Efficacy and safety of platelet-rich plasma intracavernous injection for patients with erectile dysfunction: A systematic review, meta-analysis, and meta-regression
Sally Suharyania,Moses Leonardoa,Heru Harsojo Oentoengb,Edwin Raja Pardamean Lumban Tobingc,Christiano Tansolc,Timotius Ivan Hariyantoa*()
aFaculty of Medicine, Pelita Harapan University, Tangerang, Indonesia bDepartment of Andrology and Sexual Medicine, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia cDepartment of Urology, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
Objective: Intracavernous injection might be offered to patients with erectile dysfunction (ED) who did not respond to the first-line oral treatment. Platelet-rich plasma (PRP) might offer improvement in erectile function since it contains numerous growth factors. This study aimed to evaluate the efficacy and safety of PRP intracavernous injection for patients with ED.
Methods: We conducted relevant literature searches on Cochrane Library, Medline, Scopus, and ClinicalTrials.gov ↗ databases using specific keywords. The results of continuous variables were pooled into the mean difference (MD) and dichotomous variables into the odds ratio along with 95% confidence interval (95% CI).
Results: A total of six studies were included. Our pooled analysis revealed that PRP intracavernous injection was associated with a significant increase in the erectile function domain of the International Index of Erectile Function at 1 month (MD 3.47 [95% CI 2.62-4.32], p<0.00001, I2=7%), 3 months (MD 3.19 [95% CI 2.25-4.12], p<0.00001, I2=0%), and 6 months (MD 3.21 [95% CI 2.30-4.13], p<0.00001, I2=0%) after the intervention when compared with baseline values. PRP was also superior to a placebo in terms of improvement in erectile function domain of the International Index of Erectile Function score at 1 month (MD 2.83, p<0.00001), 3 months (MD 2.87, p<0.00001), and 6 months (MD 3.20, p<0.00001) post-intervention. The adverse events from PRP injection were only mild without any serious adverse events.
Conclusion: PRP intracavernous injection may offer benefits in improving erectile function in patients with ED with a relatively good safety profile.
. [J]. Asian Journal of Urology, 2024, 11(4): 545-554.
Sally Suharyani, Moses Leonardo, Heru Harsojo Oentoeng, Edwin Raja Pardamean Lumban Tobing, Christiano Tansol, Timotius Ivan Hariyanto. Efficacy and safety of platelet-rich plasma intracavernous injection for patients with erectile dysfunction: A systematic review, meta-analysis, and meta-regression. Asian Journal of Urology, 2024, 11(4): 545-554.
• Three sessions of PRP injection (15 days apart): 3 mL PRP was injected into each corpus cavernosum (total 6 mL) with additional of 6 mL injected subcutaneously
·- Moderate: 60 ·- Severe: 40
NA
56.1
NA
46.7
66.7
93.3
Shaher et al., 2023 [19]
Double-blind RCT
• 100 (intervention group: 50; control group: 50)
• Two sessions of PRP injection (2 weeks apart): 3 mL PRP was injected into each corpus cavernosum at three different sites: 1 cm proximal to the corona, 1 cm distal to the root of penis, and at the mid-penile shaft
• Three sessions of PRP injection (15 days apart): 3 mL PRP was injected into each corpus cavernosum with sites of injection varying by 1 cm in the mid-penile region
- NA
64.2±46.6
54.4
30.8
51.6
51.6
NA
Wong et al., 2021 [21]
Prospective study
• 30
• Three sessions of PRP injection (3 weeks apart): 1-2 mL PRP was injected into each corpus cavernosum
- NA
25.7
54.9
25.7
40
16.7
30
Zaghloul et al., 2021 [22]
Prospective study
• 34
• Eight sessions of PRP injection (1 week apart): 0.5 mL PRP was injected into each corpus cavernosum (total of 1 mL)
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