On May 7, US researchers published a paper in the World Journal of Men’s Health titled “COVID-19 Endothelial Dysfunction Can Cause Erectile Dysfunction: Histopathological, Immunohistochemical, and Ultrastructural Study of the Human Penis”, in which they demonstrated for the first time that Covid-19 could be present in the tissue of a human penis long after men recover from the infection. They discussed how it can lead to erectile dysfunction.
Ranjith Ramasamy, Eliyahu Kresch, Kajal Khodamoradi and Russell Saltzman et al. Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA and other institutes noted that coronavirus infection could result in widespread blood vessel dysfunction or endothelial dysfunction that can lead to or contribute to erectile dysfunction.
Endothelial dysfunction can be defined as a condition in which the linings of small blood vessels fail to perform its functions normally. It results in the damage of the tissues that get blood supply from those vessels.
How the research was conducted?
The research was based on four subjects. The team of researchers found that Covid-19 was present in the penile tissue of 2 men who had been infected. However, it was not present in the 2 men who had no history of the infection. Both men had been infected by the Covid-19 virus for around six to eight months. Those who had the virus showed evidence of endothelial dysfunction, but the men who were free from the virus did not show such signs.
Ranjith Ramasamy, Associate Professor at University of Miami Miller School of Medicine, said, “Our research shows that COVID-19 can cause widespread endothelial dysfunction in organ systems beyond the lungs and kidneys. The underlying endothelial dysfunction that happens because COVID-19 can enter the endothelial cells and affect many organs, including the penis.”
He further added that in the pilot study, they found the men who did not complain of erectile dysfunction before getting infection had developed “severe erectile dysfunction” after the onset of the infection.
One of the men had to be hospitalised for Covid-19, while the second subject only had mild symptoms of the infection. The penile tissue was collected from these two men who underwent penile prosthesis surgery for erectile dysfunction. The tissue was also collected from other two men who underwent similar surgery but did not have a history of Covid-19 infection. The researchers analysed the samples for endothelial dysfunction as well as the presence of the virus.
The conclusion of the research
The researchers believe that similar to other complications related to the Covid-19 infection, subsequent endothelial dysfunction might result in erectile dysfunction. In some cases, it could be due to the presence of the virus in penile tissue itself, said the researchers. They came up with two hypotheses. They said, “First, similar to other complications related to COVID-19, ED can be the result of systemic infection resulting in widespread endothelial dysfunction. This is supported by our findings of endothelial dysfunction seen in men with COVID and ED. Second, we can also hypothesise that the worsening of these patient’s ED can be due to the virus’ presence within the cavernosal endothelium itself. This is best supported by our findings with TEM.”
The researchers believe that the patients should be aware of such complications. They said in the paper, “Patients should be aware of the potential complication of post-COVID-19 ED. Any changes observed in erectile function after infection should be followed up with the appropriate specialist for treatment and to help the further investigation into the condition. Future studies are needed to validate the effects of this virus on sexual function.”
Similar researches have been done in the past. In December 2020, Huffpost quoted Judson Brandeis, a urologist in California saying, “ED will become more common in anyone who has a severe COVID infection. COVID can hurt you in many ways, now add erectile dysfunction to the list.” While talking to Healthy Men Today, he said, “Erectile function is highly dependent on pressurized blood flow, which starts at the heart, pulses through the large arteries, and then flows through the small blood vessels. Conditions like diabetes, high cholesterol, and smoking cause damage to the inner lining of the blood vessels, which causes ED. So does COVID-19.”
He had further added that as the body has not seen this virus before, it launches a non-specific counter-attack to suppress the virus and hurt itself in the process particularly the endothelium, a delicate layer of cells that lines the blood vessels. This results in erectile dysfunction.