Efficacy and Safety of Intracavernosal Injection of Autologous Platelet Rich Plasma for Treatment of Erectile Dysfunction

Purpose: This work aimed to evaluate the efficacy and safety of intracavernosal injection (ICI) of autologous platelet rich plasma (PRP) for the treatment of erectile dysfunction (ED).

Method: This study included 30 patients (mean age 55.1) suffering from ED for more than 1 year. They were non-responders to oral phosphodiesterase type 5 (PDE5) inhibitors. Before initial therapy by PRP, all patients were subjected to history taking, examination and evaluation of erectile function (EF) using an abridged Arabic version of International Index of Erectile Function (IIEF-5). Additionally, patients were evaluated by Penile Color Doppler Ultrasonography (PCDUS). ICI of PRP was done once per week for 2 months.Follow up of EF and penile hemodynamics included evaluation of patients by IIEF-5 at 1, 2, 3 months and PCDUS at 3 months after initiation of therapy.

Results: IIEF-5 score showed significant improvement at 1, 2 and 3 months after PRP injection. The injections improved the penile hemodynamics on both sides such that, the right peak systolic velocity (PSV), end diastolic velocity (EDV) and diameter of cavernosal artery differed after treatment compared to pre treatment levels (p value 0.012, 0.002 and 0.000) respectively. Also, PRP therapy improved the left side PSV, EDV and cavernosal artery diameter but the difference was statistically significant only in the left cavenosal EDV and cavernosal artery diameter (p value 0.002 and 0.000) respectively. Moreover, the results revealed a significant difference between response to ICI before and after treatment (p value 0.028). Also, the treatment was well tolerated and no major side effects were reported.

Conclusion: ICI of PRP could improve erectile function, penile hemodynamics, response to ICI, patient satisfaction and might be a salvage treatment for patients with severe erectile dysfunction who failed response to medical treatment.