Can anxiety and depression serve as primary factors associated with erectile dysfunction after coronavirus disease?

OBJECTIVE: We investigated the association between anxiety and depression and erectile dysfunction (ED) in patients who developed ED after coronavirus disease 2019 (COVID-19). PATIENTS AND METHODS: This study included 228 men who were hospitalized in pandemic wards between July 2021 and January 2022 with positive reverse transcription-polymerase chain reaction test results for the severe acute respiratory syndrome coronavirus 2 RNA. All patients responded to a Turkish version of the International Index of Erectile Function (IIEF) questionnaire to determine erectile status. Patients were administered the Turkish version of the Beck Depression Inventory (BDI) and Generalized Anxiety Disorder 7-item scale (GAD-7) questionnaires the day after hospitalization and also during the 1st month after diagnosis of COVID-19 to compare the COVID-19 situation with the previous situation. RESULTS: Patients' mean age was 49.66 ± 13.3 years. The mean pre-COVID-19 erectile function score of 28.65 ± 1.33 decreased to a mean post-COVID-19 score of 26.58 ± 4.23, which indicates a statistically significant difference (p=0.03). Post-COVID-19 ED occurred in 46 (20.1%) patients; 10 (4.3%) patients had mild, 23 (10.0%) had mild-to-moderate, 5 (2.1%) had moderate, and 8 (3.5%) patients had severe ED. The mean pre-COVID-19 BDI score (which indicates depression) of 1.79 ± 2.45 increased to a mean post-COVID-19 score of 2.42 ± 2.89 (p<0.01). Additionally, the mean pre-COVID-19 GAD-7 score of 4.79 ± 1.83 increased to a mean post-COVID-19 score of 6.79 ± 2.52, which indicates a statistically significant difference (p<0.01). We observed a negative correlation between the increase in BDI and GAD-7 scores and the decrease in IIEF scores (r=0.426, p<.001, r=0.568, p<.001, respectively). CONCLUSIONS: Our study highlights that COVID-19 can cause ED and that disease-induced anxiety and depression serve as primary contributors to ED.

Laparoscopic transperitoneal ureterolithotomy is an effective and safe method for >15 mm impacted ureteral stones in elderly patients: single center 10-year experience.

OBJECTIVE: The aim of our study is to investigate the efficacy and safety of laparoscopic ureterolithotomy operation in elderly patients with large and impacted ureteral stones. PATIENTS AND METHODS: Between January 2011 and July 2021, 66 elderly patients with impacted, > 15 mm upper and middle ureteral stones underwent laparoscopic ureterolithotomy in our center. The data for all patients were evaluated retrospectively. RESULTS: The mean age of the patients was 65 ± 5.43 years. The mean stone size was 20.2 ± 2.5 mm. The mean operation time was 93.6 ± 13.2 minutes. Among patients, 16 (24.2%) had history of unsuccessful shock wave lithotripsy and 12 (18.1%) patients had history of ureterorenoscopy. Stone-free rate was 95.4% in all patients. Modified Clavien grade 1 complications were seen in 18 patients (27.2%), but no significant perioperative and postoperative complications were observed. Urinary extravasation lasting 5, 7 and 9 days was observed in 5 patients (7.5%) who were treated conservatively. The mean hospital stay was 3.4 ± 1.52 days. The patients were asymptomatic at the 6th week post-op follow-up, and no stones were seen on direct X-ray and abdominal ultrasonography. Intravenous urography and non-contrast tomography (NCCT) taken 3 months later did not show any obstruction or stenosis in the ureter. CONCLUSIONS: Laparoscopic ureterolithotomy can be considered as the first treatment option for elderly patients with impacted and large ureteral stones, thanks to its high success and acceptable complication rates.

Does COVID-19 cause testicular damage? A cross-sectional study comparing hormonal parameters.

OBJECTIVE: We aimed to predict the potential testicular damage of COVID-19 by comparing the hormones FSH, LH, and TT before COVID-19 with values measured after COVID-19. PATIENTS AND METHODS: A total of 348 patients - who were followed up in our urology clinic for varicocele, premature ejaculation, erectile dysfunction and infertility, had FSH, LH and TT levels measured one year before COVID-19 and were positive for COVID-19 after a Polymerase Chain Reaction (RT-PCR) tests - were included in the study. Presence of pneumonia compatible with COVID-19, hospitalization in the intensive care unit and FSH, LH and TT values before and after COVID-19 were recorded, along with lung computed tomography (CT). RESULTS: The post-COVID-19 LH value (9.72±3.27 mIU/mL) of the patients was significantly higher than the pre-COVID-19 LH value (5.72±2.50 mIU/mL) (p<0.001). The post-COVID-19 TT (253.85±88.03 ng/dl) value was significantly lower than the pre-COVID-19 TT value (351.08±106.19 ng/dl) (p<.001). In addition, while there was a mean decrease of 127.8 ng/dl in TT level in patients with pneumonia, a decrease of 39.03 ng/dl was observed in patients without pneumonia (p<.001). CONCLUSIONS: COVID-19 may cause an increase in serum LH levels while decreasing TT levels. Additionally, those with COVID-19 pneumonia may experience a greater decrease in serum TT levels than those with COVID-19 without pneumonia.