochemical indicators, except for HDL levels (2.2 0.4 vs. 2.3 0.4 mmol/L;p= 0.067). In group 2, significant differences were noted in the dynamics of the IIEF-5 scale, the level of HDL, and the blood flow velocity in the right and left cavernous arteries. There were no significant differences in blood flow in the left and right dorsal arteries, levels of total cholesterol, LDL, triglycerides, glucose, HbA1c, systolic blood pressure. In the 1st group of patients, there were no adverse events, in the 2nd group, in 3 patients mild side effects. CONCLUSIONS:The improvement in the quality of erection in the group of patients taking Edelim is associated with decrease in the lipid profile, glucose, glycated hemoglobin, which can be regarded as a variant of pathogenetic conservative treatment of ED.