A Possible Mechanism of Erectile Dysfunction in Coronavirus Disease-19: Cavernosal Smooth Muscle Damage: A Pilot Study

INTRODUCTION: Studies have reported that COVID-19 may cause erectile dysfunction (ED), however, its role in the pathophysiology of ED has not yet been fully elucidated. We aimed to elucidate COVID-19's effects on cavernosal smooth muscle, which has a pretty important role in erection physiology, by corpus cavernosum electromyography (cc-EMG). MATERIALS AND METHODS: Twenty-nine male patients aged 20-50 years who applied to the urology outpatient clinic due to ED were included in the study. Nine patients that had COVID-19 and were treated as outpatients were classified as group 1, 10 patients who were hospitalized due to COVID-19 were classified as group 2, and 10 patients who did not have COVID-19 were classified as the control group (group 3). Patients underwent diagnostic evaluation including International Index of Erectile Function (IIEF)-5 form, penile color Doppler ultrasonography (CDUS), cc-EMG, and fasting serum levels of reproductive hormones (07-11 am). RESULTS: According to penile CDUS and hormonal values results, there was no significant difference between the groups. According to cc-EMG results, amplitudes and relaxation capacities of the cavernosal smooth muscle EMG activities of patients in group 3 were significantly higher than those in the other groups. CONCLUSIONS: COVID-19 can cause ED not only by psychogenic and hormonal factors but also with cavernosal smooth muscle damage.