12 research outputs found
HistoScanning techinque for detection of local relapse after high-intensity ultrasound ablation for prostate cancer
Objective. To determine a possible role for HistoScanning technique in surveillance for patients who underwent HIFU-ablation for prostate cancer. Material and methods. Eighty patients who underwent transurethral resection and HIFU-ablation in university clinic with different follow-up duration (range: 36 β 84 months; median β 52 months) were included in this study. All patients underwent prostate specific antigen (PSA) testing, transrectal ultrasound examination and HistoScanning of residual prostatic tissue during follow-up. Results. Overall, 72 patients of 80 had suspicious lesions on HistoScanning during post-HIFU surveillance. Eleven patients had VHS value, which is the sum of volume of suspicious lesions, exceeding 1 cm3; 10 patients experienced biochemical relapse by Stuttgart definition (90.9%). Significant predictors of biochemical relapse were PSA nadir over 1.0 ng/ml (hazard ratio [HR]: 3.1; confidence interval [CI]: 1.7 β 3.5) and VHS / Vres. ratio over 0.5 (HR: 4.9; CI: 3.9 β 5.5). Ten patients reached VHS / Vres. threshold value (> 0.5) β₯ 3 months before meeting criteria for Stuttgart biochemical failure. Conclusion. HistoScanning may prove useful for surveillance for patients who underwent HIFU-ablation for prostate cancer, but it still requires further standardization and validation in this setting.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. Π£ΡΡΠ°Π½ΠΎΠ²ΠΈΡΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΡΡ ΡΠΎΠ»Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠΈ HistoScanning Π² Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΈ Π·Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌΠΈ, ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΠΌΠΈ HIFU-Π°Π±Π»Π°ΡΠΈΡ ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρ ΡΠ°ΠΊΠ° ΠΏΡΠΎΡΡΠ°ΡΡ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΎΡΠ»ΠΈ 80 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΊΠΎΡΠΎΡΡΠΌ Π² ΠΊΠ»ΠΈΠ½ΠΈΠΊΠ΅ ΡΡΠΎΠ»ΠΎΠ³ΠΈΠΈ Π‘ΠΠΠ£ Π² ΡΠ°Π·Π½ΡΠ΅ ΡΡΠΎΠΊΠΈ (Π΄ΠΈΠ°ΠΏΠ°Π·ΠΎΠ½: 36 β 84 ΠΌΠ΅ΡΡΡΠ΅Π²; ΠΌΠ΅Π΄ΠΈΠ°Π½Π° β 52 ΠΌΠ΅ΡΡΡΠ°) Π±ΡΠ»Π° Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π° ΡΡΠ°Π½ΡΡΡΠ΅ΡΡΠ°Π»ΡΠ½Π°Ρ ΡΠ΅Π·Π΅ΠΊΡΠΈΡ ΠΈ HIFU-Π°Π±Π»Π°ΡΠΈΡ. ΠΡΠ΅ΠΌ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ Π² Ρ
ΠΎΠ΄Π΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ Π²ΡΠΏΠΎΠ»Π½ΡΠ»ΡΡ Π°Π½Π°Π»ΠΈΠ· ΠΊΡΠΎΠ²ΠΈ Π½Π° ΠΏΡΠΎΡΡΠ°Ρ-ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½ΡΠΈΠ³Π΅Π½ (PSA), ΡΡΠ°Π½ΡΡΠ΅ΠΊΡΠ°Π»ΡΠ½ΠΎΠ΅ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΈ Π³ΠΈΡΡΠΎΡΠΊΠ°Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ΅Π·ΠΈΠ΄ΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ. ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π£ 72 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΈΠ· 80 Π±ΡΠ»ΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Ρ ΠΏΠΎΠ΄ΠΎΠ·ΡΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΠΎΡΠ°Π³ΠΈ ΠΏΡΠΈ Π³ΠΈΡΡΠΎΡΠΊΠ°Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ Π½Π° ΠΏΡΠΎΡΡΠΆΠ΅Π½ΠΈΠΈ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ. Π£ 11 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ VHS, Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΡΡΠΈΠΉ ΡΡΠΌΠΌΠ°ΡΠ½ΡΠΉ ΠΎΠ±ΡΡΠΌ ΠΏΠΎΠ΄ΠΎΠ·ΡΠΈΡΠ΅Π»ΡΠ½ΡΡ
ΠΎΡΠ°Π³ΠΎΠ², Π΄ΠΎΡΡΠΈΠ³Π°Π» Π±ΠΎΠ»Π΅Π΅ 1 ΡΠΌ3; Ρ 10 ΠΈΠ· Π½ΠΈΡ
Π±ΡΠ» Π·Π°ΡΠΈΠΊΡΠΈΡΠΎΠ²Π°Π½ Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ΅ΡΠΈΠ΄ΠΈΠ² ΠΏΠΎ Stuttgart (90.9%). ΠΠ½Π°ΡΠΈΠΌΡΠΌΠΈ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠ°ΠΌΠΈ Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π° ΡΠ²Π»ΡΠ»ΠΈΡΡ Π½Π°Π΄ΠΈΡ PSA Π±ΠΎΠ»Π΅Π΅ 1.0 Π½Π³/ΠΌΠ» (ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠ΅ ΡΠΈΡΠΊΠΎΠ² [ΠΎΡ]: 3.1; Π΄ΠΎΠ²Π΅ΡΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΠΈΠ½ΡΠ΅ΡΠ²Π°Π» [ΠΠ]: 1.7 β 3.5) ΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ VHS/VΡΠ΅Π·. Π±ΠΎΠ»Π΅Π΅ 0.5 (ΠΎΡ: 4.9; ΠΠ: 3.9 β 5.5). Π£ 10 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΏΠΎΡΠΎΠ³ΠΎΠ²ΠΎΠ³ΠΎ Π·Π½Π°ΡΠ΅Π½ΠΈΡ VHS/VΡΠ΅Π·. (> 0.5) ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²ΠΎΠ²Π°Π»ΠΎ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Ρ Π½Π° β₯ 3 ΠΌΠ΅ΡΡΡΠ°. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. HistoScanning ΠΌΠΎΠΆΠ΅Ρ ΠΎΠΊΠ°Π·Π°ΡΡΡΡ ΠΏΠΎΠ»Π΅Π·Π½ΡΠΌ ΠΏΡΠΈ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΈ Π·Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌΠΈ ΠΏΠΎΡΠ»Π΅ HIFU-Π°Π±Π»Π°ΡΠΈΠΈ ΠΏΡΠΈ ΡΠ°ΠΊΠ΅ ΠΏΡΠΎΡΡΠ°ΡΡ, Π½ΠΎ ΡΡΠ΅Π±ΡΠ΅Ρ Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠ΅ΠΉ ΡΡΠ°Π½Π΄Π°ΡΡΠΈΠ·Π°ΡΠΈΠΈ ΠΈ Π²Π°Π»ΠΈΠ΄Π°ΡΠΈΠΈ
Role of salvage radical prostatectomy, cryoablation and HIFU-ablation in management of patients with prostate cancer recurrence after radiation therapy
Several options for salvage treatment of radiation-recurrent prostate cancer exist. The main option is a salvage radical prostatectomy, which offers optimal cancer control and allows to perform specimen pathology, but it is technically challenging and poses increased risk for certain complications. Alternative modalities of salvage therapy are HIFU-ablation and cryoablation. This review covers the role for those methods, their oncological efficacy and morbidity.Π‘ΡΡΠ΅ΡΡΠ²ΡΠ΅Ρ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΎ Π²Π°ΡΠΈΠ°Π½ΡΠΎΠ² ΡΠ°Π»ΡΠ²Π°ΠΆΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΏΡΠΈ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π°Ρ
ΡΠ°ΠΊΠ° ΠΏΡΠΎΡΡΠ°ΡΡ ΠΏΠΎΡΠ»Π΅ Π»ΡΡΠ΅Π²ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΡΠ½ΠΎΠ²Π½ΡΠΌ Π²Π°ΡΠΈΠ°Π½ΡΠΎΠΌ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ°Π»ΡΠ²Π°ΠΆΠ½Π°Ρ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½Π°Ρ ΠΏΡΠΎΡΡΠ°ΡΡΠΊΡΠΎΠΌΠΈΡ, ΠΊΠΎΡΠΎΡΠ°Ρ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ²Π°Π΅Ρ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΡΠΉ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΠΈ Π΄Π°ΡΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΡΠ°Π΄ΠΈΡΠΎΠ²Π°Π½ΠΈΡ, Π½ΠΎ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ΅Ρ
Π½ΠΈΡΠ΅ΡΠΊΠΈ ΡΡΡΠ΄Π½ΠΎΠΉ ΠΈ Π³ΡΠΎΠ·ΠΈΡ ΡΡΠ΄ΠΎΠΌ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ. Π°Π»ΡΡΠ΅ΡΠ½Π°ΡΠΈΠ²Π½ΡΠΌΠΈ Π²Π°ΡΠΈΠ°Π½ΡΠ°ΠΌΠΈ ΡΠ°Π»ΡΠ²Π°ΠΆΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΠ²Π»ΡΡΡΡΡ HIFU-Π°Π±Π»Π°ΡΠΈΡ ΠΈ ΠΊΡΠΈΠΎΠ°Π±Π»Π°ΡΠΈΡ. Π ΠΎΠ±Π·ΠΎΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π° ΡΠΎΠ»Ρ ΠΊΠ°ΠΆΠ΄ΠΎΠ³ΠΎ ΠΈΠ· ΡΡΠΈΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ², ΠΈΡ
ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΈ ΡΠ°ΡΡΠΎΡΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ
Difficulties in differential diagnosis between obstructive and non-obstructive azoospermia
Introduction. The difference between obstructive and non-obstructive azoospermia (OA and NOA) is important for the choice of treatment tactics and adequate counseling of a married couple.Objective. To describe, analyze, and classify possible challenges in differentiating between two types of azoospermiaMaterials and methods. The retrospective review of database on surgical sperm retrieval attempts performed our hospital (n = 754). A subpopulation of 216 patients who were preliminary diagnosed with OA, was selected for further analysis. All patients had testicular pathology data following sperm retrieval attempt. Rate of reclassification was assessed as a primary outcome. Reclassified cases were further analyzed to find a possible reason for incorrect differential diagnosis.Results. Among 216 patients with initially suspected OA, 131 (60.6%) had evidence of spermatogenic dysfunction on pathological examination of seminiferous tubules. Multivariate regression analysis showed that only regular exposure to high temperatures was an independent predictor of NOA detection in patients with normal endocrine and clinical parameters (OR = 1.989; 95% CI = 1.101 β 3.595). Analysis of the decision tree showed that patients with inhibin B levels below 93 pg/ml had the highest risk of an incorrect initial diagnosis (82.6%).Conclusions. Differential diagnosis of OA and NOA is not such a simple task. Any case of azoospermia against the background of normal semen volume by default should be considered as a case of NOA if there is no anamnestic or clinical data clearly indicating obstruction. Regular exposure to high temperature is likely to cause azoospermia in men with initially severe disorders of spermatogenesis. Finally, the reference values of inhibin B offered by most laboratories are not intended to assess reproductive function
Lipidomic profile of seminal plasma in non-obstructive azoospermia with sperm maturation arrest
Introduction. The difference between obstructive and non-obstructive azoospermia with sperm maturation arrest is important for the choice of treatment tactics and adequate counseling of a married couple.Purpose of the study. The study aimed to assess the semen lipid profile in patients with sperm maturation arrest. Materials and methods. Samples of seminal plasma for lipid composition of 24 men with normozoospermia and 64 men with azoospermia were studied. Patients with azoospermia underwent microdissection testicular biopsy followed by the detection of testicular tissue pathology. Lipid extracts were analyzed by liquid chromatography with mass spectrometry. Lipid data were compared with the results of pathomorphological studies.Results. Comparison of two groups revealed a statistically significant concentration differences for 22 lipids detected in positive-ion mode and 11 lipids detected in negative-ion mode. Those lipids mainly belong to the classes hexosylceramides, sphingomyelins and phosphatidylcholines β simple ethers and oxidized lipids. In multivariate analysis, the following lipids were found to be statistically significant predictors of sperm maturation arrest: PC 16: 0_22: 6 lipid (Ξ²-coefficient: -0.73; 95% confidence interval (95% CI): -1.42 to -0.27; odds ratio (OR): 0.48; OR CI: 0.24 to 0.76; Wald's test: -2.58; p = 0.01), SM d20: 1/22:2 lipid (Ξ²-coefficient 4.96; 95% CI 2.29 to 9.13; OR: 142.31; OR CI: 9.90 to 9.22^103; Wald's test: 2.93; p = 0.003); PG 20:3_22: 6 lipid (Ξ²-coefficient 2.52; 95% CI 1.13 to 4.49; OR: 12.37; OR CI: 3.10 to 89.27; Wald's test: 3.02; p = 0.002); PC O- 16: 1/16:0 lipid (Ξ²-coefficient 1.96; 95% CI -4.12 to 0.27; OR: 0.14; OR CI: 0.02 to 0.76; Wald's test: -2.05; p = 0.04). The prediction model characteristics of sperm maturation arrest, obtained during cross-validation in the positiveion mode composed: sensitivity 91%, specificity 85%; in negative-ion mode: sensitivity 75%; specificity 81%.Conclusions. Even though early stages of spermatogenesis are equally preserved in both fertile men and men with homogeneous sperm maturation arrest, the semen in the studied group of patients differed in its lipid profile. Patients with non-obstructive azoospermia, associated with meiosis arrest, may have unique lipidomic characteristics of seminal plasma, which in the future will make it possible to differentiate various variants of severe male infertility using non-invasive methods
Surgical correction of urinary incontinence associated with orgasm (climacturia) using a compression graft (clinical cases)
Climacturia is a rarely discussed functional complication of radical prostatectomy. Various methods of medical and surgical treatment of climacturia have been described. In this article we present two clinical cases of successful surgical treatment of climacturia which involved three-piece penile prosthesis implantation and placement of compression graft made of porcine dermal collagen on urethra
POWER DOPPLER IMAGING IN PATIENTS WITH SUSPECTED PROSTATE CANCER
Abstract. This study was aimed to evaluate the role of power Doppler imaging in diagnosis of prostate cancer and prediction of its aggressiveness. This study included 118 patients with prostate cancer suspected due to elevation of prostate specific antigen (PSA) values to > 4.0 ng/ml. All patients underwent transrectal prostate biopsy with ultrasound guidance for histological verification. Prostate was scanned in power Doppler mode and one of vascularization patterns was assigned, as described by Zhao et al. Power Doppler imaging results and biopsy results were compared. Forty eight patients had normal results of power Doppler imaging. Fifty five patients had focal enhancement of blood flow, which allowed to perform a targeted biopsy of suspected lesion. Fifteen patients had diffusely enhanced blood flow. Sensitivity of power Doppler imaging was 82.4%, specificity was 70.5%, positive and negative predictive values were 66.7% and 72.3% correspondingly. Overall accuracy for prostate cancer detection was 81.1%. Association between observed vascular patterns and Gleason score, tumor dissemination and PSA level was detected. Power Doppler imaging allows efficient detection, staging and prediction of aggressiveness of prostate cancer, when compared to standard transrectal ultrasound imaging
New approaches to management of erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia
This paper addresses the background of phosphodiesterase-5 inhibitors use in erectile dysfunction and lower urinary tract symptoms, as well as a special position which is held by tadalafil as an only drug from its class suitable for daily intake. Tadalafil pharmacodynamics and hypotheses concerning its mechanism of action on prostatic tissue are discussed. Special attention is paid to drugΒ»s efficacy and safety in elderly men, who often require therapy for benign prostatic hyperplasia with lower urinary tract symptoms. It is mentioned that tadalafil may be used in penile rehabilitation programs in men who underwent radical prostatectomy
The use of tadalafil on demand in specific categories of patients
Patients with erectile dysfunction require special approach. Any therapy should be prescribed with patientβs individual features, comorbidities and concominant medication in mind. Considering good efficacy and safety profile of tadalafil, together with appearance of its generic forms on the market, making such treatment more accessible for our patients, soon it may become the most commonly prescribed drug from phosphodiesterase-5 inhibitors class. Therefore, evidence on its use in special groups of men with specific anamnestic features should be systematized. In this article we discuss the use of 20 mg tadalafil on demand in specific categories of patients suffering from erectile dysfunction: in men with metabolic syndrome, benign prostate diseases, neurological conditions and, finally, in men who express wish to become fathers
Assessment of influence of βBESTFertilβ supplement on semen analysis parameters, oxidative stress markers and sperm DNA fragmentation index in infertile males
Background. Idiopathic male infertility remains an important problem in andrology and reproduction, despite steady advances in diagnostics and treatment of conditions associated with impaired fertility in men. Only available option of conservative treatment for idiopathic male infertility is an empiric antioxidant therapy.Materials and methods. Fifty five men from infertile couples without any identifiable cause of male infertility who received βBESTFertilβ supplement were enrolled in this study. Semen analysis parameters (sperm density, percentage of sperm with progressive motility (categories A and B), sperm morphology, leukocyte concentration), MAR-test results, reactive oxygen species concentration as measured by chemiluminescence assay and sperm DNA fragmentation index evaluated using TUNEL method were registered and compared with baseline values after 90 days of treatment. Patient compliance was assessed by a number of capsules taken throughout the study period.Results. There was a significant difference in percentage of sperm with normal morphological features (median 2 % vs 4 %; p <0.001) and in percentage of A + B motile sperm (medium 31.2 % vs 41.15 %; p <0.001). Also, a statistically significant decrease in sperm DNA fragmentation index (median 17.8 % vs 15 %; p <0.001) and reactive oxygen species concentration in seminal plasma (median 0.7 mV/s vs 0.5 mV/s; p = 0.002). Forty-three (78.2 %) patients were fully compliant, 11 (20 %) patients had compliance over 90 %, and 1 patient was 89 % compliant. No treatment-related adverse events were observed.Conclusion. βBESTFertilβsupplement may be used in empiric therapy of idiopathic male infertility and has a good safety profile. Separate intake of morning and evening supplement doses increases efficacy of multicomponent antioxidant therapy by preventing possible interaction between biochemically incompatible components. Treatment with βBESTFertilβsupplement leads to a decrease in reactive oxygen species seminal concentration and sperm DNA fragmentation index
Sperm oxidative stress: clinical significance and management
Oxidative stress is one of the leading causes of sperm dysfunction. Excessive amounts of reactive oxygen species can damage sperm membranes and disrupt their DNA integrity, which affects not only the likelihood of getting pregnant naturally, but also the clinical outcomes of assisted reproductive technologies and the risk of miscarriage. Sperm cells are extremely vulnerable to oxidative stress, given the limited functional reserve of their antioxidant systems and the DNA repair apparatus. Lifestyle factors, most of which are modifiable, often trigger generation of reactive oxygen species.Β Both the lifestyle modification and use of antioxidant dietary supplements are adequate and compatible ways to combat male oxidative stress-associated infertility. The search for other internal and external sources of reactive oxygen species, the identification of the etiology of oxidative stress and treatment of respective diseases are necessary for the successful regulation of redox processes in the male reproductive system in clinical practice, which is required not only to overcome infertility, but also to prevent induced epigenetic disorders in subsequent generations. The article presents the analysis of the molecular mechanisms of male idiopathic infertility. The authors provide an overview of how to prevent oxidative stress as one of the causes of subfebrile fever. The article provides an overview of modern therapeutics, as well as the options for eliminating the consequences of the effect of reactive oxygen species on spermatogenesis and male reproductive system in general