Efficacy of autologous platelet-rich plasma for the treatment of erectile dysfunction
Epifanova, MV1; Chaliy, ME2; Gvasalia, BR3; Repin, AM2; Artemenko, SA2
1: Research Institute for Uronephrology and Reproductive Health, Sechenov First Moscow State Medical University (Moscow, Russia); 2: Department of Urology, Sechenov First Moscow State Medical University (Moscow, Russia); 3: Central Military Clinical Hospital (Moscow, Russia)
Objective: Phosphodiesterase type 5 inhibitors (PDE5Is) are the leading drugs for the treatment of erectile dysfunction (ED), being recommended as a first line treatment by urological guidelines. However, some patients do not respond to drug therapies. Platelet-rich plasma (PRP) has been suggested to be effective in the management of ED. The aim of this study was to assess the efficacy of autologous platelet-rich plasma (PRP) for the treatment of ED.
Methods: 60 patients aged 43.7 (SD=13.7) with ED (mean duration of ED was 7.7±1.7 months) were randomly separated into 2 groups. Group A received 4 ml activated PRP (aPRP) intracavernosal injection weekly (totally 3 times), while Group B received PRP injections according to the same schedule plus 5 mg of tadalafil daily during 28 days. The International Index of Erectile Function (IIEF), Erection Hardness Scale (EHS), EndoPAT, Penile duplex Doppler ultrasound (PDDU), Sexual Encounter Profile (SEP) and complications (if any) were evaluated at 4 weeks, 3 and 6 months. Data sets were statistically compared and p<0.05 was considered as significant.
Results: At week 4 and at 3 months Group B shows significant improvement in IIEF score compared to baseline (р=0.001). There was no apparent difference in results between groups at 6 months. SEP score was similar in both groups during the study, but EHS score was higher in group B at 3 months (р=0.002). EndoPAT - endothelial function was significantly improved in both groups at 6 months compared to baseline (р=0.018) as well as resistive index (RI) in the cavernosal arteries (р=0.001). The treatment was well tolerated and none of the men experienced treatment related discomfort or reported any adverse effects from the treatment.
Conclusion: PRP seems to be able to improve vascular endothelial function and erection hardness to treat erectile dysfunction with less adverse effects and better safety. Longer followup is needed to establish the place of PRP in restoring of erectile function.
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