Analyzed the sources of foreign and Russian literature. Discussed existing today conservative and surgical methods of treatment of retrograde ejaculation, their efficacy and safety in patients with diabetes. A new method of antegrade ejaculation restoration which has been developed in Endocrinology Research Center described.

Venogenic erectile dysfunction (ED) is 20 to 60 % of all causes of erection problems. In most cases, the choice of surgical treatments depends on the degree and pattern of vascular disorders in the genesis of ED. The authors use the alternative treatment procedure X-ray endovascular occlusion of veins in the prostatic plexus. There is a significant improvement in the quality of erection in the first 3 months after surgery. The application of this innovative technology permits safe, mini-invasive and pathogenetically sound treatment for ED caused by abnormal venous drainage from the cavernous bodies.

This article describes a new technique of correction of the retrograde ejaculation in patients with type 1 diabetes mellitus. Currently, treated 12 patients with type 1 diabetes mellitus and retrograde ejaculation as a manifestation of urogenital form of autonomic diabetic neuropathy. The positive effect of the operation was achieved in 11 of 12 treated patients. Registered 2 cases of physiological pregnancy.

The article presents the results of the use of alternative method of treatment--endovascular occlusion of the prostatic plexus--in patients with isolated venogenic erectile dysfunction. The IIEF-5 and AMS questionnaires were used for the evaluation of results of the operation. Improvement of quality of erection in the first 3 months after surgery was achieved in the majority of patients. The use of this innovative technology provides secure, minimally invasive and pathogenetically justified treatment of ED caused by abnormal venous drainage from the cavernous bodies.

The choice of method of surgical treatment of prostatic adenoma depends on the size of prostate, but often it can be limited to the patients with anesthesia risk or somatic risk. The article presents an alternative method of treatment of large prostatic adenomas--x-ray guided endovascular occlusion of prostate arteries, through which 38 patients were treated. Effectiveness of x-ray guided endovascular occlusion was evaluated in comparison to open prostatectomy (40 patients) and the administration of 5alpha-reductase inhibitor (43 patients). In the first two months after surgery, significant reduction in prostate volume and increased urinary flow rate was observed. Length of stay in the group of x-ray guided endovascular occlusion of prostate arteries was significantly less than in the group of open prostatectomy--2.3 days versus 19.7, respectively (P < 0.001). Variants of use of x-ray guided endovascular occlusion of prostate arteries in clinical practice are presented.

The article presents original experience with use of undecanoate (nebido, BayerHealthcare Pharmaceuticals, Germany) in androgenic testosteron replacement therapy in males with hypogonadism. Prospective studies of nebido efficacy were made in males with vein-occlusive erectile dysfunction (n = 20), chronic pelvic pain syndrome (n = 77), metabolic syndrome (n = 170). Retrospective studies assessed efficacy of nebido monotherapy in patients with erectile dysfunction and hypogonadism (n = 34), hematological and urological safety of the drug (n = 40). Laboratory monitoring was performed in all the studies according to ISSAM recommendations. The patients were not included in contraindications to androgenic therapy. Nebido treatment significantly improved libido and erectile function, efficacy of phosphodiesterase of type 5 inhibiors used in moderate and severe erectile dysfunction. Depressive, asthenic, pain symptoms declined in males with chronic pelvic pain. Body fat reduced in metabolic syndrome with alleviation of its other components. Insignificant rise of hemoglobin level and packed cell volume was observed in some patients while a PSA level increase was clinically significant in 10% patients who had initial PSA > 2.5 ng/ml and acromegalia. Also, nebido depressed production of gonadotropins and spermatogenesis. Thus, nebido is highly effective in sexual dysfunction and other somatic disorders caused by hypogonadism. Nebido does not induce severe side effects, but clinically significant rise of PSA level requires treatment discontinuation and more careful urological examination. In view of nebido ability to suppress spermatogenesis, the drug should not be used in reproductively active men.

The objective of the present review was to consider the available data on the risk of development of prostatic hyperplasia and prostate cancer in patients presenting with acromegalia. It is shown that the incidence of prostatic diseases in acromegalic patients is significantly higher than in the general population. Prostatic hyperplasia occurs in patients of all age groups presenting with acromegalia while its treatment reduces the volume of the prostate gland. The reviewed publications do not report cases of prostate cancer.