Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial

Poulios, Evangelos; Mykoniatis, Ioannis; Pyrgidis, Nikolaos; Zilotis, Filimon; Kapoteli, P.; Kotsiris, Dimitrios; Kalyvianakis, D.; Hatzichristou, Dimitrios

doi:10.1016/j.jsxm.2021.03.008

Cited by 62 publications

(39 citation statements)

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“…Patients treated with PDE5 inhibitors display high discontinuation rates due to adverse events or inefficacy and, thus, research on novel ED treatment is imperative (Burnett and Hellstrom, 2012). Promising single or combination treatment modalities that may comprise growth factor therapy, stem cell therapy, or even gene therapy and tissue engineering may make their way through the clinical pipeline (Poulios et al, 2021;Raheem et al, 2021). Consequently, studies comparing the efficacy and safety of such treatment strategies in the form of monotherapy or combination therapy with PDE5 inhibitors are mandatory.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Phosphodiesterase-type 5 Inhibitors on Erectile Function: An Overview of Systematic Reviews

et al. 2021

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Background: Multiple systematic reviews explore the effect of phosphodiesterase type 5 (PDE5) inhibitors on erectile dysfunction (ED), with each study addressing specific outcomes. However, physicians and policymakers require a holistic approach of this topic.Objective: To summarize the current evidence regarding the efficacy and safety of PDE5 inhibitors for the management of ED through an overview of systematic reviews.Methods: Studies were identified by searching PubMed, Web of Science, Cochrane Library and Scopus databases, as well as sources of grey literature until June 12, 2021 (PROSPERO: CRD42020216754). We considered systematic reviews, meta-analyses or network meta-analyses of randomized trials that provided outcomes about the efficacy and safety of any approved PDE5 inhibitor (avanafil, sildenafil, tadalafil and vardenafil). We constructed forest plots for meta-analytic effects regarding the change in erectile function, adverse events and dropouts after administration of PDE5 inhibitors in the general population and in specific patient groups.Results: We included 23 studies with 154,796 participants and a total of 258 meta-analytic effects. Sildenafil 25 mg [Weighted Mean Difference (WMD): 13.08, 95% Confidence Interval (CI): 10.1-16.06] seemed to be statistically superior to all interventions in improving erectile function compared to placebo, but studies with low-dose sildenafil are lacking. Moreover, comparing among different PDE5 inhibitors, sildenafil 50 mg or sildenafil 100 mg were considered the most effective compounds in the general population. The latter derived, however, predominantly from indirect comparisons among different PDE5 inhibitors. Still, sildenafil 100 mg was associated with more treatment-related adverse events and dropouts. Interestingly, low-dose daily tadalafil may be more effective than high-dose on-demand tadalafil (WMD: 1.24, 95% CI: 0.03-2.44). Furthermore, testosterone and PDE5 inhibitors in patients with ED and hypogonadism seem to further improve symptoms, while the addition of a-blockers in patients with urinary symptoms treated with PDE5 inhibitors does not provide additional benefits (WMD: −0.8, 95% CI: −1.65-0.06).Conclusion: Although the efficacy and safety of PDE5 inhibitors, compared to placebo, is well-documented, the existing evidence comparing different PDE5 inhibitors is low. Therefore, high-quality, head-to-head, trials comparing different PDE5 inhibitors are necessary to determine their ideal dosage and formulation based on their safety and efficacy profile.Systematic Review Registration: PROSPERO, identifier [CRD42020216754].

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Section: Discussionmentioning

confidence: 99%

The Effect of Phosphodiesterase-type 5 Inhibitors on Erectile Function: An Overview of Systematic Reviews

et al. 2021

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“…Several preclinical and clinical trials were designated in using autologous PRP for treating ED with a limitation of small groups and short follow-up periods (Chung, 2021;Zaghloul et al, 2021). The main outcome measures for those preclinical trials on ED were erectile function, evaluated with intracavernosal pressure and histopathology of the cavernous tissue (Poulios et al, 2021;Wu et al, 2021).…”

Section: These Augmented Levels Of Platelets Have Been Demonstratedmentioning

confidence: 99%

“…Several preclinical and clinical trials were designated in using autologous PRP for treating ED with a limitation of small groups and short follow‐up periods (Chung, 2021; Zaghloul et al, 2021). The main outcome measures for those preclinical trials on ED were erectile function, evaluated with intracavernosal pressure and histopathology of the cavernous tissue (Poulios et al, 2021; Wu et al, 2021). Besides, the main outcome measures for clinical trials included validated questionnaires as well as penile duplex Doppler ultrasound (Alkandari et al, 2021; Epifanova et al, 2020; Raheem et al, 2021; Scott et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Assessment of the intracavernosal injection platelet‐rich plasma in addition to daily oral tadalafil intake in diabetic patients with erectile dysfunction non‐responding to on‐demand oral PDE5 inhibitors

et al. 2022

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This study aimed to evaluate the effectiveness of ICI of platelet‐rich plasma (PRP) in addition to daily oral tadalafil intake in diabetic erectile dysfunction (ED) patients non‐responding to PDE5 inhibitors. Overall, 48 patients complaining of ED non‐responding to on‐demand PDE5 inhibitors were allocated into 2 equal groups, diabetics and non‐diabetics that were given a daily dose of 5 mg tadalafil plus vardenafil 20 mg on demand during the study besides being subjected to 3 doses of ICI of PRP, 4 weeks apart. Responses to on‐demand PDE5 inhibitors, International index of erectile function‐5 (IIEF‐5) score, erection hardness scores (EHS) and pharmaco‐dynamic duplex studies were assessed. After PRP injections, 33% and 50% of cases were satisfied with on‐demand PDE5 inhibitors, respectively, whereas 41% and 66% of them showed improved EHS response. Compared with baseline scores, the mean IIEF‐5 scores were significantly improved after PRP therapy in the diabetic ED group (12.1 vs. 8.04, p = 0.003) as well as in the non‐diabetic ED group (14.8 vs. 10.2, p = 0.001) linked to pharmaco‐penile duplex readings. Both good and fair diabetic control exhibited significant responses to ICI therapy of PRP compared with bad controlled cases. The significant improvement included; the IIEF‐5 score increase (86.7%, 126% vs. 16.1%), improved EHS as well as penile duplex readings. Baseline HbA1C demonstrated a significant negative correlation with IIEF‐5 score before (p = 0.019) and after PRP therapy (p = 0.002) respectively. It could be concluded that ICI of PRP could be an effective therapy for treating ED patients non‐responding to on‐demand oral PDE5 treatment.

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“…Only one randomized, double blind, placebo-controlled study has been conducted and published to date evaluating the effects of PRP in men with mild and moderate ED ( 34 ). This was conducted by Poulios et al and published in 2021, and is the highest quality study to date of PRP injections in ED.…”

Section: Review Of the Current Evidencementioning

confidence: 99%

Erectile dysfunction: Is platelet-rich plasma the new frontier for treatment in patients with erectile dysfunction? A review of the existing evidence

Anastasiadis

Ahmed

Khoja

et al. 2022

Front. Reprod. Health

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Erectile dysfunction (ED) is one of the commonest disorders in adult males and affects 12–19% of men of reproductive age. Only few studies have evaluated the impact of ED on men and couples with infertility—these studies report higher rates of ED in this sub-group of men compared to the general population, with the prevalence of ED in men diagnosed with male infertility ranging from 6.7 to 61.6%. Nevertheless, ED is considered a rare cause of male infertility, accounting for about 0.4–5% of all causes of male infertility. ED remains a poorly treated condition globally and current therapies, like oral medication, offer only temporary symptomatic relief and do not influence disease progression—patients are potentially on lifelong treatment, with ED worsening over time. In contrast, regenerative medicine may potentially reverse or halt the progression of ED processes. In this article, we review the evidence for intracavernosal injections of platelet-rich plasma (PRP) in the treatment of ED.

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Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial

Cited by 62 publications

References 35 publications

The Effect of Phosphodiesterase-type 5 Inhibitors on Erectile Function: An Overview of Systematic Reviews

The Effect of Phosphodiesterase-type 5 Inhibitors on Erectile Function: An Overview of Systematic Reviews

Assessment of the intracavernosal injection platelet‐rich plasma in addition to daily oral tadalafil intake in diabetic patients with erectile dysfunction non‐responding to on‐demand oral PDE5 inhibitors

Erectile dysfunction: Is platelet-rich plasma the new frontier for treatment in patients with erectile dysfunction? A review of the existing evidence

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