COMBINED THERAPY OF THE ERECTILE DYSFUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION

Erectile dysfunction (ED) is a typical complication of arterial hypertension (AH) which stands among other more studied complications such as: micro- and macroangiography, retinopathy etc. It often causes damage to patients' health and also initiates depression. Vascular ED constitutes 70% of all etiological and organic factors of sexual disorders. Thus, it is necessary to seek prolonged safe and effective treatment of the erectile dysfunction, including the following cardiologic pathology. Aim. The aim is to study the prolonged combined therapy with sildenafil, tivortin and therapy with local negative pressure (LNP) in hypertensive patients with erectile dysfunction. Material and Methods. The investigation of the effective ÊÎÌÁ?ÍÎÂÀÍÀ ÒÅ?ÀÏ?ß Å?ÅÊÒÈËÜÍί ÄÈÑÔÓÍÊÖ?¯ Ó ÏÀÖ?ªÍÒ?Â Ç À?ÒÅ??ÉÍÎÞ Ã?ÏÅ?ÒÅÍÇ?ªÞ Î.?. Â?íòîí?â ÄÂÍÇ "?âàíî-Ôðàíê?âñüêèé íàö?îíàëüíèé ìåäè÷íèé óí?âåðñèòåò" Êàôåäðà óðîëî´?¿ (çàâ. - ïðîô. ª.À. Ëèòâèíåöü) ÓÄÊ: 616-08+616.69-008.1+616.12-008.331.1 combined therapy with sildenafil +tivortin, sildenafil + tivortin and LNP therapy was used for hypertensive patients with erectile dysfunction. The examination of patients and complex therapy were carried out. Group 1 (25 patients) received therapy with inhibitors of phosphodiesterase - the 5th type (sildenafil) "on demand". Group 2 (25 patients) received sildenafil in a dose of 50 mg every other day; Group 3 (25 patients ) received sildenafil 50mg every other day + tivortin; Group 4 (25 patients) - sildenafil 50mg every other day + tivortin + LNP therapy; Group 5 (20 patients) was a comparative group. The effectiveness of the administered therapy was evaluated by means of IIEF. Patients' answers to the questions were evaluated by scores (from 1to 5); the higher score - the better sexual function of male. The subdivision of the erectile function included 6 questions, with a maximum of30 scores. The erectile dysfunction was diagnosed when the patient scored less than 26.Therapy results were excellent with a rise of the erectile dysfunction indices to 50%; indices of 25-30% were good; indices of 10% were satisfactory, and indices lower than 10% were poor. Results and Discussion.One month after the start of therapy the erectile dysfunction index rose in Group2, Group 3, and Group 4. In Group 3 with the use of sildenafil, tivortin and LNP therapy indices were higher. Thus, in Group 4 excellent results were observed in 19 patients (76,0%); good results were observed in 5 patients (20,0%); satisfactory results were seen in 1 patient (4,0%). In Group 3, excellent results were observed in 15 patients (60,0%); good results were noted in 6 patients (24,0%) and satisfactory results - in 4 patients (16,0%). The final evaluation of complex therapy effectiveness showed excellent and good results in 96,0% of patients of Group 4 and 84,0% of patients in Group 3. Poorer indices were revealed in patients of Group 1: 21 patients (84,0%) had satisfactory results,10 patients of Group 2 had excellent results (25,0%) and 12 patients (48,0%) had satisfactory results. In Group 5 indices of erectile dysfunction were unchanged; in 2 patients (10,0%) results were poor. The obtained data show high effect of complex therapy in the male erectile dysfunction. For such hypertensive patients, tivortin and LNP therapy were used. The effect of such therapy was significant. It was due to antihypoxic and antioxidant action of tivortin, since the role of NO in the genesis of hypertensive patients with erectile dysfunction is significant. LNP therapy finds out additional arterial sources which do not function and the intensive enrichment of cavernous tissue with oxygen also takes place.