COVID-19 infection as a new risk factor for penile Mondor disease.

BACKGROUND: Penile Mondor disease is a superficial dorsal vein thrombophlebitis of the penis, which mainly affects young and middle-aged men. It generally manifests as a visible painful cord located along the dorsal surface of the penis with signs of skin inflammation. The condition is usually self-limiting, but in severe cases a surgical procedure may be necessary in addition to pharmacological treatment. Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 is associated with a frequent incidence of thrombophilia; therefore, such a prothrombotic state during infection may be a significant risk factor for penile Mondor disease. CASE PRESENTATION: The 34-year-old patient reported moderate pain felt on the surface of the penis. During the medical interview, the patient did not admit significant risk factors for Mondor Disease, apart from the previous, a month earlier COVID-19 disease. Examination revealed swelling erythema and a thick indurated cord on the surface of the penis. Color Doppler ultrasound was performed to confirm assumptions and exclude thrombosis of other penile vessels. Based on visible clots in the course of the superficial penile vein and after exclusion of vasculitis due to autoimmune disease the diagnosis of penile Mondor disease was made. Pharmacological therapy was implemented to further break down the clot and prevent rethrombosis in the penile vessels. The patient did not report any treatment complications and returned for a control visit, which revealed complete clot dissolution on ultrasound; therefore, complete recovery was stated. CONCLUSIONS: This case report presents the correlation between SARS-Cov-2 infection and penile Mondor disease, based on the confirmed influence of COVID-19 on the pathophysiology of thrombosis. It can be concluded that COVID- 19 is a risk factor for Mondor disease, as in the presented case the virus was the only prothrombotic risk factor for the patient. Consequently, the possibility of developing thrombosis in the form of penile Mondor disease should be taken into account among patients with post-COVID-19 and active SARS-Cov-2 infection.

Does SARS-CoV-2 Affect Male Urogenital System?

BACKGROUND: Widely known facts about Sars-Cov-2 infection's impact on urogenital system may play a relevant role in under-standing, diagnosing, and preventing male urological disorders. Sars-CoV-2 attacks the vascular endothelium of the entire organism; therefore, infection complications are visible in various organs. Relatively small number of original studies are available on Sars-CoV-2 infection and the effect on the reproductive system and fertility in men. The vast majority of publications focus only on discussing the effects of COVID-19 infection on just one aspect of male urology or fertility. OBJECTIVES: The aim of this review was to present the current understanding of the effects of COVID-19 infection on the male genitourinary system in the context of nephrological and reproductive system complications in men, considering the potential pathomechanisms causing significant nephrological disorders in the course of viral infection, as well as long-term effects of Sars-CoV-2 infection. We tried to make clinicians aware of urogenital complications in the course of COVID-19 occurrence and encourage them to create preventive procedures. METHODS: The article presented has been classified by us as "review". Of course, when searching for publications and making their critique, we focused primarily on the words: "Sars-CoV-2", "male urogenital system", "male infertility", "lower urinary tract symptoms". Therefore, there was no explicit and rigorous work selection methodology. Search strategies were based on the experience of the authors of the work. In order to select articles for the systematic review, literature searches were conducted on PubMed (https://pubmed.ncbi.nlm.nih.gov) using the following keywords: "Sars-CoV- 2" AND "male urogenital system" OR "male infertility" The search results were retrieved and manually screened for duplicate removal. Then abstracts and titles were checked for relevance. The articles were selected if they met the following inclusion criteria: human studies, focus on Sars-CoV-2 and male urogenital system or male infertility, published from 2020 to 2021, written in English, free full-text available. We included clinical trials, meta-analyses, randomized controlled studies, reviews, systematic reviews. RESULTS: After the literature search, a total of 267 articles were retrieved, including 153 reviews, 53 systematic reviews, and 61 original articles. Eventually, after abstract and title screening, 2 original articles, 29 reviews, and 8 systematic reviews were accepted. In our review paper, we presented data from 2 systematic reviews, 17 reviews, 2 meta-analyses, 1 case study, and 18 original articles, including 3 animals studies, 2 in vitro studies, and 14 human studies. CONCLUSION: Serious concerns for urologists among COVID-19 patients should be mainly orchitis, male infertility, priapism, erectile dysfunction, and lower urinary tract symptoms. It seems that the conclusions drawn should be treated with caution because, as mentioned above, in a pandemic, urinary complications are underdiagnosed and there are too few clinical trials and case reports.