Efficacy, commercialisation and evidence relating to platelet rich plasma injections for the treatment of erectile dysfunction

Abstract

Background: Platelet rich plasma (PRP) injections have been marketed as a form of autologous stem cell therapy under the banner of regenerative medicine. Utilised in other medical fields (orthopaedics, dermatology), urological application includes treatment of both erectile dysfunction and Peyronie's disease. The evidence base and uptake of PRP is yet to be described. Aim: The aim of this study was to specifically systematically review the evidence for PRP treatment of erectile dysfunction. Furthermore, we sought to determine the availability and trends in provision of this procedure. Methods: A systematic review of literature databases was performed to assess available evidence for PRP in the treatment of human erectile dysfunction. No language or study design restrictions were placed. A systematic search of Twitter, Google analytics and Symplur was also performed to evaluate providers, marketing and global trends pertaining to use and interest in PRP for ED. Additionally, we performed a web based evaluation of current global availability of this therapy with a focus on provision within Australia and New Zealand. Findings: Following systematic review, no published peer reviewed scientific articles demonstrating results pertaining to the use of PRP for human erectile dysfunction were found. A single provider (P-shot±) has patented the method outlining use of PRP for erectile dysfunction and as such remains the most widely available, with a global total of 683 registered providers. Of the 19 countries offering this therapy, Australia (n = 8) and New Zealand (n = 8) contain the 4th greatest number of providers, with the majority being found in the USA (n = 610). No urologists were identified as being providers of this therapy within Australia or New Zealand. Most Australian and New Zealand providers do not provide upfront costings on their website with 2 of 16 providers indicating an average cost of $1400 per procedure. Twitter use encompassing the #P-shot hashtag demonstrated 63 individual tweets in the past 3 months with a total of 77357 impressions. Within the past 3 months 24% of tweets derive from the patent owner of P-shot± directly with 98% of tweets derived from cosmetic/aesthetic providers with only 1.6% from urologists. No tweets were found from recipients of the procedure. Within September alone a cumulative total of 2365 searches relating to PRP were performed on Google with 25% directly pertaining to erectile dysfunction. Conclusion: Despite a global presence of PRP for ED and ongoing active marketing and public interest in PRP, no scientific evidence has been published to establish an evidence-based risk benefit profile for PRP use for erectile dysfunction. Given the uncertain efficacy and possibility for harmful side effects a greater body of evidence examining the efficacy and safety of this procedure is required.L6213520802018-03-27 <br />