Abstract. Military personnel experience long-term consequences of severe injuries that have a significant impact on quality of life and sexual function. There is growing evidence that post-traumatic stress disorder, which develops secondary to injury, is associated with higher rates of erectile dysfunction (ED), decreased sexual desire, and premature ejaculation. Combat-related injuries can also have significant consequences for male fertility, as they typically serve during their peak sexual activity years.

The aim of the work was to study of indicators of quality of life and sexual function of men of different age groups, injured as a result of hostilities, before and after the end of treatment.

Methods. The study included treatment outcomes and questionnaire surveys of 136 men with combat injuries and concomitant sexual dysfunction before and after treatment for the dysfunction. To determine health-related quality of life, a survey was conducted using the SF-36 questionnaire. The second criterion for differentiating the severity of ED was the sum of the scores of the International Index of Erectile Function-5 questionnaire. According to the form of erectile dysfunction, patients were divided into two groups: group 1 – patients with psychogenic erectile dysfunction after combat trauma (n = 84); group 2 – patients with erectile dysfunction of mixed genesis – included patients, combatants with endothelial dysfunction, metabolic syndrome, dyslipidemia, hypertension, ischemic heart disease, late hypogonadism (n = 52). Results. The increase in the average score of the domains of general health, role-physical functioning, and role-emotional functioning was significant. There was a trend toward improvement in the domains of mental health and life activities. In the case of mixed ED, as a result of treatment, patients experience significant improvements in role-physical functioning and pain. There is a trend towards improvement in all other indicators. After comprehensive treatment, the average scores of the MIEF-5 questionnaire domain for sexual satisfaction significantly increased from 2.8 to 5.5 and erectile function from 7.2 to 16.7 (p < 0.05) in men with psychogenic ED. In men with a mixed form of erectile dysfunction, treatment has virtually no effect on sexual desire and orgasmic function, but erectile function increases the most, by 7.3 points (p < 0.05).

Conclusions. The results of the study indicate a significant prevalence of psychogenic and mixed forms of erectile dysfunction, which usually affects men after suffering combat injuries. As a result of the treatment of erectile dysfunction, both psychogenic and mixed forms, overall health, role-physical, and role-emotional functioning improves. There was a trend toward improvement in the domains of mental health and life activities. This is especially true for the younger age group of men. After comprehensive treatment, men with psychogenic erectile dysfunction of both age groups significantly increased their sexual satisfaction and erectile domain scores. Men with mixed erectile dysfunction have the greatest increase in erectile function.

Keywords: erectile dysfunction, quality of life, combat trauma, treatment

Full text: PDF (Ukr)

1. Охорона психічного здоров'я в умовах війни. Київ: Наш формат, 2017. У 2 т. 1 том -568 с., 2 том - 549 с.
2. Castillo O, Chen IK, Amini E, Yafi FA, Barham DW. Male sexual health related complica- tions among combat veterans. Sex Med Rev. 2022;10(4):691-697 doi.org/10.1016/j.sxmr.2022.06.002
3. Breyer BN, Cohen BE, Bertenthal D, Rosen RC, Neylan TC, Seal KH. Sexual dysfunction in male Iraq and Afghanistan war veterans: Association with posttraumatic stress disorder and other combat-related mental health disorders: A population-based cohort study. J Sex Med. 2014;11:75-83. doi.org/10.1111/jsm.12201
4. Banti M, Walter J, Hudak S, Soderdahl D. Improvised explosive device-related lower genitourinary trauma in current overseas combat operations. J Trauma Acute Care Surg. 2016;80(1):131-134. doi.org/10.1097/TA.0000000000000864
5. Bird ER, Piccirillo M, Garcia N, Blais R, Campbell S. Relationship between posttraumatic stress disorder and sexual difficulties: A systematic review of veterans and military personnel. J Sex Med. 2021;18(8):1398-1426. doi.org/10.1016/j.jsxm.2021.05.011
6. Lins L, Carvalho FM. SF-36 total score as a single measure of health-related quality of life: Scoping review. SAGE Open Med. 2016;4:2050312116671725. doi.org/10.1177/2050312116671725
7. Petkari E, Lapin B, Boehnke JR. Quality of life dimensions in people living with mental disorders: moving beyond global scores. Quality of life research, 2024. doi.org/10.1007/s11136-024-03844-4
8. Vorobets DZ, Fafula RV, Chaplyk VV, Vorobets MZ, Onufrovych OK, Besedina AS, Vorobets ZD. Erectile dysfunction and quality of life of men affected by hostilities in the Russian-Ukrainian war. Regulatory Mechanisms in Biosystems. 2024;15(1):62-66. doi.org/10.15421/022409
9. Gökçe Mİ, Yaman Ö. Erectile dysfunction in the elderly male. Turk J Urol 2017;43:247-451. doi.org/10.5152/tud.2017.70482
10. Kim S, Cho MC, Cho SY, Chung H, Rajasekaran MR. Novel emerging therapies for erectile dysfunction. World J Mens Health. 2021;39(1):48-64. doi.org/10.5534/wjmh.190009
11. Leslie SW, Sooriyamoorthy T. Erectile Dysfunction. [Updated 2024 Jan 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
12. Мa M, Yu B, Qin F, Yuan J. Current approaches to the diagnosis of vascular erectile dysfunction. Transl Androl Urol. 2020;9(2):709-721. doi.org/10.21037/tau.2020.03.10
13. Minhas AS, Goerlich E, Corretti MC, Arbab-Zadeh A, Kelle S, Leucker T, Lerman A, Hays AG. Imaging Assessment of Endothelial Function: An Index of Cardiovascular Health. Front. Cardiovasc. Med. 2022;9:778762. doi.org/10.3389/fcvm.2022.778762
14. Xing J. Metabolic syndrome/cardiovascular disease and erectile dysfunction (ED). Transl Androl Urol. 2015;4(S1):AB039.
15. Ho JH, Adam S, Azmi S, Ferdousi M, Liu Y, Kalteniece A, Dhage SS, Keevil BG, Syed AA,Ammori BJ, Ahern T, Donn R, Malik RA, Soran H. Male sexual dysfunction in obesity: Therole of sex hormones and small fibre neuropathy. PLoS One. 2019;14(9):e0221992. doi.org/10.1371/journal.pone.0221992
16. Onufrovych OK, Fafula RV, Vorobets MZ, Besedina AS, Melnyk OV, Vorobets DZ, Vorobets ZD. Parameters of oxidative, nitrasive and anti-oxidative status in men with erectile dysfunction due to combat trauma. Regulatory Mechanisms in biosystems. 2024;15(1):97-101. doi.org/10.15421/022414
17. Salman M, Shehzadi N, Khan MT, Islam M, Amjad S, Afzal O. Erectile dysfunction: prevalence, risk factors and involvement of antihypertensive drugs intervention. Trop J Pharm Res. 2016;15(4):869-876. doi.org/10.4314/tjpr.v15i4.29
18. Salonia A, Bettocchi C, Carvalho J, Corona G, T.H. Jones T.H., et al. Sexual and Reproductive Health. European Association of Urology 2022. 252 p.
19. Фещенко ЮІ, Мостовой ЮМ, Бабійчук ЮВ. Процедура адаптації міжнародного опитувальника оцінки якості життя MOS SF-36 в Україні. Досвід застосування у хворих бронхіальною астмою. Український пульмонологічний журнал. 2002; 3:9-11.
20. Cappelleri JC, Siegel RL, Glasser DB, Osterloh IH, Rosen RC. Relationship between patient self-assessment of erectile dysfunction and the sexual health inventory for men. Clin Ther. 2001;23(10):1707-1719. doi.org/10.1016/S0149-2918(01)80138-7
21. Rosen RC, Cappelleri JC, Gendrano N. The International Index of Erectile Function (IIEF): a state-of-the-science review. International Journal of Impotence Research. 2002;14:226-244. doi.org/10.1038/sj.ijir.3900857