PMID- 37713110
OWN - NLM
STAT- Publisher
LR  - 20230915
IS  - 2724-6116 (Electronic)
IS  - 2724-6116 (Linking)
DP  - 2023 Sep 15
TI  - Regenerative treatment with platelet-rich plasma in patients with refractory 
      erectile dysfunction: short-term outcomes and predictive value of mean platelet 
      volume.
LID - 10.23736/S2724-6507.23.04060-5 [doi]
AB  - BACKGROUND: The vast majority of erectile dysfunction (ED) treatments are 
      currently symptomatic and do not influence disease progression. Regenerative 
      medicine may potentially reverse or stop the progression of complicated ED by 
      restoring erectile capacity. We aimed to evaluate potential safety and 
      effectiveness and the clinical correlates of platelet function before 
      platelet-rich plasma (PRP) injection in men with vascular ED unresponsive to 
      phosphodiesterase-5 inhibitors (PDE-5is). METHODS: A number of 150 patients with 
      vascular ED were enrolled in an open-label, single arm, multicenter, prospective, 
      interventional, non-randomized study. After 1-month pharmacological washout from 
      PDE-5is, the 5-item International Index of Erectile Function (IIEF-5) 
      questionnaire was administered and dynamic penile duplex ultrasound (d-PDU) was 
      performed. Patients then underwent intracavernous PRP injection. One month after 
      treatment, IIEF-5 and d-PDU were evaluated. Primary aim of the study was to 
      assess efficacy and safety of PRP treatment by evaluating the proportion of 
      patients achieving minimal clinically important differences (MCID) in the IIEF-5 
      questionnaire. Secondary endpoint was to determine whether MPV could correlate 
      with improvement in d-PDU parameters. RESULTS: Most patients (80%) had a 
      significant improvement in ED symptoms (IIEF-5 Score: 12+/-2.6 vs. 19+/-3.0; 
      P<0.0001) and in PSV (32+/-3.5 cm/s vs. 42+/-7.6 cm/s; P<0.0001) after d-PDU 
      evaluation. The ROC curve analysis showed a significant accuracy (72.1%, CI: 
      64.0-80.2, P</=0.0001) for MPV in identifying men clinically responding to PRP with 
      favorable MCID>/=5 at 1 month follow-up. The MPV<8.95 fL was identified as the best 
      predictor of success rate with a sensitivity of 90% and a specificity of 54.1%. 
      CONCLUSIONS: This study provides the first evidence that PRP could represent an 
      effective and safe option for patients poorly responding to PDE-5is. MPV higher 
      than 8.95 fL may identify patients with poor response to treatment that might 
      benefit of successive re-challenge with PRP.
FAU - Francomano, Davide
AU  - Francomano D
AD  - Department of Experimental and Clinical Medicine, Magna Grecia University, 
      Catanzaro, Italy.
FAU - Iuliano, Stefano
AU  - Iuliano S
AD  - Department of Experimental and Clinical Medicine, Magna Grecia University, 
      Catanzaro, Italy.
FAU - Deho, Federico
AU  - Deho F
AD  - ASST-Sette Laghi, Circolo &amp; Fondazione Macchi Hospital, University of 
      Insubria, Varese, Italy.
FAU - Capogrosso, Paolo
AU  - Capogrosso P
AD  - ASST-Sette Laghi, Circolo &amp; Fondazione Macchi Hospital, University of 
      Insubria, Varese, Italy.
FAU - Tuzzolo, Piergiorgio
AU  - Tuzzolo P
AD  - Department of Urology, Campus Bio-Medico University, Rome, Italy.
FAU - LA Vignera, Sandro
AU  - LA Vignera S
AD  - Department of Clinical and Experimental Medicine, University of Catania, Catania, 
      Italy.
FAU - Antonini, Gabriele
AU  - Antonini G
AD  - Department of Urology, Quisisana Clinic, Rome, Italy.
FAU - Aversa, Antonio
AU  - Aversa A
AD  - Department of Experimental and Clinical Medicine, Magna Grecia University, 
      Catanzaro, Italy - aversa@unicz.it.
LA  - eng
PT  - Journal Article
DEP - 20230915
PL  - Italy
TA  - Minerva Endocrinol (Torino)
JT  - Minerva endocrinology
JID - 101777342
SB  - IM
EDAT- 2023/09/15 12:42
MHDA- 2023/09/15 12:42
CRDT- 2023/09/15 11:14
PHST- 2023/09/15 12:42 [medline]
PHST- 2023/09/15 12:42 [pubmed]
PHST- 2023/09/15 11:14 [entrez]
AID - S2724-6507.23.04060-5 [pii]
AID - 10.23736/S2724-6507.23.04060-5 [doi]
PST - aheadofprint
SO  - Minerva Endocrinol (Torino). 2023 Sep 15. doi: 10.23736/S2724-6507.23.04060-5.