BMC urology · 2026
Efficacy of autologous adipose-derived stromal vascular fraction and platelet-rich plasma intracavernous injections in patients with erectile dysfunction: a retrospective comparative study.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Albayrak Ahmet Tevfik, Basaga Yasar, Comert Mehmet, Sezgic Melih Can, Gunay Kadir Cem, Baloglu İbrahim Halil, Kirecci Sinan Levent
Аннотация
BACKGROUND: Vasculogenic erectile dysfunction (ED) is primarily driven by impaired penile hemodynamics, and conventional phosphodiesterase type 5 inhibitors (PDE5i) may offer limited benefit in patients with persistent endothelial dysfunction. Regenerative therapies such as platelet-rich plasma (PRP) and adipose-derived stromal vascular fraction (AD-SVF) have emerged as potential alternatives; however, comparative clinical data remain limited.
METHODS: This retrospective study included 60 men with non-severe, PDE5i-refractory vasculogenic ED (International Index of Erectile Function-5 [IIEF-5] > 10) treated with either PRP (n = 30) or AD-SVF (n = 30) between April and September 2022. Changes in erectile function and penile hemodynamics were evaluated using IIEF-5 scores and peak systolic velocity (PSV) using penile Doppler ultrasonography at 3, 6, and 12 months following treatment.
RESULTS: Both treatment modalities were associated with significant improvements in erectile function over time. At 3 months, PRP resulted in greater short-term improvement in IIEF-5 scores compared with AD-SVF (+ 3.7 ± 2.4 vs. +1.0 ± 1.3; p < 0.001). At 6 months, AD-SVF demonstrated significantly greater improvements in IIEF-5 (+ 5.2 ± 1.7 vs. +3.7 ± 2.4; p = 0.007) and PSV (+ 3.0 ± 1.5 vs. +0.9 ± 1.1 cm/s; p < 0.001), with PRP outcomes remaining stable from 3 months onwards, indicating early functional plateau. At 12 months, AD-SVF gains were maintained (ΔIIEF-5: +5.4 ± 2.0 vs. +3.7 ± 2.4; p = 0.004; ΔPSV: +3.2 ± 1.7 vs. +1.0 ± 1.1 cm/s; p < 0.001). Subgroup analyses suggested more pronounced vascular benefits of AD-SVF in patients with hypertension and hyperlipidemia, whereas PRP showed a more uniform, moderate effect across subgroups. No serious adverse events were observed.
CONCLUSIONS: In this retrospective, real-world analysis of men with PDE5i-refractory vasculogenic ED, PRP was associated with faster short-term functional improvement, whereas AD-SVF demonstrated greater and more sustained gains from 6 months onwards. These findings should be interpreted as exploratory and hypothesis-generating, underscoring the need for prospective, controlled trials to better define the role of regenerative therapies in vasculogenic ED.
METHODS: This retrospective study included 60 men with non-severe, PDE5i-refractory vasculogenic ED (International Index of Erectile Function-5 [IIEF-5] > 10) treated with either PRP (n = 30) or AD-SVF (n = 30) between April and September 2022. Changes in erectile function and penile hemodynamics were evaluated using IIEF-5 scores and peak systolic velocity (PSV) using penile Doppler ultrasonography at 3, 6, and 12 months following treatment.
RESULTS: Both treatment modalities were associated with significant improvements in erectile function over time. At 3 months, PRP resulted in greater short-term improvement in IIEF-5 scores compared with AD-SVF (+ 3.7 ± 2.4 vs. +1.0 ± 1.3; p < 0.001). At 6 months, AD-SVF demonstrated significantly greater improvements in IIEF-5 (+ 5.2 ± 1.7 vs. +3.7 ± 2.4; p = 0.007) and PSV (+ 3.0 ± 1.5 vs. +0.9 ± 1.1 cm/s; p < 0.001), with PRP outcomes remaining stable from 3 months onwards, indicating early functional plateau. At 12 months, AD-SVF gains were maintained (ΔIIEF-5: +5.4 ± 2.0 vs. +3.7 ± 2.4; p = 0.004; ΔPSV: +3.2 ± 1.7 vs. +1.0 ± 1.1 cm/s; p < 0.001). Subgroup analyses suggested more pronounced vascular benefits of AD-SVF in patients with hypertension and hyperlipidemia, whereas PRP showed a more uniform, moderate effect across subgroups. No serious adverse events were observed.
CONCLUSIONS: In this retrospective, real-world analysis of men with PDE5i-refractory vasculogenic ED, PRP was associated with faster short-term functional improvement, whereas AD-SVF demonstrated greater and more sustained gains from 6 months onwards. These findings should be interpreted as exploratory and hypothesis-generating, underscoring the need for prospective, controlled trials to better define the role of regenerative therapies in vasculogenic ED.