We aim to summarize the latest evidence on platelet-rich plasma (PRP) intracavernosal injections efficacy in men affected by primary organic erectile dysfunction (ED). We reviewed the literature for randomized controlled trials (RCTs) or prospective and retrospective comparative studies evaluating PRP alone or in combination for ED treatment. A comprehensive search in PubMed, Scopus, Web of Science, and ClinicalTrials.gov was performed for English language full-text articles or conference abstracts. A qualitative and quantitative data synthesis was provided. Overall, seven records were included: three RCTs evaluated PRP vs. placebo, one study separately tested PRP and low-intensity shock wave therapy (Li-SWT), three studies compared Li-SWT or low-intensity pulsed ultrasound alone with their combination with PRP. Of 641 included patients, 320 received PRP. Despite the heterogeneity among inclusion criteria, dose and protocol of PRP administration, and outcomes measured, most studies independently reported better sexual outcomes in patients who received PRP, without significant severe side effects. In meta-analysis, where only placebo-controlled studies were included, patients treated with PRP showed higher International Index of Erectile Function (erectile function domain) score compared to patients who received placebo: pooled mean difference (95% Confidence Interval) of 2.99 (1.86, 4.13) after 1 month (209 patients) vs. 2.85 (1.61, 4.09) after 3 months (204 patients) vs. 3.21 (1.82, 4.60) after 6 months (199 patients) of follow-up. In men affected by primary organic ED, PRP intracavernosal injections demonstrated an objective improvement or at least a tendency in erectile function recovery. Patient numbers, and the short-term follow-up may limit the generalizability of these observations. High quality, large-scale, and standardized controlled trials are needed before recommending its definitive use in clinical practice.

我们的目的是总结富血小板血浆（PRP）海绵体内注射对原发性器质性勃起功能障碍（ED）男性疗效的最新证据。我们回顾了评估 PRP 单独或联合治疗 ED 的随机对照试验 (RCT) 或前瞻性和回顾性比较研究的文献。在 PubMed、Scopus、Web of Science 和 ClinicalTrials.gov 中对英文全文文章或会议摘要进行了全面检索。提供了定性和定量数据综合。总体而言，纳入了七项记录：三项随机对照试验评估了 PRP 与安慰剂的比较，一项研究分别测试了 PRP 和低强度冲击波疗法 (Li-SWT)，三项研究将单独使用 Li-SWT 或低强度脉冲超声与它们的组合进行比较富血小板血浆。在 641 名患者中，320 名接受了 PRP。尽管纳入标准、PRP 给药剂量和方案以及测量的结果之间存在异质性，但大多数研究独立报告接受 PRP 的患者有更好的性结果，且没有明显的严重副作用。在仅纳入安慰剂对照研究的荟萃分析中，与接受安慰剂的患者相比，接受 PRP 治疗的患者显示出更高的国际勃起功能指数（勃起功能领域）评分：汇总平均差（95% 置信区间）为 2.99（随访 1 个月（209 名患者）后为 1.86，4.13）对比 3 个月（204 名患者）后为 2.85（1.61，4.09）对比 6 个月（199 名患者）后为 3.21（1.82，4.60）。在患有原发性器质性勃起功能障碍的男性中，PRP 海绵体内注射显示出客观的改善或至少是勃起功能恢复的趋势。 患者数量和短期随访可能会限制这些观察结果的普遍性。在推荐其在临床实践中明确使用之前，需要进行高质量、大规模和标准化的对照试验。