New treatment possibilities for postcovid hypogonadism and erectile dysfunction

OBJECTIVES: COVID-19 affects ACE receptors in testis, that decrease male sexual function. Recently, we have seen an increasing number of patients with erectile dysfunction (ED) appearing 3-6 months after COVID-19. The aim of our study was to determine effectiveness of hormone therapy, autologous stem cells (ASC) and Plasma rich Platelets (PRP) - therapy in patients with hypogonadism and ED. METHODS: 123 patients with ED, which appeared 3-6 months after COVID-19. Patients were divided into 2 groups: 1st- 68 patients with primary hypogonadism (Tm = 7.43 + 2.1 below 12 nmol / l), and 2nd - 55 patients with secondary hypogonadism (Tm = 14.1 + 1.8 nmol / l). RESULTS: In the first group, patients were prescribed stimulating -1a group or replacement – 1b group hormone therapy for 2 months. After 2 months of hormone replacement therapy, 28 patients were diagnosed with normal T levels, but only 19 patients (61.2%) in group 1b improved their erectile function. In the second group, 55 patients were also prescribed stimulating hormone phytotherapy for 2 months and PRP therapy. 23 patients - group 2a responded to therapy with the disappearance of symptoms of hypogonadism and improvement of ED. 32 patients - group 2b - did not have significant improvements, so they received 2 courses of 5 intravenous injections of 5 million autologous stem cells (50 millions in total). 22 patients improved erectile function to normal values (IIEF -5 increased to 19.4 + 2.2). CONCLUSIONS: 1. A significant proportion of men with postcovid hypogonadism and ED are men with normal levels of T, but reduced sensitivity of tissue receptors to T which are blocked with Interleukins (secondary hypogonadism). 2. In the treatment of secondary postcovid hypogonadism, intracavernous PRP therapy and intravenous autological stem cell therapy have a significant clinical effect and can be considered as promising treatments for this pathology. CONFLICTS OF INTEREST: All authors declare absence of any conflicts of interests.