Efficacy of Platelet-rich Plasma in the Treatment of Erectile Dysfunction: A Meta-analysis of Controlled and Single-arm Trials

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Nov 14

PMID 39541282

Authors

Shaokang Du

Shiwei Sun

Fuyu Guo

Hongyao Liu

Affiliations

Soon will be listed here.

Abstract

Background: Erectile dysfunction (ED) is a prevalent condition in urology, and studies on the effectiveness of platelet-rich plasma (PRP) for this condition have been conducted; however, the evidence remains inconclusive. This meta-analysis aimed to evaluate the effectiveness of PRP in treating ED.

Methods: On May 17, 2024, a literature search was performed and evaluated using the Cochrane method. The primary outcome measured was the International Index of Erectile Function (IIEF) score, while the secondary outcomes included Minimal Clinically Important Difference (MCID) and peak systolic velocity (PSV).

Results: A total of 12 controlled trials involving 991 patients and 11 single-arm trials with 377 patients were analyzed. The findings revealed that compared to the control group, the PRP group demonstrated better outcomes in terms of the IIEF score and MCID (SMD = 0.59 (95% CI: [0.34, 0.84]; RR = 1.94 (95% CI: [1.33, 2.83]), In the single-arm trials, a significant improvement in IIEF scores was observed following PRP treatment (SMD = -0.99 95% CI: [-1.53, 0.46]).

Conclusion: PRP appears effective in treating erectile dysfunction, but further high-quality, large-sample trials with longer follow-up are needed to fully understand its effects.

References

Yu Z, Zhang Y, Tang Z, Song J, Gao X, Sun T . Intracavernosal Adeno-Associated Virus-Mediated S100A1 Gene Transfer Enhances Erectile Function in Diabetic Rats by Promoting Cavernous Angiogenesis via VEGF-A/VEGFR2 Signaling. J Sex Med. 2019; 16(9):1344-1354. DOI: 10.1016/j.jsxm.2019.06.011. View

Pavlovic V, Ciric M, Jovanovic V, Stojanovic P . Platelet Rich Plasma: a short overview of certain bioactive components. Open Med (Wars). 2017; 11(1):242-247. PMC: 5329835. DOI: 10.1515/med-2016-0048. View

Schirmann A, Boutin E, Faix A, Yiou R . Pilot study of intra-cavernous injections of platelet-rich plasma (P-shot®) in the treatment of vascular erectile dysfunction. Prog Urol. 2022; 32(16):1440-1445. DOI: 10.1016/j.purol.2022.05.002. View

Shaher H, Fathi A, Elbashir S, Abdelbaki S, Soliman T . Is Platelet Rich Plasma Safe and Effective in Treatment of Erectile Dysfunction? Randomized Controlled Study. Urology. 2023; 175:114-119. DOI: 10.1016/j.urology.2023.01.028. View

Vieiralves R, Schuh M, Favorito L . Low-intensity extracorporeal shockwave therapy in the treatment of erectile dysfunction - a narrative review. Int Braz J Urol. 2023; 49(4):428-440. PMC: 10482445. DOI: 10.1590/S1677-5538.IBJU.2023.9904. View

Zaghloul A, Mahmoud ElNashar A, GamalEl Din S, Zaki Said S, Saad H, Refaat Eldebs H . Smoking status and the baseline international index of erectile function score can predict satisfactory response to platelet-rich plasma in patients with erectile dysfunction: A prospective pilot study. Andrologia. 2021; 53(9):e14162. DOI: 10.1111/and.14162. View

Achraf C, Abdelghani P, Jihad P . Platelet-rich plasma in patients affected with Peyronie's disease. Arab J Urol. 2023; 21(2):69-75. PMC: 10208162. DOI: 10.1080/2090598X.2022.2135284. View

Shahinyan G, Weinberger J, Shahinyan R, Yang S, Mills J, Eleswarapu S . Analysis of Direct-to-Consumer Marketing of Platelet-Rich Plasma for Erectile Dysfunction in the US. JAMA Netw Open. 2022; 5(5):e2214187. PMC: 9136622. DOI: 10.1001/jamanetworkopen.2022.14187. View

Enck P, Klosterhalfen S . Placebos and the Placebo Effect in Drug Trials. Handb Exp Pharmacol. 2019; 260:399-431. DOI: 10.1007/164_2019_269. View

10.

Shamloul R, Ghanem H . Erectile dysfunction. Lancet. 2012; 381(9861):153-65. DOI: 10.1016/S0140-6736(12)60520-0. View

11.

Dai W, Zhou A, Zhang H, Zhang J . Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Trials. Arthroscopy. 2016; 33(3):659-670.e1. DOI: 10.1016/j.arthro.2016.09.024. View

12.

Mykoniatis I, Pyrgidis N, Sokolakis I, Ouranidis A, Sountoulides P, Haidich A . Assessment of Combination Therapies vs Monotherapy for Erectile Dysfunction: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021; 4(2):e2036337. PMC: 7893498. DOI: 10.1001/jamanetworkopen.2020.36337. View

13.

Poulios E, Mykoniatis I, Pyrgidis N, Zilotis F, Kapoteli P, Kotsiris D . Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial. J Sex Med. 2021; 18(5):926-935. DOI: 10.1016/j.jsxm.2021.03.008. View

14.

Quartagno M, Carpenter J . Multiple imputation for IPD meta-analysis: allowing for heterogeneity and studies with missing covariates. Stat Med. 2015; 35(17):2938-54. PMC: 5064632. DOI: 10.1002/sim.6837. View

15.

Burnett A . Commentary RE: The International Index of Erectile Function (IIEF): A Multidimensional Scale for Assessment of Erectile Dysfunction. Urology. 2020; 145:308-309. DOI: 10.1016/j.urology.2020.04.071. View

16.

MORELAND R, Gupta S, Goldstein I, Traish A . Cyclic AMP modulates TGF-beta 1-induced fibrillar collagen synthesis in cultured human corpus cavernosum smooth muscle cells. Int J Impot Res. 1998; 10(3):159-63. DOI: 10.1038/sj.ijir.3900323. View

17.

Zugail A, Alshuaibi M, Lombion S, Beley S . Safety and feasibility of percutaneous needle tunneling with platelet-rich plasma injections for Peyronie's disease in the outpatient setting: a pilot study. Int J Impot Res. 2023; 36(2):140-145. DOI: 10.1038/s41443-023-00744-y. View

18.

Ragheb A, Lotfy A, Fahmy M, Elmarakbi A . Safety and efficacy of platelet-rich plasma injection for treatment of erectile dysfunction: a prospective randomized controlled study. Basic Clin Androl. 2024; 34(1):16. PMC: 11460124. DOI: 10.1186/s12610-024-00232-3. View

19.

Clavijo R, Kohn T, Kohn J, Ramasamy R . Effects of Low-Intensity Extracorporeal Shockwave Therapy on Erectile Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med. 2016; 14(1):27-35. DOI: 10.1016/j.jsxm.2016.11.001. View

20.

Francomano D, Iuliano S, Deho F, Capogrosso P, Tuzzolo P, La Vignera S . Regenerative treatment with platelet-rich plasma in patients with refractory erectile dysfunction: short-term outcomes and predictive value of mean platelet volume. Minerva Endocrinol (Torino). 2023; . DOI: 10.23736/S2724-6507.23.04060-5. View