Keywords: men with shrapnel and bullet wounds; erectile dysfunction; quality of life; SF-36.

Abstract Erectile dysfunction and the associated quality of life are a pressing social and medical problem for millions of people. The basis of the work was the results of a survey of 298 men injured as a result of combat operations (shrapnel and bullet wounds) using the questionnaires of the International Index of Erectile Function-5 (IIEF-5) and the SF-36 Health Status Survey (SF-36) questionnaire to characterize the quality of life. The research group was divided into two: men aged 20-39 years (group 1) and men aged 40-53 years (group 2). The control group consisted of 48 clinically healthy men without complaints of sexual dysfunction or cardiac, neurological or endocrinological pathology. It is shown that men aged 20-39 years have a mild form of ED where the total score is 19.57 ± 0.44. Men of the 2nd group aged 40-53 years also have a mild form of ED, but the total score is much lower and is 17.74 ± 0.41. Patients of both age groups affected by hostilities suffer from both mental and physical health components. Indicators such as general health, role functioning due to physical condition, and pain intensity have probably lower values compared to the contol group. Lower indicators of role functioning due to physical condition indicate limitations in everyday life due to unsatisfactory physical condition. The decrease in the physical functioning index has statistically significant differences only in patients of the 2nd observed group. Thus, a mild form of erectile dysfunction is observed in men injured as a result of hostilities. No significant differences in the severity of erectile dysfunction were found between male war victims of two age groups. All IIEF-5 domains were significantly reduced in men affected by combat operations. It has been proven that the physical and mental components of health suffer in victims of hostilities. Against the background of a decrease in all indicators on the scales of the physical component of health, general health and role functioning caused by physical condition lag behind the most. In the psychological domain, the most pronounced changes are recorded in such components as mental health, vital activity and social functioning. Сorrelation analysis revealed the significant correlation between physical functioning and role functioning caused by emotional state (r = +0.64; P < 0.05).

Adler, A. B., Dolan, C. A., & Castro, C. A. (2000). US soldier peacekeeping expe-riences and well-being after returning from deployment to Kosovo. Proceeding of the 36th International Applied Military Psychology symposium. Split, Croa-tia. Pp. 30–34.
Araujo, A. B., Durante, R., Feldman, H. A., Goldstein, I., & McKinlay, J. B. (1998). The relatioship beween depression symptoms and male erectile dysfunction: Cross-sectional result from the Massachussets male aging study. Psychosom. Med., 60, 458–465. http://doi.org/10.1097/00006842-199807000-00011
Calzo, J. P., Austin, S. B., Charlton, B. M., Missmer, S. A., Kathrins, M., Gaskins, A. J., & Chavarro, J. E. (2021). Erectile dysfunction in a sample of sexually ac-tive young adult men from a U.S. cohort: Demographic, metabolic and mental health correlates. The Journal of Urology, 205(2), 539–544.
Campolina, A. G., & Ciconelli, R. M. (2008). O SF-36 e o desenvolvimento de novas medidas de avaliação de qualidade de vida [SF-36 and the development of new assessment tools for quality of life]. Acta Reumatologica Portuguesa, 33(2), 127–133 (ЯЗЫК?).
Cappelleri, J. C., Rosen, R. C., Smith, M. D., Mishra, A., & Osterloh, I. H. (1999). Diagnostic evaluation of the erectile function domain of the International index of erectile function. Urology, 54(2), 346–351.
Caspi, A., Sugden, K., Moffitt, T. E., Taylor, A., Craig, I. W., Harrington, H., McClay, J., Mill, J., Martin, J., Braithwaite, A., & Poulton, R. (2004). Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science, 301(5631), 386–389.
Charney, D. S. (2004). Psychobiological mechanisms of resilience and vulnerability: Implications for successful adaptations to extreme stress. Am. J. Psychiatre, 161, 195–216. http://doi.org/10.1176/appi.ajp.161.2.195
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behav. Res. Ther., 308, 319–345. http://doi.org/10.1016/s0005-7967(99)00123-0
Fugl-Meyer, A. R., Lodnert, G., Brenholm, I. B., & Fugl-Meyer, K. S. (1997). On life satisfaction in male erectile dysfunction. Int. J. Impot. Res., 9, 141–148. http://doi.org/10.1038/sj.ijir.3900269
Grover, S. A., Lowensteyn, I., Kaouache, M., Marchand, S., Coupal, L., DeCarolis, E., Zoccoli, J., & Defoy, I. (2006). The prevalence of erectile dysfunction in the primary care setting: Importance of risk factors for diabetes and vascular dis-ease. Archives of Internal Medicine, 166(2), 213–219.
Hackett, G., Kirby, M., Wylie, K., Heald, A., Ossei-Gerning, N., Edwards, D., & Muneer, A. (2018). British society for sexual medicine guidelines on the man-agement of erectile dysfunction in Men-2017. J. Sex. Med., 1, 1–28. http://doi.org/10.1016/j.jsxm.2018.01.023
Halligan, S. L., Michael, T., Clark, D. M., & Ehlers, A. (2003). Posttraumatic stress disorder following assault: The role of cognitive processing, trauma memory, and appraisal. J. Consult. Clin. Psychol., 71, 419–431. http://doi.org/10.1037/0022-006x.71.3.419
Hoge, C. W., Auchterlonie, J. L., & Millice, C. S. (2006). Mental health problems, use of mental health service and attrition from military service after returning from deployment to Iraq or Afghanisnan. JAMA, 295(9), 1023–1032. http://doi.org/10.1001/jama.295.9.1023
Hoge, C. W., Castro, C. A., Messe, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N. Engl J Med., 351(1), 13–22. http://doi.org/10.1056/NEJMoa040603.
Hopman, W. M., & Verner, J. (2003). Quality of life during and after inpatient stroke rehabilitation. Stroke, 34(3), 801–805.
Horpinchenko, I. I., & Vorobets, D. Z. (2010). The relationship of indicators of questionnaires of the international index of erectile function, ED-PZ with health-related quality of life, depending on the severity of erectile dysfunction. Urology, 52, 31–41 (in Ukrainian).
Jelsma, J., Maclean, E., Hughes, J., Tinise, X., & Darder, M. (2005). An investigation into the health-related quality of life of individuals living with HIV who are receiving HAART. AIDS Care, 17(5), 579–588.
Kozopas, N. M., Boykiv, N. D., Dorofeyeva, U. S., Fafula, R. V., Maksymyuk, H. V. (2021). Seminal plasma proinflammatory cytokines and semen quality in overweight and obese men. Rivista Italiana Della Medicina Di Laboratorio, 17(1), 24–30.
Kupelian, V., Shabsigh, R., Araujo, A. B., O'Donnell, A. B., & McKinlay, J. B. (2006). Erectile dysfunction as a predictor of the metabolic syndrome in aging men: Results from the Massachusetts male aging study. The Journal of Urolo-gy, 176(1), 222–226.
Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the United States. Prevalence and predictors. JAMA, 281(6), 537–544.
Lekhan, V. M. (2014). Quality of life of patients with chronic diseases and the disabled: General patterns. Herald of Social Hygiene and Health Care Organiza-tion of Ukraine, 3, 20–24 (in Ukrainian).
Lins, L., & Carvalho, F. M. (2016). SF-36 total score as a single measure of health-related quality of life: Scoping review. SAGE Open Medicine, 4, 2050312116671725.
Lins-Kusterer, L., Valdelamar, J., Aguiar, C. V. N., Menezes, M. S., Netto, E. M., & Brites, C. (2019). Validity and reliability of the 36-item short form health survey questionnaire version 2 among people living with HIV in Brazil. Braz J Infect Dis., 23(3), 13–21. http://doi.org/10.1016/j.bjid.2019.08.001
McWilliams, L. A., Cox, B. J., & Asmundson, G. J. (2005). Symptom structure of posttraumatic stress disorder in a nationally representative sample. J. Anxiety Disord., 19(6), 626–641. http://doi.org/10.1016/j.janxdis.2004.06.003
Melman, A., & Gingell, G. C. (1999). The epidemiology and pathophysiology of erectile dysfunction. J. Urol., 161, 5–11.
Melnyk, O., Vorobets, M., Fafula, R., Kovalenko, I., & Vorobets, Z. (2023). Uroge-nital infection as a factor of development of male infertility. Mikrobiolohichnyi Zhurnal, 85(2), 93–112.
Motl, R. W., McAuley, E., Snook, E. M., & Gliottoni, R. C. (2009). Physical activity and quality of life in multiple sclerosis: Intermediary roles of disability, fatigue, mood, pain, self-efficacy and social support. Psychology, Health and Medicine, 14(1), 111–124.
Ozer, E. J., Lipsey, T. L., & Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychol. Bull., 129, 52–73. http://doi.org/10.1037/0033-2909.129.1.52
Pelle, A. J., Kupper, N., Mols, F., & de Jonge, P. (2013). What is the use? Applica-tion of the short form (SF) questionnaires for the evaluation of treatment effects. Quality of Life Research, 22(6), 1225–1230.
Ritchie & Elspeth Cameron. (2017). Protection of mental health in conditions of war. Kyiv: Our format (2017). In 2 vols. Volume 1, 568 pp., Volume 2, 549 pp. (In Ukrainian). UDALITE ILI OFORMITE PO VSEM PRAVILAM!
Romanenko, Y. M., & Liannoi, O. (2011). Research methodology of the quality of life of surgical patients in the process of physical rehabilitation. Pedagogy, psy-chology and medico-biological problems of physical education and sports: a collection of scientific works / edited by S. S. Yermakova. Kharkiv, 4, 134–137. UDALITE ILI OFORMITE PO VSEM PRAVILAM!
Rosen, R. C., Riley, A., Wagner, G., Osterloh, I. H., Kirkpatrick, J., & Mishra, A. (1997). The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49(6), 822–830.
Salonia, A., Bettocchi, C., Boeri, L., Capogrosso, P., Carvalho, J., Cilesiz, N. C., Cocci, A., Corona, G., Dimitropoulos, K., Gül, M., Hatzichristodoulou, G., Jones, T. H., Kadioglu, A., Martínez Salamanca, J. I., Milenkovic, U., Modgil, V., Russo, G. I., Serefoglu, E. C., Tharakan, T., Verze, P., & Minhas, S. (2021). European association of urology guidelines on sexual and reproductive health-2021 update: Male sexual dysfunction. European Urology, 80(3), 333–357.
Schalock, R. L. (2004). The concept of quality of life: what we know and do not know. Journal of Intellectual Disability Research, 48(3), 203–216.
Shamloul, R., & Ghanem, H. (2013). Erectile dysfunction. Lancet, 381(9861), 153–165.
Sun, P., Cameron, A., Seftel, A., Shabsigh, R., Niederberger, C., & Guay, A. (2006). Erectile dysfunction – an observable marker of diabetes mellitus? A large na-tional epidemiological study. The Journal of Urology, 176(3), 1081–1085.
Thompson, I. M., Tangen, C. M., Goodman, P. J., Probstfield, J. L., Moinpour, C. M., & Coltman, C. A. (2005). Erectile dysfunction and subsequent cardi-ovascular disease. JAMA, 294(23), 2996–3002. http://doi.org/10.1001/jama.294.23.2996
Vorobets, D. Z. (2010). Relationships between the form of erectile dysfunction and health-related quality of life in men aged 20–40 years. Herald of Problems of Вiology and Мedicine, 2, 56–63 (in Ukrainian). UDALITE ILI OFORMITE PO VSEM PRAVILAM
Vorobets, D. Z., & Kodrov, V. I. (2011). Effectiveness of complex treatment of men with various forms of sexual dysfunction. Herald of Scientific Research, 1, 47–52 (in Ukrainian).
Ware Jr., J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473–483.
Watson, P. J., & Shalev, A. (2005). Assessment and treatment of acute traumatic stress. CNS Spectr, 10, 123–131. http://doi.org/10.1017/s1092852900019465
Watts, G. F., Chew, K. K., & Stuckey, B. G. (2007). The erectile-endothelial dys-function nexus: New opportunities for cardiovascular risk prevention. Nature Clinical Practice. Cardiovascular Medicine, 4(5), 263–273.
Yafi, F. A., Jenkins, L., Albersen, M., Corona, G., Isidori, A. M., Goldfarb, S., Maggi, M., Nelson, C. J., Parish, S., Salonia, A., Tan, R., Mulhall, J. P., & Hellstrom, W. J. (2016). Erectile dysfunction. Nature Reviews. Disease Primers, 2, 16003.
Yagensky, A. V., Hofer, S., Sichkaruk, I. M., & Oldridge, N. (2013). Assessment of quality of life in patients with coronary heart disease: Validation results of the Ukrainian version of the MacNew heart disease health-related quality of life questionnaire. Ukrainian Journal of Cardiology, 3, 22–28.