To describe the evidence of Platelet Rich Plasma (PRP), Stem cells therapy (SCT) and Extracorporeal shockwave therapy (ESWL) for the treatment of Peyronies disease (PD), including information from the main urological society guidelines.
A literature review of PubMed articles published between 2000 and 2023 was conducted, utilizing keywords such as "Peyronie's Disease", "Penile curvature", "Platelet Rich Plasma", "Stem cells", and "Extracorporeal shockwave therapy". Only full-text articles in English were included, excluding case reports and opinions.
A considerable number of clinical trials were conducted using PRP penile injections for therapy of PD, showing reduction of curvature, plaque size and improvement in quality of life. Preclinical studies in rats have shown the potential benefit of adipose-derived stem cells, with improvements in erectile function and fibrosis. Human studies with mesenchymal stem cells demonstrated promising results, with reduction of curvature and plaque size. ESWL effects on PD were investigated in randomized clinical trials and demonstrated no significant impact in curvature or plaque size, but reasonable effect on pain control.
Restorative therapies has emerged as an innovative treatment option for PD and the results from current studies appear to be promising and demonstrated good safety profile. Unfortunately, due to scarce evidence, PRP and SCT are still considered experimental by American Urological Association (AUA) and European Association of Urology (EAU) guidelines. ESWT is recommended, by the same guidelines, for pain control only. More high-quality studies with long-term follow-up outcomes are needed to evaluate efficacy and reproducibility of those therapies.
International braz j urol : official journal of the Brazilian Society of Urology. 2024 Aug 12 [Epub ahead of print]
Francesco Costantini Mesquita, Rodrigo Barros, Thiago Fernandes Negris Lima, David Velasquez, Luciano A Favorito, Edoardo Pozzi, James Dornbush, David Miller, Francis Petrella, Ranjith Ramasamy
Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA., Serviço de Urologia, Hospital Universitário Antônio Pedro - Universidade Federal Fluminense - UFF, Niterói, RJ, Brasil., Serviço de Urologia, Hospital Memorial Arthur Ramos, Maceió, AL, Brasil., Unidade de Pesquisa Urogenital, Universidade Estadual do Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brasil., AU/UGA Medical Partnership, Athens, GA, USA.