Efficacy and safety of platelet-rich plasma intracavernosal injection for patients with erectile dysfunction: A systematic review, meta-analysis, and meta-regression

Abstract

ObjectiveIntracavernosal injection might be offered to patients with erectile dysfunction (ED) who did not respond to the first-line oral treatments. 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 intracavernosal injection for patients with ED. MethodsWe 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 odds ratio (OR) along with their 95% confidence intervals (95% CI) using fixed-effect models. ResultsA total of six studies were included. Our pooled analysis revealed that PRP intracavernosal 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%) post-intervention when compared with baseline values. PRP was also superior to placebo in terms of improvement in the International Index of Erectile Function scores at 1 month (MD 2.83, p<0.0001), 3 months (MD 2.87, p=0.0004), and 6 months (MD 3.20, p<0.0001) post-intervention. The adverse events from PRP injection were only mild without any serious adverse events. ConclusionPRP intracavernosal injection may offer benefits in improving erectile function in patients with ED with a relatively good safety profile. However, further randomized clinical trials with larger sample sizes are still needed to confirm the results of our study.