Malinga Dominic Mpumelelo, Laher Abdullah E, McDowall Jared, Adam Ahmed
Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Division of Urology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Curr Urol. 2022 Jun;16(2):55-62. doi: 10.1097/CU9.0000000000000111. Epub 2022 Jun 27.
Coronavirus disease 2019 (COVID-19) has an established impact on multiple organ systems, including the vascular and urogenital systems. Vascular effects may include venous thromboembolic disease, which could theoretically be a precursor to priapism-a urological emergency defined as an abnormal condition of prolonged penile erection lasting >4 hours. To better explore this association, we critically appraised all the published COVID-19 cases associated with priapism.
After PROSPERO registration CRD42021245257), a systematic search of Google Scholar, Scopus, Embase, Web of Science, PubMed, Cumulative Index to Nursing and Allied Health Literature, Global Index Medicus, and Cochrane Database of Systematic Reviews was performed using specific search terms. The following study metadata were extracted: age, requirement for respiratory support, cavernous blood gas findings, management of priapism, and patient outcomes.
Fifteen single-patient case reports were included in this review. Of these, all of the patients presented with ischemic priapism, 9 patients (60.0%) were >60 years of age, 4 (26.7%) reported more than a single episode of priapism, 11 (73.3%) presented with pneumonia, 8 (53.3%) required mechanical ventilation, D-dimer was elevated in 5 of the 6 (83.3%) patients in whom this was reported, and among the 13 patients in whom mortality was reported, 4 (30.8%) died.
Early reports suggest a prognostic relationship between COVID-19 and coexisting priapism. However, owing to commonalities in their pathophysiology and the small dataset reported in the literature, the probable association between COVID-19 and priapism is still theoretical. Further research is needed to confirm this association.
2019冠状病毒病（COVID-19）已对包括血管和泌尿生殖系统在内的多个器官系统产生影响。血管效应可能包括静脉血栓栓塞性疾病，从理论上讲，这可能是阴茎异常勃起的先兆，阴茎异常勃起是一种泌尿外科急症，定义为阴茎持续勃起超过4小时的异常情况。为了更好地探究这种关联，我们对所有已发表的与阴茎异常勃起相关的COVID-19病例进行了批判性评估。
在PROSPERO注册（CRD42021245257）后，使用特定检索词对谷歌学术、Scopus、Embase、科学网、PubMed、护理及相关健康文献累积索引、全球医学索引和Cochrane系统评价数据库进行了系统检索。提取了以下研究元数据：年龄、呼吸支持需求、海绵体血气结果、阴茎异常勃起的处理及患者结局。
本综述纳入了15篇单病例报告。其中，所有患者均表现为缺血性阴茎异常勃起，9例（60.0%）患者年龄>60岁，4例（26.7%）报告有不止一次阴茎异常勃起发作，11例（73.3%）出现肺炎，8例（53.3%）需要机械通气，6例报告了D-二聚体的患者中有5例（83.3%）升高，在报告了死亡率的13例患者中，4例（30.8%）死亡。
早期报告提示COVID-19与并存的阴茎异常勃起之间存在预后关系。然而，由于它们在病理生理学上的共性以及文献中报告的数据集较小，COVID-19与阴茎异常勃起之间可能的关联仍属理论上的。需要进一步研究来证实这种关联。
