The Urology department pilot study sought to analyze penile tissue of men who recovered from symptomatic COVID-19 infection and developed erectile dysfunction (ED) after the infection.

The small study evaluated penile tissue collected from four men scheduled for penile prosthesis surgery due to erectile dysfunction. Two men had a history of Covid-19 infection, and the other two men had no history of illness.

Covid-19 is known to cause widespread damage to blood vessels throughout the body. SARS-CoV-2 causes damage to the cell layer lining blood vessels called endothelial cells. Endothelial cells contain two components that SARS-CoV-2 needs to infect cells. The SARS-CoV-2 spike protein binds to specialized receptors called ACE-2 and enters cells containing an enzyme called TMPRSS-2. Blood vessels have a high number of both ACE-2 receptors and TMPRSS-2.

The Miami research team hypothesized that endothelial damage in penile tissue could be the cause of post-Covid-19 erectile dysfunction.

The researchers evaluated penile tissue collected from four men scheduled for penile prosthesis surgery to test the theory due to erectile dysfunction. Two of the men had a history of Covid-19 infection. One had a severe disease requiring hospitalization. One had a mild case. These two cases were compared to a control group of two men who had no history of infection.

The paper is titled, “COVID-19 Endothelial Dysfunction Can Cause Erectile Dysfunction: Histopathological, Immunohistochemical, and Ultrastructural Study of the Human Penis.“

Urologists took biopsies from an area of the penis called the corpus cavernosum. A variety of tests were performed to evaluate cellular changes in the tissue. Damage to the penile vascular from Covid-19 could explain new onset erectile dysfunction after infection.

The scientists used three techniques to test for the effects of Covid-19. Transmission electron microscopy (TEM), Immunohistochemistry staining (eNOS), and viral PCR testing.

Transmission electron microscopy (TEM) revealed the presence of viral particles in men with a history of Covid-19 infection.

Immunohistochemical staining showed dramatic changes in the penile tissue of men with a history of Covid-19.

The scientists were unable to detect SARS-CoV-2 through PCR testing. The study authors propose the lack of detection is due to a low viral load in the penis.

The sample size of this pilot study is quite small. The results are not meant to provide a definitive scientific answer regarding the effects of Covid-19 on male sexual function. This small pilot study is the first paper to demonstrate penile damage on a cellular level. Further research will be needed.

This paper may also help some men overcome vaccine hesitancy. A study in the American Journal of Men’s Health showed men are less likely to seek help for any medical condition. Data analysis by Kaiser Health showed a gender gap with Covid-19 vaccination. More women are getting vaccinated than men. A CNN poll found 57 percent of Republican men did not plan to get vaccinated against Covid-19.

This paper from The University Of Miami helps men understand the importance of preventing getting infected from Covid-19.

There are three FDA-approved vaccines for Covid-19. The two messenger RNA vaccines from Moderna and Pfizer offer 95% protection against Covid-19. The Covid-19 vaccines from Pfizer and Moderna use messenger RNA (mRNA). A single strand of mRNA delivers instructions to human cells to produce an antibody against the SARS-CoV-2 spike protein.

The Johnson and Johnson’s Janssen vaccine offers 72% protection against infection and 86% against severe disease. The Janssen vaccine uses Adenovirus 26 (AD26) as the vector to deliver DNA material into our cells to provoke an immune response.

The Moderna and Janssen vaccines are approved for those 18 years old and up. The Pfizer vaccine is approved starting at age 16.

All three vaccines are highly effective in preventing death.

This paper shows the Covid-19 vaccine may also protect men from erectile dysfunction.

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