ABOUT THE NEED TO CREATE PERSONALIZED REHABILITATION PROGRAMS FOR PATIENTS WITH DEMYELINATING PATHOLOGY

Abstract

In most patients with multiple sclerosis there are developed the pelvic dysfunction, which significantly affects their general condition, impairs quality of life and may even lead to autoaggressive tendencies. Erectile dysfunction in multiple sclerosis is one of the manifestations of pelvic disorders, characterized by clinical heterogeneity and polyetiology. In most cases, the pathogenesis of sexual dysfunction in multiple sclerosis is mixed and is an integrative result of focal spinal cord injury and the patient's personal response to the disease, as well as changes in partnerships and social relationships. Erectile dysfunction in multiple sclerosis is characterized by clinical heterogeneity. The opinion is expressed about the need to develop differentiated personalized programs for its correction in patients taking into account different pathogenetic variants. Regional specifics are no less important in establishing such programs. In order to clarify the pathogenetic variants of erectile dysfunction among 33 men from the Western region of Ukraine with remitting type of multiple sclerosis in the post−performance period, a study was conducted, where three such variants were identified. This is a predominantly the disorder of suprasacral regulation of erection, sacral regulation of erection and psychogenic erectile dysfunction. A variant of erectile dysfunction with a predominant impairment of the sacral regulation of erection was defined as prognostically unfavorable. The obtained data are expected to be used in the development of neurorehabilitation personalized programs for patients with demyelinating pathology, taking into account the regional specifics. Key words: demyelinating pathology, multiple sclerosis, remitting course, erectile dysfunction, regional specifics.