The cardiac and inflammatory changes caused by Covid-19 have multiple manifestations in the body, and it was already known that they could affect the male reproductive system, causing painful swelling by invading the testicles. Now, two scientifically documented cases show that a symptom of a severe SARS-CoV-2 coronavirus infection can be priapism, the appearance of erections of more than four hours that must be treated clinically to avoid further damage.
As described by the American Journal of Emergency Medicine, a first case detected in Miami, Florida, refers to a 69-year-old man with a history of obesity who was admitted to Intensive Care after a week with respiratory symptoms. Due to his rapid deterioration, the patient had to be intubated and placed face down to improve intubation. To the turning him the next day, the nurse observed that he had an erection.
They were administered ice packs, but the erection remained for the next three hours, so he notified urology while the excess blood was drained from the limb. Finally, with the arrival of the specialist, the decongestant phenylephrine was administered, which achieved detumescence after 30 minutes of treatment. The patient, however, ended up dying after a prolonged admission as a result of respiratory problems.
The second case corresponds to a 62-year-old patient treated in Versailles, on the outskirts of Paris. He had also developed severe respiratory symptoms and had been on a respirator when it was detected that he had an erection. As in the American case, the first measure was to apply ice packs, but four hours later the priapism remained. To the draw blood, doctors observed small blood clots or thrombi.
In his case, he was treated with etilephrine and also an antithrombotic, since they suspected that the clots could have plugged the veins of the penis that prevented the erection from descending. The treatment was effective and the general condition of the patient improved. 14 days later, the assisted respiration could be withdrawn and he ended up being discharged.
The conclusion after reviewing the cases concluded that the thromboembolic complications that occur in 30% of severe cases of Covid-19 had this rare manifestation, preventing the blood comes out of the cavernous ducts of the penis.
The ischemic priapismAs this form of permanent erection is known, it is painful and is not related to sexual function. The blood trapped in the penis also stops receiving oxygen, so the consequences of leaving it untreated can be very serious.
Doctors admit that not enough evidence yet to identify priapism as a direct consequence of the disease, but they have called for study future cases in depth.