Although in some studies verapamil has been found to be effective in the treatment of Peyronie's disease, we did not find any improvement in comparison with the control group. Furthermore, larger scale studies are warranted to assess the effect of this drug on the treatment of Peyronie's disease.

Since the first emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as novel coronavirus (2019-nCoV), in Wuhan, China, in December 2019 (Tan et al., 2020), the virus has spread rapidly worldwide and, therefore, has been officially declared a pandemic outbreak with more than 10 million confirmed cases and 499,000 deaths according to the WHO report (Situation Report, 2020). Pneumonia with fever seems to be the most common presentation of SARS-CoV-2 infection (Guan et al., 2020; Wang, Hu et al., 2020). SARS-CoV-2 was also detected in specimens of faeces and a small percentage of blood and urine

Background To explore the potential mechanisms of SARS-CoV-2 in targeting the prostate gland, leading to exacerbation of benign prostatic hyperplasia (BPH) symptoms and greater risks of BPH complications such as acute urinary retention. Methods A categorized and comprehensive search in the literature has been conducted by 10 April 2021 using international databases including PubMed, Embase, Web of Science, Scopus, and Cochrane Library in line with the PRISMA guidelines recommendations. PICO strategy was used to formulate the research question. The following terms were used: urology, COVID-19, coronavirus, BPH, inflammation, androgen receptors, LUTS, IPSS, PSA, and SARS-CoV-2 or a combination of them. Studies with irrelevant purposes and duplicates were excluded. The selected studies were performed on humans and published in English. Results The research revealed 89 articles. After title screening and considering exclusion criteria, 52 papers were included for the systematic review. BPH is a common condition affecting older men. SARS-CoV-2 infects the host cell by binding to angiotensin converting enzyme 2 (ACE2). A hyperactivated RAS system during infection with SARS-CoV-2 may lead to activation of pro-inflammatory pathways and increased cytokine release. Thus, this virus can lead to exacerbation of lower urinary tract symptoms (LUTS) and trigger inflammatory processes in the prostate gland. Since androgen receptors (AR) play an important role in the BPH pathophysiology and infection with SARS-CoV-2 may be androgen-mediated, BPH progression and its related symptoms can be a complication of COVID-19 through AR involvement and metabolic disturbances. Conclusions Based on the current findings, SARS-CoV-2 can possibly damage the prostate and worsen BPH and its related LUTS through ACE2 signaling, AR-related mechanisms, inflammation, and metabolic derangement. We encourage future studies to investigate the possible role of COVID-19 in the progression of BPH-related LUTS and examine the prostatic status in susceptible patients with relevant available questionnaires (e.g., IPSS) and serum biomarkers (e.g., PSA).

The result from this study suggests that amniotic membrane is an inexpensive, easy, and biodegradable graft with very little antigen effect which seems to be the ideal solution for urethroplasty.