Abstract

Introduction. Modern studies indicate a close relationship between the deterioration of the quality of the ejaculate and the increase in the symptoms of the lower urinary tract (LUTS) with the increase in the age of the man. Taking into account the common pathogenesis of reproductive dysfunction, LUTS and the development of possible preventive measures, we conducted an independent study.The study objective was to evaluate the effectiveness of the combined dietary supplement Rotaprost to improve the functional state of the male genitourinary system.Materials and methods. The study included 30 patients with clinical and laboratory signs of infertility and LUTS aged 23–65 years (mean age 44.91 ± 4.5). Patients were divided into two groups of 15 patients. Group 1 with chronic pelvic pain syndrome (CPPS) of IIIb category (US National Institutes of Health, 1995) with secretory type of infertility and LUTS, group 2 of 15 patients with stage 1 benign prostatic hyperplasia (BPH), pathozoospermia and LUTS. During the study, clinical and laboratory parameters were registered, NIH-CPSI, IPSS-QoL, IIEF-5, NRS questionnaires were used, spermogram data, MAR test, oxidative stress, DNA fragmentation, and electron microscopy of spermatozoa were evaluated. All patients before and after treatment underwent triplex ultrasound of the scrotum and transrectal ultrasound of the prostate. Expert-class devices E-CUBE 15 (Alpinion) were used. Patients included in the design of the study took Rotaprost capsules No. 30, 1–2 times a day for 30 days at the place with meals, drinking a small amount of water. After the course of treatment, patients were examined again.Results. The results of the study showed a more significant effect on the parameter of progressive mobility after treatment in the group with CPPS IIIb (group 1) by 23.5 % compared to the BPH group, where the total increase was 10.7 %. Also, an interesting finding was the trend towards a decrease in the number of leukocytes in the semen while taking Rotaprost in patients with CPPS IIIb (from 1.22 million/ml to 0.43 million/ml) compared with the BPH group, where changes are less significant (from 0.68 million/ml to 0.36 million/ml). Comparing the level of reactive oxygen species in the ejaculate and assessing the DNA fragmentation of spermatozoa revealed a statistically significant decrease during treatment in both groups, reducing the amount of residual urine. The drug had a significant effect on the level of pain, assessed by the NRS scale and improved the quality of life, including IPSS-QoL and NIH-CPSI data. Conclusions. Rotaprost mineral-herbal complex allows to correct moderate pathozoospermia and indicators of impaired urination in the vast majority of patients with CPPS IIIb and men with stage 1 BPH.The use of the Rotaprost mineral-herbal complex for a month leads to an improvement in the quality of life of patients with CPPS IIIb, reducing their pain by 25 %, restoring the quality of urination, and reduce the prostate volume of men with stage 1 BPH.High safety and adherence to therapy in the studied groups of patients is explained by the general pathogenetic mechanisms of the development of these diseases in men over 40 years of age and the possibility of a complex effect on the key pathophysiological cellular mechanisms of age-related changes in the genitourinary system of men by multifactorial components of modern dietary supplements.

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