Dados do Trabalho

Título

PLATELET-RICH PLASMA VS PLACEBO FOR ERECTILE DYSFUNCTION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Introdução e Objetivo

Erectile dysfunction (ED) is the persistent inability to attain and maintain a penile erection to permit satisfactory sexual performance. The central physiopathology is endothelial dysfunction of the blood vessels of the corpora cavernosa. Injection of platelet-rich plasma (PRP) aims angiogenesis stimulation and stem cells recruitment, with regeneration of damaged tissue. It has gained interest as a regenerative medicine for ED in the past years. This study aims to evaluate the effectiveness of platelet-rich plasma in treating erectile dysfunction.

Método

We performed a systematic review and meta-analysis with articles published in Pubmed, Embase, and Cochrane comparing PRP (intervention group) with a placebo (control goup) in patients with ED. The main endpoint was the proportion of patients achieving the Minimal Clinically Important Difference (MCID) in the International Index of Erectile Function (IIEF) domain one month, three months, and six months after PRP. MCID is the smallest difference in a domain of interest score that patients perceive as beneficial. MCID in patients with mild ED is 2, and moderate ED is 5.

Resultados

Three randomized clinical trials with 221 patients were analyzed. A total of 108 underwent PRP. The proportion of MCID after 1 month (Figure 1A) was 68.5% and 27.4% in the intervention and control groups, respectively, with a statistically significant difference (OR 5.16; 95% CI 2.93-9.08; p < 0.00001). After 3 months (Figure 1B), the proportion was 61.1% and 27.4%, respectively, and there was also a statistically significant difference (OR 3.78; 95% CI 2.18-6.56; p < 0.00001). After 6 months (Figure 1C), the proportion was 62% and 22.1%, respectively, and there was also a statistically significant difference (OR 5.39; 95% CI 3.01-9.64; p < 0.00001).

Conclusão

The group treated with PRP injections in clinical trials showed a statistically significant higher proportion of MCID, placing it as a promising regenerative therapy for ED. This is the first meta-analysis comparing platelet-rich plasma with a placebo, and more studies are important for therapy consolidation, with greater homogeneity both in the preparation of PRP as in the indication and application protocols.