Efficacy of platelet-rich therapies versus placebo in the treatment of erectile dysfunction: an updated systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION

Platelet-rich therapies (PRTs), including platelet-rich plasma and platelet-rich fibrin matrix, have drawn attention as treatments for erectile dysfunction (ED). However, evidence regarding their effectiveness remains limited.

OBJECTIVES

To determine the efficacy of PRTs in the treatment of ED.

METHODS

We performed a systematic search of PubMed, Embase, and Cochrane Library in April 2025 for studies comparing PRT with placebo in patients with ED. Pooled risk ratios, mean differences, and standardized mean differences with 95% CIs were calculated. We used the Grading of Recommendations Assessment, Development, and Evaluation tool to assess the certainty of evidence and strength of recommendations. The outcomes of interest were the mean change in the erectile function domain of the International Index of Erectile Function (IIEF) score, the rate of men achieving minimum clinically important difference (MCID) in the IIEF-EF score, peak systolic velocity (PSV), end diastolic velocity (EDV), and visual analogue scale (VAS) pain score after injection.

RESULTS

We included seven randomized controlled trials (RCTs) comprising 479 patients, of whom 239 (49.9%) were randomized to PRTs. There were no differences between PRTs and placebo in the combined IIEF score at 1, 3, and 6 months of follow-up. There was no difference between groups in terms of the rate of men achieving MCID in IIEF-EF at 1 month, and at 3 months. PRTs showed a significantly higher rate of men achieving MCID in IIEF-EF at 6 months; however, it is noteworthy that only 3 studies provided data for this outcome, which may limit the robustness and generalizability of this result, thus should be interpreted with caution. There were no differences between groups in the PSV, EDV, and VAS pain score after injection.

CONCLUSION

This meta-analysis of RCTs provides low-to-moderate certainty evidence that PRTs do not confer superior efficacy over placebo in improving sexual function in men with ED. However, the small number of patients restricts the generalizability of our conclusions. Additional high-quality studies are required to clarify the clinical role of PRTs in the management of ED.