The aim: Is to determine the features of hemodynamics and the character of structural and functional changes in the prostate gland in middle-aged infertile males in the conditions of chronic hepatitis. Materials and methods: We studied the features of hemodynamics and structural and functional state of the prostate gland in middle-aged males who had suffered from chronic hepatitis with the help of ultrasound scanning, Color-Doppler sonography, and histology, morphology, and statistics. Results: It was detected that in 3-5 years after chronic viral hepatitis in middle-aged males (the first period), the volume of the prostate gland increases to (27.1±1.2) cm3, and its mass to (28.0±1.7) g compared to the control. Blood flow rates in the prostate gland: arterial blood flow velocity, blood flow diastolic velocity, volumetric blood flow are significantly lower than the control ones. Glandular zone surface decreases to 53% and connective tissue increases to 43%. Epithelium in the secretory area of the gland is compressed. Conclusions: 1.According to the data of ultrasound diagnostics and Color-Doppler sonography, the volume of the prostate gland increases to (27.1±1.8) cm3 and its mass to (28.0±1.7) g at chronic viral hepatitis, compared to the control (21.3±1.5) cm3 and (24.7±1.3) g (р<0.05). Atrophic changes in the prostate gland are manifested with the decreased height of the columnar epithelium of the gland and overgrowth of connective tissue in the stroma of the organ. 2.Angioechometric indices of arterial blood circulation in central and peripheral zone of the prostate decreases to (7.26±0.46) cm/sec and (7.80±0.32) cm/sec respectively compared to the control (18.30±3.10) cm/sec and (17.70±2.90) cm/sec. Venous blood flow rates decrease to (2.45±0.21) cm/sec and (2.60±0.16) cm/sec compared to (5.54±0.8) cm/sec and (5.36±0.03) cm/sec (р<0.05).

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Over the last years, mortality because of cardiovascular diseases (CVD) increased significantly in Ukraine. If we speak about atrial fibrillation (AF) itself, the number of recurrent arrhythmias cases as the main cause of hospitalization of patients with AF increased at 66% over the last 20 years. Independent development factors of AF are heart failure, aortic and mitral valve diseases, arterial hypertension, left atrial enlargement, and also obesity and obstructive sleep apnea, etc. In 2013 A.A. Novykov from Kherson region and several other researchers proved the influence of chaotic changes of meteofactors in cases of overt or hidden functional cardiovascular disorders (CVD) that can significantly influence its hemodynamic stability, functional ability, particularly its rhythmic activity. The main problem in the treatment of one or another nosological entity of CVD today is not the adjustment of a medication for its treatment, but the finding of pathogenetic links in the development of the disease itself. Especially this occurs, when the patient gets several organs or systems disabled simultaneously. Several scientists and practicing physicians are interested in the development of new approaches to diagnosis and treatment of AF in patients with ischemic heart disease (IHD) considering the peculiarities of clinical course and comorbidity. After all, the finding of complications’ causes in comorbid pathology in patients with IHD will contribute to treatment optimization and prevention of other complications, especially those resulting from the anticoagulant therapy, for example when a functional liver state or metabolic processes are impaired.

Aim: To determine the possible positive influence on correction of erection duration with redistributing of blood flow in pelvic arteries. Materials and methods: Blood fl ow indices were determined with the methods of color Doppler ultrasound diagnostics of penis arteries in 9 middle-aged males with erectile dysfunction, in whose anamnesis there had been diabetic nephropathy. Results: We determined that the maximum blood flow velocity in the cavernous arteries of the penis was 31.5 cm/sec on average, and diastolic blood flow velocity was 13.4 cm/sec, compared to 60 cm/sec and 25 cm/sec respectively in the norm. The resistive index decreased to 0.58 compared to 0.92 in the norm. Gotten indices show the presence of erectile arterial dysfunction in middle-aged males with diabetic nephropathy. Performed experiments in animals with directing of arterial blood flow from the caudal sciatic artery to the deep and spinal arteries of the penis showed widened lumen in them to 50% in average that causes the continuous erection. Conclusions: According to the data of the Doppler ultrasound of the penis in middle-aged males, in whose anamnesis there had been diagnosed diabetic nephropathy, we found out bilateral cavernous dysfunction. According to the data of the angiography exclusion of the caudal sciatic artery directed the blood flow into the internal pubic artery and its final branches, the deep and spinal arteries of the penis with signif i cant (to 50% in average), increasing of their internal diameter and continuous erection.

Diseases of testicles are an important social problem because according to WHO data, the male factor is about 45% in the structure of sterile marriage. Among many pathogenic factors distorting spermatogenic and endocrine function of testicles, acute and chronic circulatory disorders in them play a great role. Recent studies showed that one of the causes of male infertility is chronic ethanol intoxication causing distorted hemomicrocirculation in testicles, so determining the character of cytologic changes in them in these circumstances remains relevant. Objects and methods. In the study, we used 14 histological micropreparations from testicular biopsy specimens from middle-aged infertile males (22-35 years) with chronic alcoholism in anamnesis,. In some biopsy specimens, ultrastructural changes in testicles were studied under the electronic microscope, testicular hemodynamics in infertile males was examined with ultrasound. Results. In middle-aged infertile males with chronic alcoholism, the volume of testicles decreases compared to normal. The arterial blood flow rate in them decreases significantly. The diameter of tortuous looped seminiferous tubules decreases compared to normal. Their membrane is thickened; the layers of spermatogenic epithelial cells are reduced. The volume of interstitial endocrinocytes decreases compared to normal. Testosterone level in blood decreases too. Ultrastructural changes in testicles are manifested with irregular thickness and curving of spermatogenic epithelial basal membrane, vacuolization of myoid cellular, supporting epitheliocytes, and interstitial endocrinocyte cytoplasm with reduced mitochondrial cristae and tubules in the endoplasmic reticulum. In ejaculate of infertile males, sperm concentration decreases to (30.65±1.70) million/ml compared to (75.80±4.20) million/ml, the number of pathologic forms of spermatozoids increases twice, the number of spermatozoids with progressive movement decreases.