The diagnostic value of the NO-synthase, Ca2+- and Na+-dependent ATP-hydrolase systems and the therapeutic potential of NO-stimulators in erectile dysfunction of men injured as a result of combat operations (combat trauma)
Abstract
Erectile dysfunction (ED), as a sexual disorder, is characterized by persistent inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. Among the numerous pathological conditions that precede ED or are complicated with it, neurotic disorders, metabolic disorders, blood vessels diseases, partial androgen deficiency, combat injuries, etc. take precedence. An injury is not only a physical, but also a psychological trauma, which is often stretched over some period of time. Post-traumatic stress disorder, depressive states, and post-traumatic chronic pain may develop as a result of a combat wound. These conditions also affect sexual function. The search for sensitive indicators that would reflect both the physiological status of the organism and metabolic changes inside the cell is an urgent issue of modern biochemistry, physiology and medicine in general. This study involved results of examination and treatment of 136 men, participants in hostilities, with sexual dysfunction and leading complaints of erectile dysfunction. The control group consisted of 48 clinically healthy men without complaints of sexual dysfunction or cardiac, neurological or endocrinological pathology. According to the form of ED, patients were divided into groups: patients with psychogenic ED after a combat injury (n = 84) and patients with ED of mixed genesis, which included participants in hostilities with endothelial dysfunction, metabolic syndrome, dyslipidemia, hypertension, coronary heart disease, late hypogonadism (n = 52). It was shown that the development of psychogenic and mixed forms of ED is mostly associated with stress hyperprolactinemia with normal indicators of cavernous dopplerography, lipid metabolism and androgen levels. The Na+,K+-ATPase activity of peripheral blood lymphocytes was significantly decreased in men of different age groups with a mixed form of ED. The Ca2+,Mg2+-ATPase activity of plasma membrane and endoplasmic reticulum decrease was significantly decreased in men with ED of both psychogenic and mixed forms, but a more pronounced decrease was observed with increasing age of patients. Complex treatment of patients with a mixed form of ED with sildenafil leads to a significant increase in Na+,K+-ATPase activity and Ca2+,Mg2+-ATPase activity of endoplasmic reticulum in lymphocytes in patients with ED of mixed genesis. Complex treatment of young age patients with psychogenic ED led to a decrease in the arginase activity in patients with both psychogenic and mixed ED. A decrease in cNOS activity was accompanied by a corresponding increase in iNOS activity in patients with mixed form of ED. Treatment of patients with the use of sildenafil led to non significant increase in cNOS activity in the lymphocytes of patients of both age groups.References
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