Profilaktik tibbiyot va salomatlik
–
Профилактическая
медицина
и
здоровье
–
Preventive Medicine
and Health
Journal home page:
https://inscience.uz/index.php/preventive-medicine
Prevention of erectile dysfunction in men with COVID-19
Rustambek BOBOEV
Andijan State Medical Institute
ARTICLE INFO
ABSTRACT
Article history:
Received April 2023
Received in revised form
10 May 2023
Accepted 25 May 2023
Available online
15 August 2023
Experience gained in the fight against COVID-19 has
highlighted that indicators of a predisposition to a more severe
course of the disease include not only advanced age, obesity,
hypertension, and diabetes mellitus, but also male gender.
Notably, one of the consequences of coronavirus infection is
endothelial dysfunction. In this condition, the lining of small
blood vessels is compromised, leading to insufficient blood
supply to the tissues they serve, resulting in functional loss.
Studies indicate that this vascular dysfunction may contribute
to the development of impotence in men who have recovered
from COVID-19.
2181-3663
/©
2023 in Science LLC.
https://doi.org/10.47689/2181-3663-vol2-iss4-pp1
This is an open-access article under the Attribution 4.0 International
(CC BY 4.0) license (
https://creativecommons.org/licenses/by/4.0/deed.ru
Keywords:
coronavirus infection,
erectile dysfunction,
testosterone,
libido,
erection,
prostate.
COVID-19
bilan
kasallangan
erkaklarda
erektil
disfunksiyani profilaktikasi
ANOTATSIYA
Kalit so‘zlar
:
koronavirus infeksiyasi,
erektil disfunksiya,
testosteron,
libido,
ereksiya,
prostate bezi.
COVID-
19 ga qarshi kurashishda to‘plangan tajribalardan
ma’lum bo‘ldiki, kasallikning og‘ir kechishiga moyilligini
ko‘rsatuvchi belgilarga keksalik,
semirish, gipertoniya va qandli
diabet, shuningdek erkak jinsini ham kiritish lozim. Qayd
etilishicha, koronavirus infeksiyasining oqibatlaridan biri bu
endotelial disfunksiyadir. Bunday holatda mayda qon
tomirlarning shilliq qavati buziladi va ular oziqlanadigan
to‘qimalar normal qon bilan ta’minlanmaydi va o‘z
funksiyalarini yo‘qotadi. Tadqiqotga ko‘ra, qon tomirlarning bu
disfunksiyasi COVID-19 dan tuzalgan erkaklarda jinsiy
zaiflikning rivojlanishiga olib kelishi mumkin.
1
Senior lecturer, Department of Urology, Faculty of Medicine, Andijan State Medical Institute.
E-mail: boboev.rustambek1983@mail.ru
Profilaktik tibbiyot va salomlatlik
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Профилактическая медицина и здоровье–
Preventive Medicine and Health
Issue
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2
№
4 (2023) / ISSN 2181-3663
2
Профилактика эректильной дисфункции у мужчин с
COVID-19
АННОТАЦИЯ
Ключевые слова:
коронавирусная
инфекция,
эректильная дисфункция,
тестостерон,
либидо,
эрекция,
предстательная железа.
С накоплением опыта в борьбе с COVID
-
19 стало
очевидно, что к факторам, предрасполагающим к более
тяжелому течению заболевания, следует относить не
только пожилой возраст, ожирение, артериальную
гипертензию и сахарный диабет, но и мужской пол.
Отмечается, что одним из последствий коронавирусной
инфекции является эндотелиальная дисфункция –
нарушение слизистой оболочки мелких кровеносных
сосудов, из
-
за чего ткани, питаемые этими сосудами,
теряют нормальное кровоснабжение и свои функции.
Согласно исследованию, такая сосудистая дисфункция
может способствовать развитию импотенции у мужчин,
перенесших COVID
-19.
In the modern era, COVID-19 is the biggest challenge facing healthcare
professionals and scientists worldwide. High contagiousness and severe course of the
disease have become a serious test for the global healthcare system. All over the world,
measures were taken to limit the spread of the disease, up to the re-proliferation of
multidisciplinary and specialized clinics to increase the ability to provide emergency care
to patients with coronavirus infection, suspend elective surgeries, inpatient and
outpatient care for seriously ill patients, including urological profile [1, 2, 3, 4]. Significant
efforts and funds have been devoted to the treatment of COVID-19, while the interaction
of the virus with various organs and systems of the human div has been poorly studied
so far [10,11, 12, 13].
As experience gained in the fight against COVID-19, it became clear that the signs
indicating a predisposition to a more severe course of the disease should include not only
old age, obesity, arterial hypertension, and diabetes mellitus, but also male sex [6, 7, 8, 9].
It is noted that one of the consequences of coronavirus infection is endothelial
dysfunction. In this condition, the mucous membrane of small blood vessels is disturbed,
and the tissues they feed cease to be supplied with blood normally and lose their
functions. According to the study, this dysfunction of the blood vessels can lead to the
development of impotence in men who have recovered from COVID-19.
The purpose of the study
is to study the effect of coronavirus infection on erectile
function.
MATERIAL AND RESEARCH METHODS
From 2021 to 2022, 46 men who had COVID-19 pneumonia and complained of a
pronounced decrease in libido, erectile function, and the quality of sexual intercourse
after the illness were consulted in the urology department of the clinic of the Andijan
State Medical Institute. The duration of the disease ranged from 3 to 6 months. The age of
the patients ranged from 38 to 57 years. All of them had at least one PCR-positive
respiratory swab for COVID-19. Anamnestically, all patients, based on computed
tomography (CT) of the chest, were diagnosed with pneumonia of varying severity.
Profilaktik tibbiyot va salomlatlik
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Профилактическая медицина и здоровье–
Preventive Medicine and Health
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Patients with a mild course of COVID-19, complicated by CT-1 pneumonia, were treated
on an outpatient basis, under the supervision of a local therapist. Patients with moderate
and severe courses (pneumonia CT-2 and CT-3) were hospitalized in specialized COVID
hospitals, where they underwent the main stages of therapy. At the same time, 75% of
them were on the support of humidified O
2
, and 11% of patients were treated in COVID
intensive care using non-invasive artificial lung ventilation in the CPAP mode
(continuous positive airway pressure mode
–
Continuous Positive airway pressure).
The diagnostic complex included a physical examination, general blood and urine
tests, a biochemical blood test, an ultrasound examination of the prostate and scrotum
organs, a study of the level of a common prostate -specific antigen, a study of hormonal
status
–
the total level of testosterone (T), luteinizing hormone (LH), prolactin was
determined (P).
Patients were surveyed using the following questionnaires: IIEF (The International
Index of erectile function, International Index of Erectile Function, IIEF-5);
IPSS (International Prostate Symptom Score, International Prostate Symptom
Index, a scale for the overall assessment of prostate diseases); AMS (Aging Males
Symptoms, Male Aging Symptoms Questionnaire).
The results of the study
showed that during the physical examination, no
significant pathology was detected in the applied men. General clinical blood and urine
tests, the results of a biochemical blood test were within normal limits.
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Ultrasound examination (ultrasound) showed that the volume of the pancreas was
less than 45 cm
3
, and the volume of residual urine was 0-50 ml.
All those who applied noted a decrease in sexual desire of varying severity, from
sluggish periodic desires to their complete absence within 1 to 3 months after suffering
COVID-19 pneumonia.
Many of them forced themselves to have intercourse by force of will, in most cases
(67%) under the psychological pressure of their sexual partners. This eventually led to
conflicts, which further aggravated the emotional situation.
According to the results of the survey of the International Index of Erectile
Function, patients were divided into 3 groups:
Group 1
–
16 men, whose total score on the IIEF-5 scale was 17-21, were included
in the group with a mild degree of erectile dysfunction;
Group 2
–
in 22 patients, the total score was 12-16, which combined them into a
group with a moderately mild degree of erectile dysfunction
Group 3
–
8 patients with severe erectile dysfunction, as the sum of the test was 5-
7 points.
After undergoing COVID -19, patients of groups 1 and 2 noted that they were most
concerned about difficulties with the onset and maintenance of an erection, incomplete
satisfaction from sexual intercourse, and group 1 patients noted on a 3
–
4-point system
(sometimes or in half of the cases), and patients of the 2nd group
–
according to a 2-point
system (which means rarely).
The consequences of COVID-19 in patients of group 3 were expressed in the
absence of morning erection, complete dissatisfaction with sexual intercourse, and lack
of libido. Values relative to the generally accepted testosterone value of more than
12 nmol / l correspond to the norm, according to the recommendations of ISSAM
(International Society for the Study of Aging and Men's Health). In our study, the
laboratory testosterone level in these groups was: in patients of group 1 -12.0 nmol / l
and above, in group 2
–
testosterone levels were reduced to 10.0 nmol / l, in group 3
–
testosterone levels were reduced to 8.0 nmol / l.
35%
48%
17%
The results of the survey of patients
according to the IIEF-5 scale
I Group 16 (35%)
II Group 22 (48%)
III Group 8 (17%)
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FINDINGS:
1.
The topic of viral lesions of the organs of the male reproductive system with
negative consequences for erectile fertility components for urological practice is also
expanding due to the consequences of the coronavirus infection.
2.
COVID infection hurts erectile function by reducing testosterone levels.
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