Men with mild-to-moderate erectile dysfunction (ED) may benefit from intracavernosal platelet-rich plasma (PRP) injection therapy, a recent Journal of Sexual Medicine study suggests.

Researchers reported that their PRP protocol “appears to be a safe and effective short-term treatment” and that improvements were maintained for six months. However, they also noted that more research is needed.

PRP is created from a patient’s own blood. Using a platelet separator, clinicians produce PRP, which has a higher platelet concentration than whole blood. PRP injections have been used to treat conditions like arthritis and tendonitis.

Previous animal studies have suggested that PRP could be useful for the treatment of ED as well. However, trials in humans have been limited.

The current study included 60 heterosexual, sexually active men in stable relationships. All of the men had mild-to-moderate ED based on the International Index of Erectile Function’s erectile function domain (IIEF-EF). They ranged in age from 40 to 70, with an average age of 58.5 years.

Thirty men were assigned to receive two injections of PRP. The remaining 30 men received two placebo injections. The injections were spaced one month apart. At one-, three- and six-month follow-up points, the men were assessed for treatment-induced pain [using a Visual Analogue Scale], sexual experiences [using Sexual Encounters Profile diaries], erectile function [using the IIEF-EF], and treatment satisfaction [using the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) tool].

At each assessment point, the researchers determined the minimal clinically important difference (MCID) for each participant. Men with mild and mild-to-moderate ED achieved MCID if their IIEF-EF scores improved two or more points. For men with moderate ED, the MCID was defined as a 5-point IIEF-EF improvement.

Because of the COVID-19 pandemic, one man in the PRP group and four men in the placebo group did not have follow-up assessments.

The researchers reported the following results:

The men in the PRP also reported greater satisfaction with their treatment and outcomes than the placebo group. The placebo group reported more pain. No adverse events were reported for either group.

The authors noted several limitations to the research. For example, the results are based on experiences from one medical center using one type of PRP separation system. Also, the study group was small and the follow-up time was short. No comparisons of patients with varying degrees of ED were performed.

“[T]he exact mechanism through which PRP improves erectile function remains unknown,” the authors said, adding that this area needs more research.

Additional research should focus on PRP protocols for ED treatment and whether PRP would be suitable as a single therapy or as part of a combination approach.

“Overall, PRP intracavernosal injection treatment, as a new representative of the flourishing field of regenerative medicine, seems to be a promising addition to the urologist’s armamentarium. Nevertheless, before it is accepted as part of the ED algorithm, further high-quality studies are warranted to corroborate our findings,” the authors concluded.

Resources

• The Journal of Sexual Medicine - “Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial”
  Poulios, Evangelos, MSc, et al.
  (Full-text. Published: April 24, 2021)
  https://www.jsm.jsexmed.org/article/S1743-6095(21)00315-5/fulltext
  
  
• Jumpstart by WebMD - “Platelet-Rich Plasma Injections: What to Know”
  (Reviewed: August 13, 2019)
  https://www.webmd.com/fitness-exercise/platelet-rich-plasma-injections#1