New protocol in the treatment of Peyronie's disease by combining platelet-rich plasma, percutaneous needle tunneling, and penile modeling: Preliminary results

Platelet-rich plasma therapy in erectile dysfunction and Peyronie’s disease: a systematic review of the literature

“…Small sample size Zugail [ 28 ] 2023 Prospective, non-randomized, cohort study 54 patients median age 47.50 (IQR: 40–55) years Inclusion criteria: consecutive male patients with PD (difficulties to coitus due to palpable TA plaque) Exclusion criteria: Curative dose of anticoagulant medications; unstable plaques; curvature that has no impact on sexual performance; ED nonresponsive to treatments N/A Autologous PRP; sample was centrifugated at 3500 rpms for 5 min Injection of 5–6 mL of PRP into the plaque after creating multiple channels along the entire longitudinal axis of the plaque through a 25G needle. Each session scheduled 4 weeks apart for a total of 6 sessions Penile vacuum therapy was initiated on day 14 after each session for a daily use of 30 min each day Total follow up time: 7 months after the first injection Improvement in penile curvature (mean curvature 53.98 ± 23.19° vs 30.09 ± 20.61°; p = 0.001) Ecchymosis at injection site (75.9%); skin infection (1.85%) VAS score was 3 (IQR 0–4.25) at baseline and 2 h after injection 20.37% (11/54) patients referred pain Small sample size; lack of placebo group; cannot exclude if the results are due to PRP or vacuum; how self-photographs of the penis are taken may affect the outcomes Alshuaibi [ 31 ] 2023 Prospective, non-randomized, cohort study 36 patients, median age 54.08 (± 8.8) years Inclusion criteria: penile curvature due to palpable stable plaque in TA Exclusion criteria: nonstable plaques, curvature with no impact on the sexual performance, and ED not responding to treatment N/A Autologous PRP; sample was centrifugated at 3500 rpms for 5 min After the creation of multiple holes along the entire longitudinal axis of the plaque through a 25Gx5-8 inches needle, and penile manipulation for 5 min, each patient received the Injection of 10–12 mL of PRP into the plaque on erected penis; additional 5 min of penile manipulation followed. Use of vacuum started on the 7th day Total follow up time: 1 year The pretreatment mean curvature degree was 57.5 ± 20.61.…”

“…Despite promising results being reported, with an improvement in penile curvature from 53.98 ± 23.19° at baseline to 30.09 ± 20.61° post-treatment ( p = 0.001), it is impossible to establish if the benefits came from PRP injections or vacuum therapy. Analogously Alshuaibi et al also applied a combined treatment approach using percutaneous needle tunnelling followed by penile modeling and PRP injection [ 28 , 31 ]. However, in contrast to the aforementioned protocols, patients received the treatment after artificially induced erections and during general anesthesia; these measures could ensure a more accurate assessment of penile curvature and plaques position.…”