(532) Outcome of Intracavernosal Autologous Platelet Rich Plasma Injection in Vasculogenic Erectile Dysfunction

Abstract Introduction Vasculogenic erectile dysfunction (ED) has a multifaceted etiology resulting from either diminished penile blood flow or inadequate restriction of penile venous outflow during erection. The principal pathophysiological alterations include increased vascular resistance in the cavernous artery, diminished smooth muscle content accompanied by augmented collagen deposition in corporal tissue, hypertonicity of corporal smooth muscle, and endothelial dysfunction resulting in vasculogenic ED. Research suggests that intracavernosal autologous Platelet rich plasma (PRP) injection may enhance erectile function in vasculogenic ED and potentially reverse the disease process through its angiogenic, reparative, and regenerative properties. Objective This study aimed to evaluate the outcome of intracavernosal autologous PRP injection over erectile function in vasculogenic ED. Methods This was a Quasi-Experimental study conducted among 26 patients with Doppler-proven vasculogenic ED who received two sessions of 10 ml intracavernosal PRP injection with a gap of one month. Accordingly, participants were assessed at 1, 3, and 6 months after completion of the treatment protocol. The primary outcome was the percentage of men achieving the Minimal Clinically Important Difference (MCID) in International Index of Erectile Function- 5 item (IIEF-5) domain at 1, 3, and 6 months following the second injection. Secondary outcomes were changes in IIEF-5 score at 1, 3, and 6 months, as well as alterations in penile vascular parameters at 6 months. The Visual Analogue Scale (VAS) score for pain and any adverse effects subsequent to each injections were recorded. Results Out of 26 patients, 3.8% patient achieved MCID after 1, 3, and 6 months which was not statistically significant. Mean baseline IIEF-5 score was 10.85, which was changed to 11.73, 11.46, and 11.38 at 1, 3, and 6 months respectively and the changes were statistically significant (p < 0.001) at 1, 3, and 6 months. The mean right PSV increased marginally from 17.2 cm/s to 17.4 cm/s (p = 0.32), while the left PSV decreased slightly from 17.37 cm/s to 17.32 cm/s (p = 0.70). The median right EDV decreased from 3 cm/s to 2.95 cm/s (p = 0.63), and the median left EDV increased from 2.1 cm/s to 2.2 cm/s (p = 0.77), all changes being statistically insignificant. Mean VAS score for pain were 3.31 & 3.12 during the first and second sessions of intracavernosal injections. Two patients experienced minor localized edema upon first injection. Conclusions Following the administration of two intracavernosal PRP injections, administered one month apart, one patient achieved the MCID. However, the mean baseline IIEF-5 score demonstrated significant improvement at 1-month, 3-month, and 6-month intervals. In contrast, changes in penile vascular parameters on repeat Doppler ultrasound at 6 months were not statistically significant. Disclosure No