BACKGROUND: The acute (active) phase of Peyronie’s disease is characterized by penile pain, progressive curvature, and significant psychosexual distress. Conservative management during this stage aims to suppress inflammation, stabilize deformity, and preserve erectile function; however, an optimal multimodal therapeutic protocol has not yet been standardized.

AIM: To evaluate the clinical efficacy of a novel comprehensive conservative approach for penile deformity correction in patients with Peyronie’s disease in the active phase.

METHODS: An observational case-series study included 58 male patients treated between February 1, 2025 and July 27, 2025. The therapeutic protocol consisted of a nonsteroidal anti-inflammatory drug, daily administration of a phosphodiesterase type 5 inhibitor, ultrasound-guided manual traction therapy, and targeted psychotherapeutic intervention using eye movement desensitization and reprocessing (EMDR). Patients were assessed monthly for penile curvature angle, plaque size according to ultrasound examination, erectile function using the International Index of Erectile Function–5 (IIEF-5), and psychoemotional status.

RESULTS: After 3 months of treatment, the mean relative reduction in penile curvature was 24.1 ± 8.7 % (p <0.05), while plaque length decreased by 16.3 ± 6.9 % (p <0.05). The IIEF-5 score increased from 10.2 ± 1.8 to 19.4 ± 2.6 points (p <0.05). No cases of deformity progression, plaque calcification, or serious adverse events were recorded during follow-up.

CONCLUSION: The proposed multimodal conservative protocol in the active phase of Peyronie’s disease was associated with statistically and clinically significant reduction of penile deformity and improvement in erectile function. These findings support the need for further randomized controlled trials to confirm the efficacy and long-term sustainability of the therapeutic effect.

BACKGROUND: Worldwide, a high prevalence of benign diseases in women is registered, which in some cases can lead to the development of malignant neoplasms. The role of estrogens in the onset of neoplastic processes is well known. Long-term pathogenetically oriented prevention can contribute to disease regression and a reduced risk of malignant transformation.

AIM: To compare the efficacy and safety of a complex product containing resveratrol and indole-3-carbinol (dietary supplement Imaston) administered in a once- and twice-daily regimen.

METHODS: The article presents brief data on the molecular mechanisms and pathogenesis of estrogen-associated diseases, as well as the interim results of the open-label, multicenter clinical study PRIMA-024.

RESULTS: The therapy demonstrates a pronounced initial clinical response in both groups of patients with benign mammary dysplasia.

CONCLUSION: Plant-derived components (resveratrol and indole-3-carbinol) show high efficacy and safety in both the treatment and long-term prevention of benign neoplasms in women.

BACKGROUND: Varicoceles are highly prevalent among men of reproductive age and significantly affect of male infertility. Statistics show that the incidence of varicoceles is 15–20 % in men, while among patients with fertility disorders, this figure rises to 35–40 %. This underscores the importance of further understanding of this condition and its impact on spermatogenesis.

AIM: To evaluate the role of varicocele in male infertility and to assess the effectiveness of varicocelectomy in patients with primary and secondary infertility.

METHODS: The study included 300 men divided into three groups: 100 patients with primary infertility after varicocelectomy, 100 patients with secondary infertility after varicocelectomy, and 100 conditionally healthy men. Varicocele was diagnosed using physical examination and Doppler ultrasound. Varicocele grading was performed according to the WHO classification (2000). Semen parameters were evaluated before and after surgery in accordance with WHO guidelines (2010). Statistical analysis was performed using parametric methods; differences were considered significant at p <0.05.

RESULTS: Before surgery, patients with varicocele demonstrated significantly impaired semen parameters compared to the control group. After varicocelectomy, a statistically significant improvement in sperm concentration, motility, and total motile sperm count was observed in both infertility groups. The most pronounced improvement was noted in patients with primary infertility.

CONCLUSION: The results of the study confirm the significant role of varicoceles in the development of spermatogen- esis disorders and male infertility. Varicocelectomy is an effective treatment for varicocele-associated male infertility and helps improve the reproductive potential of patients.

BACKGROUND: Chronic prostatitis has multifactorial nature and develops under the influence of various factors, including social, perinatal, and somatic. Although this disease is widespread, its occurrence is associated with unfavorable living conditions, low physical activity, and poor nutrition, highlighting the importance of lifestyle for men’s health.

AIM: To identify and analyze the main social, perinatal, and somatic risk factors of the chronic prostatitis development in working-age men.

METHODS: The study included 200 men: 100 patients with diagnosed chronic prostatitis and 100 conditionally healthy men. Anthropometric parameters, social status, lifestyle characteristics, perinatal history, and somatic diseases were assessed. Statistical analysis was performed using parametric methods, with p <0.05 considered significant.

RESULTS: Patients with chronic prostatitis significantly more often demonstrated unfavorable social conditions, low physical activity, unhealthy dietary patterns, and aggravated perinatal and somatic history. Significant correlations were identified between chronic prostatitis and pathological pregnancy course, low Apgar score, low physical activity, and disordered nutrition.

CONCLUSION: Chronic prostatitis is a multifactorial disease associated with the combined influence of social, perinatal, and somatic risk factors.

BACKGROUND: Despite advances in medicine, conservative treatment of Peyronie’s disease (PD) remains challenging due to an incomplete understanding of its pathogenesis and limited evidence base, often necessitating surgical intervention.

AIM: To evaluate the efficacy and safety of the combined use of Peyroflex® capsules and gel on PD symptoms (pain, penile curvature, fibrous plaque size).

METHODS: A prospective comparative cohort study was conducted involving 82 patients with acute-phase PD. Participants were randomized into to 4 groups: 1) Peyroflex® capsules and gel; 2) Peyroflex® Gel + shock wave therapy (SWT); 3) Peyroflex® capsules + gel + SWT; 4) SWT (control group). The follow-up period was 6 months. Primary endpoints included changes in penile curvature (degrees), fibrous plaque area (mm2), and pain intensity measured by Visual Analogue Scale (scores).

RESULTS: Combination therapy with Peyroflex® line products (Group 1) demonstrated a statistically significant reduction in plaque area (from 88.7 to 69.6 mm2; p <0.001) and a trend towards reduced curvature angle. The best outcomes were achieved in Group 3 (Peyroflex® capsules + gel + SWT): curvature angle decreased from 21.1° to 13.9° (a 34.1 % reduction; p <0.001), and plaque area decreased by 51.5 % (p <0.001). The addition of Peyroflex® Gel to SWT (Group 2) enhanced the efficacy of SWT: curvature reduction was 28.4 % versus 16.3 % in the control group (p = 0.002). Pain was resolved in all groups. No adverse events were reported.

CONCLUSION: The use of Peyroflex® line products, especially in combination with SWT, demonstrates high clinical efficacy in the treatment of acute-phase PD, leading to regression of fibrous plaque and curvature. Therapy with Peyroflex® line products alone also represents an effective conservative treatment option.

BACKGROUND: Benign prostatic hyperplasia (BPH) is one of the most common urological diseases in older men and is accompanied by development of lower urinary tract symptoms, significantly reducing patients’ quality of life. In recent years, laser enucleation of the prostate has been considered a modern, minimally invasive alternative to traditional surgical treatments. The method allows for the radical removal of hyperplastic tissue with minimal blood loss and can be used in patients with varying prostate volumes and concomitant somatic pathology.

AIM: To evaluate clinical efficacy and safety of laser enucleation of the prostate in patients with lower urinary tract symptoms caused by benign prostatic hyperplasia.

METHODS: The study included patients with clinically and instrumentally confirmed benign prostatic hyperplasia who underwent laser enucleation of the prostate. All patients received standard clinical and laboratory examinations, ultrasound assessment of the urinary system with measurement of prostate volume and postvoid residual urine, and evaluation of symptom severity using the IPSS and quality of life (QoL) questionnaires. Treatment efficacy was assessed based on changes in clinical, functional, and laboratory parameters. Statistical analysis was performed using parametric and non-parametric methods; p <0.05 was considered significant.

RESULTS: Laser enucleation of the prostate resulted in a significant reduction of lower urinary tract symptoms, improvement in quality of life, and restoration of adequate urination. The incidence of intraoperative and postoperative complications was low and did not significantly affect treatment outcomes.

CONCLUSION: Laser enucleation of the prostate is an effective and safe surgical treatment for benign prostatic hyperplasia, providing marked clinical improvement and a low complication rate.

BACKGROUND: Varicocele is a varicose vein of the testicle caused by pathological venous reflux, which is characterized by its effect on fertility in men of different ages. Clinically, varicocele is found in 15 % of the male population, with 35 % of men with primary infertility and 70–81% of men with secondary infertility. Uncontrolled excessive amounts of reactive oxygen species (ROS) can cause breaks in the single-stranded and/or double-stranded DNA of spermatozoa, commonly referred to as sperm DNA fragmentation. AIM: To determine the effectiveness of surgical and conservative tactics for the treatment of subfertility in people of different age groups with varicocele and the effect on the level of fragmentation of sperm DNA.

METHODS: The study is based on a comparative analysis of the results of examination and treatment of 176 patients with varicocele who do not have concomitant pathology, with pathospermia, increased fragmentation of sperm DNA. The control group (29 patients) received complex antioxidant and spermatoprotective therapy for 3–6 months without surgical treatment (refusal of surgery, etc.). The main group (147 patients) also received similar drug rehabilitation after surgical treatment – a complex of spermatoprotectors and anti-oxidants. All patients were followed up for up to 12 months. The fragmentation of sperm DNA was assessed by the Blutol test system, the spermogram was performed on a SQA-V/SPERAMLITE, V-Sperm III computer spermograph.

RESULTS: In the main group of patients who received surgical treatment, there was a more dynamic normalization of the level of DNA fragmentation within 3–6 months in the postoperative period than in the control group without surgical treatment. On average, the positive dynamics was in the main group in 67.9 % of patients, and in the control group in 38.9 % of patients. The improvement in DNA fragmentation rates was noted in parallel with the improvement in spermogram indicators, but it was at an earlier time.

CONCLUSION: Surgical treatment of varicocele improves fertility in patients with pathospermia, increased fragmentation of sperm DNA. Normalization of sperm DNA fragmentation occurs earlier (within 3 months in the postoperative period) than improvement of pathospermia.

Erectile dysfunction and genital response insufficiency in men with infertility most often have a multifactorial nature, in which organic and psychogenic mechanisms mutually reinforce each other. Current international guidelines on male infertility emphasize the importance of a comprehensive assessment of men, including mental health evaluation; however, in routine clinical practice the psychological component often remains underestimated. Psychogenic factors such as sexual performance anxiety, insecure attachment styles, negative sexual experiences, and delayed help-seeking behavior are associated with greater severity of erectile dysfunction and reduced sexual quality of life. The aim of this review is to analyze current evidence on the role of psychogenic factors in the development of genital response insufficiency in men with infertility and to evaluate the potential of a psychogenic component rating scale for erectile dysfunction as a tool for optimizing clinical management strategies.

Psychodiagnostic methods can help differentiate psychogenic and organic forms of erectile dysfunction and improve treatment outcomes through targeted psychotherapeutic interventions. In the Russian Federation, a psychogenic component rating scale for erectile dysfunction has been developed to identify key psychological phenomena including anticipatory anxiety, avoidance of sexual intimacy, and hyperfocus on erectile performance. The scale enables stratification of patients according to the severity of psychogenic involvement, ranging from the absence of clinically significant anxiety to a predominantly psychogenic form of dysfunction.

This review compares this instrument with internationally used psychometric tools for erectile dysfunction and infertility, including SIEDY Scale 3, psychological distress scales, and questionnaires focused on sexual cognitions and expectations. The potential integration of this scale into diagnostic and therapeutic algorithms for male infertility is discussed, along with its role in reducing diagnostic and pharmacological burden and its prospects for further psychometric validation. The systematic use of the scale may serve as a functional marker of the psychogenic contribution to genital response insufficiency and may facilitate the personalization of reproductive care.

This analytical review, synthesizing data from 172 Russian and international studies, explores targeted therapy for chronic prostatitis and chronic pelvic pain syndrome using Querceprost – a multifunctional bioactive complex containing quercetin, lycopene, naringin, selenium, and zinc. The findings highlight multiple effects of Querceprost, including its antimutagenic, anti-inflammatory, cardioprotective, and neuroprotective properties. Querceprost mitigates oxidative stress, preserves nitric oxide and endothelial integrity, and modulates neurohormonal signaling. Furthermore, it promotes pro-survival cellular pathways while simultaneously inhibiting apoptosis, autophagy, and ferroptosis.

Multiple evidence suggests that inflammation and oxidative stress negatively affect sperm parameters, spermatogenesis, and testicular and epididymal function, although the etiology of infertility caused by varicocele may be multifactorial. In this regard, the anti-inflammatory effect of various drugs in patients with varicocele is being studied and in the future, it may be possible to develop new treatment methods and conduct an appropriate selection of patients for whom these drugs can help.

The article presents a review of the world literature on the influence of the inflammatory process on spermatogenesis in varicocele.

Urethral stricture in men remains an important problem of reconstructive urology. Incidence of this pathology is 229–627 cases per 100,000 men. Urethral stricture significantly affects patients’ quality of life. Despite high efficacy of autologous buccal mucosa transplants (85–93 % of surgeries are successful), their use is limited by donor zone morbidity and tissue deficit, especially in cases of repeat surgical interventions. In recent decades, tissue engineering approaches have been actively developed, including cell-free matrices, hybrid composite constructions, 3D bioprinting, cell therapy.

The review summarizes modern data on the types of matrices, clinical experience of their use and future of this approach to reconstructive surgery of the urethra.

Acute pyelonephritis is a severe urinary tract infection, fraught with the development of sepsis, septic shock and death. In most cases, uncomplicated acute renal failure is diagnosed clinically and is amenable to etiotropic antibacterial therapy. However, in patients with a high risk of an unfavorable outcome or with delayed treatment, the fusion of microabcesses with the formation of a kidney abscess is possible.

The article demonstrates a method of laparoscopic decapsulation of the kidney in a patient with apostematous pyelonephritis. The clinical data of a 48-year-old female patient who was admitted to the clinic on an emergency basis with a clinical picture of acute purulent epistematous pyelonephritis were analyzed. The patient was prepared for surgical treatment in the amount of laparoscopic decapsulation of the kidney, drainage of the abdominal cavity. The duration of the operation was 50 minutes, blood loss was 50 ml. The insurance drain was removed on the second day after the operation. There were no intraoperative complications of Clavien–Dindo ≥III. The patient was discharged on the 4^th day after the operation in a satisfactory condition under the supervision of a urologist at her place of residence.

The presented clinical case demonstrates the effectiveness and safety of minimally invasive techniques in the surgical treatment of acute purulent pyelonephritis. The presented treatment results correspond to the data of the world literature.

The article presents a review of Russian and international literature on the most common etiological factors of breast cancer development. The causes of cancer are described not only among women, but also among men. The article also describes the aspect of prevention of carcinogenesis.

Acute scrotal hematoma developing due to spontaneous rupture of the spermatic cord caused by varicocele is a relatively rare complication. Its clinical presentation is similar to testicular torsion, appendix testis torsion and malignant tumor which significantly complicates differential diagnosis. Sudden pain, scrotum enlargement, sometimes cyanosis after intraperitoneal pressure increase or intense physical activity and hematoma on the left should alarm a doctor because they can be signs of vein rupture due to varicocele. Anamnesis of varicocele, character of the injury, color Doppler ultrasound can help in differential diagnosis and to avoid unnecessary orchidectomy.

The article presents a review of international literature on a rare complication of varicocele – rupture of the testicular veins.