Platelet-Rich Plasma, a novel treatment for Erectile Dysfunction
Men with erectile dysfunction (ED) may benefit from intracavernous platelet-rich plasma (PRP) injection therapy, suggests a scientific study recently published in the Journal of Sexual Medicine.
PRP is created from the patient's own blood. Using techniques to separate the components of the blood, a concentrate enriched with platelets and growth factors is obtained. This concentrated dose of regenerative blood components is injected into each of the corpora cavernosa of the penis.
Growth factors and platelets stimulate the formation of new blood vessels and the repair of the lining of existing blood vessels. In addition, studies show anti-inflammatory, reparative, neuroprotective (helping to protect nerves from damage) effects of platelet-rich plasma.
The researchers reported that their PRP protocol "appears to be a safe and effective treatment" and that improvements were sustained for six months. However, they also noted that more research is needed.
Previous animal studies have suggested that PRP may also be useful for the treatment of erectile dysfunction. However, human trials have been limited.
The current study included 60 sexually active heterosexual men in stable relationships. All men had mild to moderate erectile dysfunction according to the erectile function domain of the International Index of Erectile Function (IIEF-EF). They ranged in age from 40 to 70 years, with a mean age of 58.5 years.
Thirty men were assigned to receive two PRP injections. The remaining 30 men received two placebo injections.
Injections were spaced one month apart. At the one-, three-, and six-month follow-up points, men were assessed for treatment-induced pain (using a visual analog scale), sexual experiences (using sexual encounter profile diaries), erectile function (using the IIEF-EF), and satisfaction with treatment using the Erectile Dysfunction Treatment Satisfaction Inventory Tool (EDITS).
At each assessment point, the researchers determined the minimum clinically important difference (MCID) for each participant. Men with mild and mild-to-moderate erectile dysfunction achieved MCID if their IIEF-EF scores improved two or more points. For men with moderate erectile dysfunction, MCID was defined as an IIEF-EFD improvement of 5 points.
Due to the COVID-19 pandemic, one man in the PRP group and four men in the placebo group did not have follow-up evaluations.
At 6 months, (69 %) patients in the PRP group achieved MCID compared with (27 %) in the placebo group. The risk difference between the two groups was 42 % (95 % CI: 18-66), P < 0.001 and the mean between-group difference adjusted for baseline in IIEF-EF score was 3.9 points (95 % CI: 1.8- 5.9).
Consequently, patients who received PRP were more satisfied with the treatment. No adverse events were observed during the study period.
The authors noted that the exact mechanism through which PRP improves erectile function remains unknown, adding that this area needs further investigation.
Further research should focus on PRP protocols for the treatment of erectile dysfunction and whether PRP would be suitable as a single therapy or as part of a combined approach.
Overall, treatment with intracavernous injection of PRP, as a new representative of the burgeoning field of regenerative medicine, appears to be a promising option in the arsenal of urologists," the authors concluded.