Autologous Platelet-Rich Plasma Penile Injection After Failed Oral Medical Management of Erectile Dysfunction

Objective: Platelet-rich plasma (PRP) injection is an evolving regenerative therapy in the management of erectile dysfunction (ED). This study aimed to evaluate the efficacy and safety of autologous intracavernosal PRP injections in patients with ED who failed oral medical management. Methods: The single-arm prospective interventional study included men with all grades of ED who received two PRP injections (prepared using the TriCell TriPReP TUBEX system) one month apart. The primary endpoint was the percentage of men who achieved the minimum clinically important difference (MCID). Secondary endpoints included change in International Index of Erectile Function-Erectile Function (IIEF-EF) domain scores from baseline to 1- and 3-month post-treatment, adverse events, and overall treatment satisfaction. Results: Thirty out of 32 enrolled patients completed the study protocol (mean age 36.53 years). Mean IIEF-EF scores significantly improved (p < 0.001) from baseline (13.01) to 1 month (15.9) and 3 months (18.03) post-treatment. MCID was achieved by 30% of patients at 1 month and 53.3% at 3 months, across all grades of ED. More importantly, patients with mild and mild-to-moderate ED showed superior response rates in achieving MCID (90% at 1 month, 100% at 3 months) compared to moderate and severe ED patients (0% at 1 month, 30% at 3 months). No adverse events were reported, and patients reported moderate satisfaction with overall treatment (mean score of 2.2 on a Likert scale of 1-4). Conclusion: PRP is safe across all grades of ED but efficacious in mild and mild-moderate grades of ED. Future, larger, placebo-controlled studies are warranted to further validate these findings.