Does SARS-CoV-2 Affect Male Urogenital System?
Authors: Balawender Krzysztof , Pliszka Anna , Krowiak Anita , Sito Maksymilian , Grabarek Beniamin Oskar , Boroń Dariusz 
Published: March 2022

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.

Objective:
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.