Autologous Platelet-Rich Plasma Penile Injection After Failed Oral Medical Management of Erectile Dysfunction
Pramod Krishnappa,1,* Wasim Jafri,1 Prasanna Matippa,1 Maneesh Sinha,1 Kumar Prabhu1 and Venkatesh Krishnamoorthy1
1Deparment of Urology, NU Hospitals, Rajajinagar, Bangalore 560010, India
Accepted: 17-September-2026
This is the first research paper published from India, exploring the role of Platelet-rich Plasma ( PRP) injection in Erectile Dysfunction.
This research study was led by Dr Pramod Krishnappa and Dr Wasim Jafri, and published in National Board of Examinations - Journal of Medical Sciences ( NBEJMS), Volume 4, Issue 11, November 2026 Edition.
Abstract
Objective: Platelet-rich plasma (PRP) injection is an evolving regenerative therapy in the management of erectile dysfunction (ED). This study aimed to evaluate the efficacy and safety of autologous intracavernosal PRP injections in patients with ED who failed oral medical management. Methods: The single-arm prospective interventional study included men with all grades of ED who received two PRP injections (prepared using the TriCell TriPReP TUBEX system) one month apart. The primary endpoint was the percentage of men who achieved the minimum clinically important difference (MCID). Secondary endpoints included change in International Index of Erectile Function-Erectile Function (IIEF-EF) domain scores from baseline to 1- and 3-month post-treatment, adverse events, and overall treatment satisfaction. Results: Thirty out of 32 enrolled patients completed the study protocol (mean age 36.53 years). Mean IIEF-EF scores significantly improved (p < 0.001) from baseline (13.01) to 1 month (15.9) and 3 months (18.03) post-treatment. MCID was achieved by 30% of patients at 1 month and 53.3% at 3 months, across all grades of ED. More importantly, patients with mild and mild-to-moderate ED showed superior response rates in achieving MCID (90% at 1 month, 100% at 3 months) compared to moderate and severe ED patients (0% at 1 month, 30% at 3 months). No adverse events were reported, and patients reported moderate satisfaction with overall treatment (mean score of 2.2 on a Likert scale of 1-4). Conclusion: PRP is safe across all grades of ED but efficacious in mild and mild-moderate grades of ED. Future, larger, placebo-controlled studies are warranted to further validate these findings.
Keywords: Erectile dysfunction, Platelet-rich plasma, P-shot, regenerative treatment, restorative therapy
Introduction
Contemporary management options of erectile dysfunction (ED) include lifestyle modifications, psychological interventions, oral phosphodiesterase inhibitors (PDE5i), intracavernosal injections of vasoactive drugs like alprostadil, vacuum erection devices, and penile prosthesis [1]. Despite the efficacy of these treatments, some patients may discontinue on-demand treatments, experience limited or no improvement, depriving them of natural-feeling erections, and most of these treatment options do not alter the underlying pathophysiologic mechanisms and offer on-demand erections [2]. Hence, newer regenerative treatment options such as platelet-rich plasma (PRP), low-intensity shockwave therapy and stem cell therapy are increasingly being studied [3].
PRP is a yellow-coloured fluid that is obtained by centrifugation of whole blood and contains growth factors, including platelet-derived growth factor, vascular endothelial growth factor, epidermal growth factor, fibroblast growth factor, transforming growth factor β and insulin-like growth factor [4]. PRP is widely used in aesthetic dermatology(hair loss treatment and facial rejuvenation), sports medicine (to heal tendons, muscles),and orthopaedics (for knee osteoarthritis), and also sparingly used in ophthalmology (corneal ulcers), gynaecology (intrauterine adhesion, premature ovarian failure, thin endometrium) and cardiothoracic surgery (sternotomy complications, bronchial fistula) [5]. In urology, PRP has been evaluated in ED [6], Peyronie’s disease [7], and stress urinary incontinence [8] with variable results. Various meta-analyses [9,10] have reported both the safety and efficacy of PRP in ED and are mostly limited to mild and moderate grade ED.
Our study aimed to assess the safety and efficacy of autologous PRP injection in our Indian patients with all grades (mild, mild-moderate, moderate, and severe) of ED who were not responding to oral medications.
