The relationship between Coronavirus Disease-19 (COVID-19) and ischemic priapism: a case-control study
Khaled Almekaty1, Ahmed E Taha2, Maged Ragab1
1Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Insights
Coronavirus Disease-19 (COVID-19) is coincident with ischemic priapism, not causal. COVID-19 did not impact priapism management or erectile dysfunction outcomes in this study.
Area of Science:
- Urology
- Infectious Diseases
- Andrology
Background:
- Ischemic priapism is a urological emergency.
- The association between COVID-19 and priapism has been reported.
- The causal relationship and impact on outcomes require further investigation.
Purpose of the Study:
- To assess the relationship between COVID-19 and ischemic priapism.
- To evaluate the influence of COVID-19 on priapism management and erectile dysfunction.
Main Methods:
- Multicentre retrospective study of 43 ischemic priapism patients.
- Patients divided into two groups: priapism only and priapism with COVID-19.
- COVID-19 severity sub-classification and follow-up for erectile dysfunction.
Main Results:
- No significant difference in age, management, recurrence, or erectile dysfunction severity between groups.
- Cavernosal aspiration success rates were high in both groups (83.3% vs. 92.3%).
- Longer priapism duration correlated with severe erectile dysfunction (19 vs. 7 hours).
Conclusions:
- Ischemic priapism can occur in mild, severe, or asymptomatic COVID-19 cases.
- COVID-19 does not appear to influence ischemic priapism treatment or erectile function outcomes.
- The relationship between COVID-19 and ischemic priapism appears coincidental rather than causal.
Abstract:
This multicentre retrospective study was conducted in 3 university hospitals in Egypt between April 2020 and June 2022. The aim was to assess the relation between Coronavirus Disease-19 (COVID-19) and ischemic priapism. Forty-three ischemic priapism patients were diagnosed and divided into two groups (30 in group I with ischemic priapism only, and 13 in group II with both ischemic priapism and COVID-19). Further sub-classification of COVID-19 patients according to the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection severity was done. Cavernosal aspiration was successful in 25 patients (83.3%) in group I and 12 (92.3%) in group II. Long term follow-up proved moderate to severe erectile dysfunction in 6 patients (20.0%) and 1 (7.7%) in group I and II, respectively. All those with severe erectile dysfunction were managed by distal shunt and prepared for penile prosthesis placement. The median duration of ischemic priapism was significantly longer in patients with severe erectile dysfunction [19 vs. 7 h, P = 0.01]. There was no statistically significant difference between both groups regarding patients' age (p = 0.8), required priapism management (p = 0.4), priapism recurrence (p = 0.1), and erectile dysfunction severity (p = 0.5). Ischemic priapism in COVID-19 patients can occur not only in severe, but also in mild or even asymptomatic cases. COVID-19 did not influence the ischemic priapism treatment protocol and post-treatment erectile function. COVID-19 and ischemic priapism seem to have a coincidence relation rather than a causal.
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