Diagnostics and the combined medical tactics at patients with erectile dysfunction at a empty sella syndrome

Background. The study of hormonal status in patients with erectile dysfunction (ED), especially the older and senior age groups, is most often limited to the evaluation of testosterone fractions

Aim: demonstrate the effectiveness of transcranial magnetotherapy in a combined treatment regimen for patients with «empty sella syndrome” (ESS).

Methods. Results of diagnostics examination and treatment of 118 patients with the ED hormonal form at the age of 23–57 are studied. The expressiveness of disturbances of erectile function and signs of androgenic deficiency are estimated by means of questionnaires of AMS and a scale of Morley, the penil color flow Doppler ultrasound with intracavernous pharmacological tests is carried out, the hormonal status is estimated. At suspicion of neuroendocrine pathology MRI of the brain is executed. At all examined patients signs of decrease erectile functions are revealed. In 62 (52.5%) observations during MRI the picture of ESS is revealed. In 22 (18.6%) observations the changes of an eyeground demonstrating increase in intracranial pressure takes place, however loss of fields of vision is not observed in any of patient. Persistent headaches are noted in 19 (16.1%) observations. In 46 (39%) observations at patients with considerable obesity signs of disturbance of tolerance to glucose and insulin resistance are revealed. To patients hormone replacement therapy is appointed, at identification of a hyperprolactinemia agonists of dopamine receptors in an individual dosage under control of level of prolactin are used, therapy of intracranial hypertensia is carried out. In complex therapy transcranial magnetotherapy is used.

Results. Therapy is effective, during treatment increase in frequency and duration of sexual intercourses is noted. At control Doppler researches of a penis improvement of a regional hemodynamics is noted. Cancellation of medicines lead to resuming of symptomatology of a disease.

Conclusion. Thus, the research shows powerful value of a syndrome of ESS in a pathogeny of ED demanding multidisciplinary approach with involvement of adjacent specialists — endocrinologists, neurologists and ophthalmologists. It is important to note that ESS, in most cases, is an accidental tomographic finding, at the same time often is followed by disturbance of tolerance to glucose, obesity, a metabolic syndrome. Introduction in complex therapy of transcranial magnetic influence substantially improves results of treatment of this category of patients, as due to additional stimulation of synthesis of pituitary hormones, and cerebral decompression.