The impact of long term COVID-19 infection on the patients' erectile function and on anxiety and on depression as well as the impact of daily tadalafil 5 mg supplementation in patients with erectile dysfunction.

OBJECTIVES: The study examined the impact of long term COVID-19 infection on the patients' erectile function and anxiety and depression in the same patients as well as the impact of daily tadalafil 5 mg supplementation on their erectile function. METHODS: Recovered 114 men were evaluated by the validated Arabic version of the international index of erectile function (ArIIEF-5) and the Arabic versions of the patient health questionnaire-9 (PHQ-9) and the generalized anxiety disorder-7 (GAD-7) at time of presentation, at 3 months and at 6 months, respectively. Forty recovered patients who still complained of ED received tadalafil 5 mg daily for 2 months then were evaluated again at 3 and 6 months by penile duplex, the Arabic versions of the patient health questionnaire-9 (PHQ-9) and the generalized anxiety disorder-7 (GAD-7) at the same periods, respectively. RESULTS: At the time of presentation, there was a positive correlation between the severity of COVID-19 infection, ArIIEF-5 and PHQ-9 (r = 0.249, p = 0.008; r = 0.241, p = 0.010, respectively). Most of the patients showed normal penile duplex parameters. There were 40 ED patients at presentation, 5 ED patients at 3 months and 3 ED patients at 6 months, respectively. CONCLUSIONS: ED in COVID-19 patients who were not suffering from chronic illnesses before the affection, is primarily psychological and completely responsive to tadalafil.

Estimation of Serum and Seminal Plasma Levels of Glactin-1 in Non-Obstructive Azoospermia Cases and Their Correlations with the Rate of Sperm Retrieval: A Comparative Prospective Study.

Background: Remarkably, the current study is one of the first to deploy galectin-1 (Gal-1) in determining the degree of impairment of spermatogenesis among cases with non-obstructive azoospermia (NOA) as well as utilizing it as a biomarker to predict the rate of sperm retrieval in these patients. The purpose of the study was to evaluate the seminal plasma and serum levels of Gal-1 in NOA patients as well as their correlations with Johnsen's tubular biopsy scoring (JTBS). Methods: The current case control study included totally 48 patients with NOA whose ages ranged from 24 to 46 years old and 50 age matched healthy controls. Gal-1 levels were measured in both seminal plasma and serum of all subjects by the enzyme-linked immunosorbent assay (ELISA). Results: A significant negative correlation between seminal plasma levels of Gal-1 and JTBS was detected (r= -0.281, p=0.048) in the NOA cases. Interestingly, the receiver operating characteristic (ROC) curve had demonstrated that the cutoff value of seminal plasma levels of Gal-1 in determining azoospermia was >0.735 ng/ml and the area under the curve (AUC) was 0.858. The sensitivity, specificity, positive predictive, and negative predictive values for seminal plasma levels of Gal-1 were 76, 92, 90.5, and 79.3, respectively. In addition, sensitivity, specificity, positive predictive, and negative predictive values for serum levels of Gal-1 were 38, 66, 52.8, and 51.6, respectively. Conclusion: Seminal plasma levels of Gal-1 are higher in NOA men versus healthy controls. Interestingly, negative correlation of seminal plasma levels of Gal-1 with JTBS was determined. Thus, it can be used as a good predictor for NOA cases.

Study of the role of microRNAs 16 and 135a in patients with lifelong premature ejaculation receiving fluoxetine daily for 3 months: A prospective case control study.

We aimed to determine the level of miRNAs 16 and 135a in lifelong premature ejaculation (LPE) patients versus controls. Moreover, we evaluated the potential interplay between the studied miRNAs and fluoxetine in these patients after utilizing fluoxetine daily for 3 months. The study involved 60 consecutive LPE patients and 20 healthy age matched individuals as controls. The median miRNA16 was significantly higher in the controls (1.02) compared to the patients (0.31) (p < 0.001). Moreover, the median miRNA-135a was significantly higher in the controls compared to the patients 1.02 and 0.35, p < 0.001, respectively. In addition, the median pre-treatment miRNA16 in the responders was 0.29 that significantly increased to 0.66 (p < 0.001). The median pre-treatment miRNA-135a in the responders was 0.27 that significantly increased to 0.65 (p < 0.001). Furthermore, considering EXP(ß) for the odds ratio evaluation, with a 95% degree of confidence, a 1 fold increase in pre-treatment miRNA 135a fold change decreases the odds for being responsive to SSRI by 0.028. Meanwhile, there was non-significant association between fluoxetine responsiveness and age, pre-treatment miRNA 16, pre-treatment PEDT and pre-treatment IELT. The current study had shown that a lower pre-treatment miRNA 135a was significantly associated with response to fluoxetine.

Predictive factors of erectile dysfunction in Egyptian individuals after contracting COVID-19: A prospective case-control study.

This study aimed to screen healthy individuals who contracted COVID-19 for erectile dysfunction (ED) and to determine the potential risk factors that can predict ED in these individuals. One hundred and seven cases versus 90 controls agreed to participate in the study. Two structured interviews with 1 month interval were conducted. All participants were evaluated by the validated Arabic version of the international index of erectile function (IIEF-5) and assessment of the psychological state by Hamilton depression rating scale (HDRS). Interestingly, the study had demonstrated a significant difference in mean testosterone level between cases and controls (3.91 ± 2.31, 5.04 ± 2.22, p < 0.001 respectively). Additionally, the study had demonstrated a significant difference in mean IIEF-5 score between cases and controls (22.63 ± 2.79, 23.54 ± 1.26, p < 0.041 respectively). Moreover, there were significant differences in mean anxiety and stress scores of the cases before and after COVID-19 (4.95 ± 4.03, 6.19 ± 3.55, p = 0.022, 12.75 ± 9.98, 15.30 ± 7.42, p = 0.024 respectively). A multiple logistic regression model for predicting ED occurrence post-COVID-19 had revealed that smoking, baseline IIEF-5 score and COVID-19 severity (p = 0.022, p = 0.017, p = 0.021, p = 0.009, p = 0.008 respectively) were the only significant independent variables.

Smoking status and the baseline international index of erectile function score can predict satisfactory response to platelet-rich plasma in patients with erectile dysfunction: A prospective pilot study.

Erectile dysfunction (ED) is a common condition with a significant impact on the quality of life. Regenerative medicine maladies are intended to repair or replace damaged tissues and organs through different therapeutic mechanisms. Our aim was to study the effect of intra-corporeal injection (ICI) of platelet-rich plasma (PRP) in ED patients. Thirty-four patients' erectile function was evaluated by filling up an abridged form of the international index of erectile function (IIEF-5) before and after PRP therapy. ICI of PRP was done once per week for 2 months. All patients were prescribed PDE5Is for one month after PRP therapy. Penile haemodynamics was assessed using 20 µg of PGE1 before and 3 months after initiating PRP therapy. Interestingly, our study had shown that there was a statistically significant difference in the IIEF-5 score after ICI of PRP (-5.5, ±5.2, p=<0.001). Furthermore, in multiple logistic regression model for PRP responsiveness, smoking and IIEF score before PRP were the only significant independent variables (p = .040, p = .023 respectively). PRP injection for ED patients may be a promising modality as well as baseline IIEF-5, and smoking status can be used as predictors for a satisfactory response to PRP in such patients.

Assessment of sexual functions in male patients with obstructive sleep apnea.

PURPOSE: Obstructive sleep apnea is characterized by repetitive cessation of breathing during sleep. It affects different aspects of sexuality. We aimed to assess male sexual function & risk factors in obstructive sleep apnea patients. METHODS: This case control study included 2 groups, 45 healthy volunteers as control group and 45 patients with confirmed diagnosis of obstructive sleep apnea. All the participants were subjected to measurement of Body Mass Index, Full night polysomnography (only for patients group) and serum total testosterone, FSH and LH. The International Index of Erectile Function-5 and Hamilton Depression Scale questionnaires were filed out for all participants. RESULTS: The mean scores for all sexual domains were significantly lower among the patients group compared to the control group (p<0.01). The Hamilton score was significantly higher among the patients group compared to the control group (p<0.0001). The mean levels of Testosterone and LH were significantly lower among the patients group compared to controls (p<0.0001), There were significant correlations between disease severity and age (r=0.48, p=0.001), Body mass index (r=0.48, p=0.001), Hamilton score (r=0.34, p=0.014) International Index of Erectile Function 5 domain score (r= -0.29, p=0.045)Testosterone level (r= -0.29, p=0.046) and LH levels (r= -0.104, p=0.049). CONCLUSION: We found that all domains of sexual function have been affected in patients group than controls. Their score was inversely related to the disease severity; which in turn has a complex interaction with other factors like age, obesity, hormones and psychological status. So when evaluating those patients, sexual dysfunction should be considered and assessed along with these factors.