Platelet-Rich Plasma Therapy for Male Sexual Dysfunction: Myth or Reality?

Introduction: Platelet-rich plasma (PRP) found its use in treating different conditions and diseases, because concentrated plasma PRP consists of many growth factors. Their interaction with surrounding cells, intracellular matrix, and mediators at the site of injection leads to tissue regeneration. Angiogenic, vasculogenic, and regenerative effects of PRP may be used for erectile dysfunction (ED) and Peyronie's disease (PD) treatment. Aim: To present a current data review of preclinical and clinical trials on PRP use for treating ED and PD. Methods: Up-to-date literature on PRP use for ED and PD treatment was analyzed. The search was based on Pubmed, Cochrane Library, clinicaltrials.gov databases, with the following key words: platelet-rich plasma and/or erectile dysfunction and/or Peyronie's disease and/or sexual dysfunction. Main Outcome Measures: The main outcome measures for preclinical trials on ED were erectile function, assessed with intracavernous pressure, and pathologic analysis of penile tissue. The main outcome measures for clinical trials on ED included penile duplex Doppler ultrasound scanning and validated questionnaires. The main outcome measures on PD were pathologic analysis of penile tissue for preclinical trials, as well as penile duplex Doppler ultrasound scanning, penile curvature angle measuring, and validated questionnaires for clinical trials. Results: 4 preclinical and 6 clinical trials were described and analyzed in this article. Limitations for both preclinical and clinical trials included small groups, short follow-up periods, a lack of control groups or groups with placebo, and the lack of quality and quantity analysis of PRP. Conclusion: Available data show the lack of adverse reactions with PRP treatment. The studies that we found were limited by small groups. This is why the data on safety and effectiveness should be taken carefully. However, it is important to mention that PRP therapy has the potential for treating male sexual dysfunction and may be useful in andrology. Copyright (C) 2019, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.