Any news that shows promise for outcomes concerning erectile dysfunction is good news. Platelet-rich plasma (PRP) might just fit into that category.
What is PRP?
PRP is a quite new treatment used for several conditions, such as osteoarthritis, joint pain and erectile dysfunction (ED), said Justin Houman, M.D., a reproductive urologist and men's health specialist at Tower Urology in Los Angeles.
"The idea is that platelets have a lot of growth factors that can help regenerate tissues," said Michael Werner, M.D., the medical director and founder of Maze Sexual & Reproductive Health, with offices in New York.
Houman added that PRP potentially helps improve the health of the penis if it has been damaged.
"It can theoretically decrease scarring, improve elasticity and increase blood flow," he said.
Men might be interested to know how PRP injections work and whether they are suitable for all men with erectile dysfunction.
How PRP injections work
Blood usually contains 93 percent red blood cells, 6 percent platelets and 1 percent white blood cells. To prepare a PRP injection, blood is drawn from the arm and processed through centrifugation to change the blood composition to 94 percent platelets and 5 percent red blood cells. The platelet-rich sample is then reinjected into the body to promote healing.
To create PRP suitable for the treatment of erectile dysfunction, a doctor essentially draws blood from the arm, spins it down, takes the fluid that is now rich in platelets and injects it into both corpora cavernosa of the penis—that's where blood flows to cause an erection.
"The idea is it promotes healthy tissue growth and, with that, good erectile function," Houman said.
"When treating erection issues, we can always manage to get you an erection," Werner said, adding that treatment starts from the least invasive option and progresses to more invasive treatments if necessary.
PRP injections are minimally invasive and natural, using blood from the patient's own body. Nothing else is added to the final injection.
"PRP is pretty noninvasive. It involves a small scratch from the needle, but other than that, there is no pain, no bruising, no dangers," Werner said. "It's just a case of seeing if it works."
What the research says
Platelet-rich plasma injections have been around for a long time, with good anecdotal results, but until now, there hasn't been much research available, Werner said.
More recently, a double-blind, randomized, placebo-controlled clinical trial studied 60 sexually active patients with mild and moderate erectile dysfunction. Results from the study, published in May 2021 in the Journal of Sexual Medicine, suggested 69 percent of the men in the trial experienced a clinical difference in erectile function from PRP injections, compared to 27 percent in the placebo group. The study concluded that PRP injections might be a promising addition to managing erectile dysfunction, but further high-quality studies are needed to corroborate the findings.
Interestingly, PRP injections potentially work toward treating erectile dysfunction rather than managing it. The goal is to reestablish whole-organ function and reverse ED. This means men can work toward the all-important spontaneity aspect of their sex life.
The Food and Drug Administration (FDA) has not yet approved PRP injections for ED, but physicians can use PRP in clinical practice without gaining FDA approval.
"This is still an experimental treatment option for men with erectile dysfunction, and research is ongoing," Houman said. "But it is not going to cause harm—as long as it is done by a medical professional—and can only help."
The best candidates for PRP injections
Physicians and researchers are still trying to figure out who may benefit most from PRP injections. Research is underway.
"I would always do PRP injections in conjunction with another treatment, such as medication or shockwave therapy, rather than on its own," Houman said. "That gives an option to maximize therapeutic effect and then pare back treatment as we see improvement."
Werner added that while research shows modest improvements in mild to moderate erectile dysfunction, PRP may not be as beneficial for men with severe erectile dysfunction.
"If you have severe erectile dysfunction, it may improve it, but you will likely still need to manage it. Therefore, it might not be the best treatment option in these cases," he said, while acknowledging there isn't much research available on use in severe ED cases to evaluate the choice one way or the other.
The bottom line is that PRP for erectile dysfunction is still relatively new but shows promise, especially with the prospect of treating erectile dysfunction rather than just managing it. It's a progressive area of regenerative cell therapy that definitely will receive more attention from researchers.