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<article article-type="review-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">urovest</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник урологии</journal-title><trans-title-group xml:lang="en"><trans-title>Urology Herald</trans-title></trans-title-group></journal-title-group><issn pub-type="epub">2308-6424</issn><publisher><publisher-name>Rostov State Medical University</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21886/2308-6424-2023-11-3-87-97</article-id><article-id custom-type="elpub" pub-id-type="custom">urovest-759</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS ARTICLE</subject></subj-group></article-categories><title-group><article-title>Физиотерапевтические подходы к лечению эректильной дисфункции: общие принципы и оценка эффективности применяемых систем</article-title><trans-title-group xml:lang="en"><trans-title>Physiotherapeutic approaches for the erectile dysfunction management: basic principles and an efficacy evaluation of the current technologies</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8811-8844</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Андросов</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Androsov</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Александр Александрович Андросов — студент Института клинической медицины им. Н.В. Склифосовского</p><p>Москва</p></bio><bio xml:lang="en"><p>Alexander A. Androsov — Student, Sklifosovsky Institute for Clinical Medicine</p><p>Moscow</p></bio><email xlink:type="simple">alexander.a.androsov@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-5842-0782</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чувалов</surname><given-names>Л. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Chuvalov</surname><given-names>L. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Леонид Леонидович Чувалов — врач-уролог лечебно-диагностического отделения № 4, ассистент Института урологии и репродуктивного здоровья человека</p><p>Москва</p></bio><bio xml:lang="en"><p>Leonid L. Chuvalov — Urologist, Medical and Diagnostic Division No. 4; Assist. of Institute for Urology and Reproductive Health</p><p>Moscow</p></bio><email xlink:type="simple">chuvalovleo386@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4369-173X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тараткин</surname><given-names>М. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Taratkin</surname><given-names>M. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Марк Сергеевич Тараткин — врач-уролог; научный сотрудник Института урологии и репродуктивного здоровья человека</p><p>Москва</p></bio><bio xml:lang="en"><p>Mark S. Taratkin — M.D.; Urologist, Researcher, Institute for Urology and Reproductive Health</p><p>Moscow</p></bio><email xlink:type="simple">marktaratkin@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8861-8187</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Королев</surname><given-names>Д. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Korolev</surname><given-names>D. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дмитрий Олегович Королев — канд. мед. наук; врач-уролог урологического отделения № 2, старший научный сотрудник, ассистент Института урологии и репродуктивного здоровья человека</p><p>Москва</p></bio><bio xml:lang="en"><p>Dmitry O. Korolev — M.D., Cand.Sc.(Med); Urologist, Urological Division No. 2, Senior Researcher, Assistant, Institute for Urology and Reproductive Health</p><p>Moscow</p></bio><email xlink:type="simple">korolevdmitryo@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-9621-7253</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Горобец</surname><given-names>Ю. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Gorobets</surname><given-names>Yu. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Юрий Павлович Горобец — аспирант кафедры урологии; врач-уролог поликлиники № 1</p><p>Москва</p><p>Ногинск</p></bio><bio xml:lang="en"><p>Yuri P. Gorobets — M.D.; Postgrad. Student, Department of Urology; Urologist</p><p>Moscow</p><p>Noginsk</p></bio><email xlink:type="simple">gorobets9@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7787-1240</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рапопорт</surname><given-names>Л. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Rapoport</surname><given-names>L. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Леонид Михайлович Рапопорт — д-р мед. наук, профессор; директор клиники урологии Института урологии и репродуктивного здоровья человека</p><p>Москва</p></bio><bio xml:lang="en"><p>Leonid M. Rapoport — M.D., Dr.Sc.(Med), Full Prof.; Headmaster, Urology Clinic of Institute for Urology and Reproductive Health</p><p>Moscow</p></bio><email xlink:type="simple">urologystatement9@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7169-2209</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Еникеев</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Enikeev</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дмитрий Викторович Еникеев — д-р мед. наук, профессор; профессор Института урологии и репродуктивного здоровья человека; Доцент кафедры урологии; доцент </p><p>Москва</p><p>Вена</p></bio><bio xml:lang="en"><p>Dmitry V. Enikeev — M.D., Dr.Sc.(Med), Full Prof.; Prof., Institute for Urology and Reproductive Health; Adjunct Prof., Dept. of Urology and Comprehensive Cancer Centre; Adjunct Prof.</p><p>Moscow</p><p>Vienna, Austria</p></bio><email xlink:type="simple">dvenikeev@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цариченко</surname><given-names>Д. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsarichenko</surname><given-names>D. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>Dmitry G. Tsarichenko — M.D., Dr.Sc.(Med), Full Prof.; Urologist, Urological Division No. 1, Institute for Urology and Reproductive Health</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3007-1315</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Еникеев</surname><given-names>М. Э.</given-names></name><name name-style="western" xml:lang="en"><surname>Enikeev</surname><given-names>M. E. </given-names></name></name-alternatives><bio xml:lang="ru"><p>Михаил Эликович Еникеев — д-р мед. наук, профессор; заведующий урологическим отделением № 2 Института урологии и репродуктивного здоровья человека</p><p>Москва</p></bio><bio xml:lang="en"><p>Mikhail E. Enikeev — M.D., Dr.Sc.(Med), Full Prof.; Head, Urological Division No. 2, Institute for Urology and Reproductive Health</p><p>Moscow</p></bio><email xlink:type="simple">urologystatement9@yandex.kz</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Первый Московский государственный медицинский университет им. И. М. Сеченова (Сеченовский университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Московский государственный медико-стоматологический университет им. А. И. Евдокимова; Ногинская областная больница</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Yevdokimov Moscow State University of Medicine and Dentistry; Noginsk Regional Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Первый Московский государственный медицинский университет им. И. М. Сеченова (Сеченовский университет); Венский медицинский университет; Университет здравоохранения им. Карла Ландштейнера — Институт урологии и андрологии</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University (Sechenov University); Medical University of Vienna; Karl Landsteiner University of Health Sciences — Institute of Urology and Andrology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>05</day><month>10</month><year>2023</year></pub-date><volume>11</volume><issue>3</issue><fpage>87</fpage><lpage>97</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Андросов А.А., Чувалов Л.Л., Тараткин М.С., Королев Д.О., Горобец Ю.П., Рапопорт Л.М., Еникеев Д.В., Цариченко Д.Г., Еникеев М.Э., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Андросов А.А., Чувалов Л.Л., Тараткин М.С., Королев Д.О., Горобец Ю.П., Рапопорт Л.М., Еникеев Д.В., Цариченко Д.Г., Еникеев М.Э.</copyright-holder><copyright-holder xml:lang="en">Androsov A.A., Chuvalov L.L., Taratkin M.S., Korolev D.O., Gorobets Y.P., Rapoport L.M., Enikeev D.V., Tsarichenko D.G., Enikeev M.E.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.urovest.ru/jour/article/view/759">https://www.urovest.ru/jour/article/view/759</self-uri><abstract><p>Физиотерапия — способ лечения широкого спектра заболеваний различных органов и систем, эффективность и целесообразность которого является предметом больших дискуссий научного сообщества на протяжении последних нескольких десятков лет. В урологии этот метод используется, в том числе при лечении пациентов с эректильной дисфункцией (ЭД), вызванной нарушением трофики тканей наружных половых органов вследствие перенесённой радикальной простатэктомии, атеросклероза, сахарного диабета, болезни Пейрони. Одним из широко распространённых эффективных и перспективных физиотерапевтических методов лечения васкулогенной ЭД является ударно-волновая терапия, основанная на дистанционном действии сфокусированной акустической волны малой интенсивности. Установлено также, что основные эффекты ударных волн, создаваемых прибором, запускают процессы неоангиогенеза и регенерации нервных волокон, замедляют фиброзную перестройку кавернозных тел и снижают симпатическое влияние на кавернозные мышцы. Некоторые системы (например, радиоволновые) в дополнение к вышеперечисленным эффектам оказывают согревающее действие, что ускоряет метаболизм и улучшает регенеративные процессы в тканях. Все применяемые на сегодняшний день ударно-волновые и радиоволновые системы демонстрируют свою эффективность при сопоставлении с sham-контролем, однако в немногочисленных сравнительных исследованиях никакой значимой разницы в эффективности между разными подходами не обнаружено. Клинические рекомендации рассматривают физиотерапию только в качестве альтернативного способа лечения пациентов с васкулогенной ЭД лёгкой степени тяжести, резистентных к пероральной вазоактивной терапии или неприемлющ004.8:616.61-006.6их приём этих препаратов. Тем не менее некоторые исследования позволяют судить об эффективности лечения этим способом пациентов с любой этиологией состояния, при этом результат лечения не зависит от количества курсов лечения, их длительности, количества импульсов за курс и периодичности сеансов терапии. Эти факторы вкупе с некоторыми недостатками оригинальных исследований (например, большой процент выхода пациентов из наблюдения) ставят под сомнение органотропность физиотерапии, вследствие чего требуются дополнительные сравнительные исследования, направленные на определение оптимального режима дозирования и изучение доли влияния органотропного и психологического компонентов физиотерапии на итоговые результаты лечения. Настоящее исследование направлено на обобщение имеющихся на настоящий момент данных, оценивающих результативность существующих видов физиотерапии, сравнение эффективности разных технологий при лечении пациентов с ЭД.</p></abstract><trans-abstract xml:lang="en"><p>Physiotherapy is a treatment method for a wide range of diseases of various organs and systems. Its efficacy and practicability are of the great discussions during the past few decades. In urology, this method is used for treatment of erectile dysfunction (ED) caused by a violation of the trophism of genitalia due to radical prostatectomy, atherosclerosis, diabetes mellitus, Peyronie's disease. Shock wave therapy based on the remote action of a low-intensity focused acoustic wave is one of the widely used effective physiotherapeutic methods for the treatment of vasculogenic ED. The main effects of shock waves are neoangiogenesis, nerve fibers regeneration, deceleration of the cavernous fibrosis and reduction of the sympathetic outflow. Some technologies (e.g. radio waves) in addition to those effects also warm the tissues, what accelerates metabolism and improves regenerative processes. All shockwave and radiowave technologies have already demonstrated their efficacy compared with sham control. However, in the few comparative studies, no significant difference was found in efficacy between different technologies. Clinical guidelines consider physiotherapy only as an alternative treatment for patients with mild vasculogenic ED who are refractory or unresponsive to oral vasoactive therapy. Nevertheless, some studies make it possible to judge the efficacy of physiotherapy for treatment of patients with either etiology of the ED. The result of the ED treatment does not depend on the number of treatment courses, their duration, the number of pulses per course and the periodicity of therapy sessions. Also, the original studies have some major shortcomings (i.e. a large percentage of patients dropping out of follow-up). These factors cast doubt on the organotropism of physiotherapy. So, additional comparative studies are required to determine the optimal dosing regimen and to explore the influence of physiotherapy organotropic and psychological components on the results of the treatment. The study aimed to summarize the currently available data evaluating the efficacy of different physiotherapeutic technologies, to compare the efficacy of different technologies for ED treatment.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>эректильная дисфункция</kwd><kwd>физиотерапия</kwd><kwd>ударно-волновая терапия</kwd><kwd>радиоволновая терапия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>erectile dysfunction</kwd><kwd>physical therapy modalities</kwd><kwd>radiowave therapy</kwd><kwd>low-intensity extracorporeal shock wave therapy</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Salonia A, Bettocchi C, Capogrosso P, Carvalho J, Corona G, Hatzichristodoulou G, Jones TH, Kadioglu A, Martinez-Salamanca JI, Minhas S, Serefoglu EC, Verze P. Sexual and Reproductive Health. EAU Guidelines. Edn. presented at the EAU Annual Congress Milan 2023. 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