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Platelet-Rich Plasma (PRP)

Platelet-rich plasma (PRP) is an autologous blood-derived biologic studied across urologic and urogynecologic conditions. These applications remain investigational. Two 2026 IC/BPS meta-analyses report symptom improvement, predominantly from uncontrolled studies; benefit over placebo or standard care remains unestablished.[1][2] PRP has also been studied as an adjunct to internal urethrotomy, for female SUI and male post-prostatectomy incontinence, erectile dysfunction, Peyronie's disease, genital lichen sclerosus, and hypospadias-repair complication prevention. The dominant cross-cutting limitation across urology is the lack of standardization in preparation protocols, concentrations, activation methods, and dosing.[3][4]

This article is the class-level hub across urologic PRP applications. For narrower deep-dives, see Antimitotics & antifibrotics (PRP as a stricture adjunct among other antifibrotics), Peyronie's disease agents (PRP as one of several intralesional options), and Intravesical IC/BPS agents (the broader instillation armamentarium).

Mechanism and preparation​

PRP is produced by centrifugation of autologous whole blood to concentrate platelets above baseline; urologic protocols have typically targeted about 2.5–5× peripheral-blood concentration.[5][6][9][18] Concentration depends on the separation system and spin protocol.[32] After activation (thrombin, calcium chloride, or collagen), platelet α-granules release a growth-factor cascade:[5][7]

FactorRole
PDGFFibroblast recruitment and proliferation
TGF-βECM synthesis and remodeling (can also drive fibrosis — see caveat below)
VEGFAngiogenesis and revascularization
IGF-1, EGF, bFGF, HGFCell proliferation, differentiation, tissue regeneration

Proposed regenerative mechanisms include revascularization, connective-tissue remodeling and effects on progenitor cells.[5] Autologous sourcing reduces donor-related concerns but does not eliminate contamination, injection injury or reactions to additives. Infection control remains necessary.[33]

Regulatory status. In the United States, FDA-cleared platelet and plasma separators in the bone-graft-handling category prepare PRP for mixing with autograft or allograft bone.[50] That device clearance does not establish an indication for injection into the bladder, urethra, corpora or genital skin.[36][50]

Classification and standardization problem​

Classification systems include Dohan Ehrenfest (P-PRP, L-PRP, P-PRF, L-PRF based on leukocyte and fibrin content) and the PAW, DEPA, and MARSPILL systems.[8][4] Across urologic PRP literature, there is no standard for:[4]

  • Single versus double spin; target platelet concentration
  • Leukocyte content (leukocyte-rich versus leukocyte-poor)
  • Activation method
  • Injection volume, number of sessions, and session interval
  • Outcome measures and follow-up

This is the single biggest obstacle to cross-study comparison and clinical adoption.

IC/BPS — investigational bladder-wall injections​

Two 2026 meta-analyses define the current evidence.

Meta-analyses​

  • Ali 2026 (8 studies): intravesical PRP improved VAS pain (pooled SMD −0.78; 95% CI −1.15 to −0.41; p < 0.001), urinary frequency, O'Leary-Sant ICSI and ICPI scores, functional bladder capacity and uroflowmetry, with within-cohort improvements reported through six months, without a placebo-controlled durability estimate.[1]
  • Simões 2026. Confirmed the signal but noted all included studies were quasi-experimental, uncontrolled or non-randomized; overall evidence level low. Pooled GRA ≥ 2 success was 48.3% in five uncontrolled studies of 128 women, assessed 1–3 months after treatment.[2]

Key prospective data​

StudynProtocolFinding
Jiang 202040 refractory IC/BPS4 monthly intravesical injections (10 mL, 2.5× concentration)GRA ≥ 2 in 28/40 (70%) at 1 mo and 27/40 (67.5%) at 3 mo after the 4th injection; urinary biomarkers showed ↓ NGF, MMP-13, VEGF with ↑ PDGF-AB[9]
Xu 2026102 non-ulcerative primary BPSNovel 2-phase protocol — weekly × 3 wk, then monthly × 3 mo; apheresis-derived PRPHigher cystoscopic hydrodistention grades (II–III) showed greater and more durable improvement than Grade I; cystoscopic grade was the only independent predictor of response[10]
Jiang 2022 (dose-finding)63 randomized to single high-dose subgroups (60 analyzed); compared with 55 earlier patients (52 analyzed)Single high-dose (100 mL blood) with saline or plasma over 20 or 40 sites, vs a previous cohort given 4 monthly low-dose (50 mL blood) injectionsAt 6 mo after the first injection (6 mo after single high-dose versus 3 mo after fourth low-dose), ICSI and ICPI improvements were smaller after single high-dose than after 4 low-dose injections (a comparison with an earlier cohort, without a sham arm); vehicle and injection-site number had no effect[11]

Practical takeaway​

Four monthly PRP bladder-wall injections are a studied IC/BPS protocol; the 2025 German S2k guideline makes no recommendation for PRP alone because data are insufficient and protocols and preparations vary.[53] Hydrodistention grade and biomarkers are exploratory correlates. See Intravesical IC/BPS agents for the broader instillation framework including triamcinolone for Hunner lesions.

Urethral stricture — adjunct to internal urethrotomy​

Rezaei 2019 supplies the randomized recurrence result covered in Antimitotics & antifibrotics. A later randomized study of strictures under 2 cm (Choudhury 2026; 32 per arm) reported mean six-month Qmax of 17.34 versus 11.39 mL/s after urethrotomy with versus without PRP; it did not establish lower recurrence.[41] Points repeated here for reference:

  • Rezaei 2019 RCT (n = 87, bulbar strictures) of IU plus submucosal PRP versus IU plus saline: 12-mo recurrence 9.09% versus 26.82% (p = 0.032); 24-mo recurrence 9/41 (21.95%) versus 18/41 (43.90%) among patients assessed.[12] The indexed abstract prints p = 0.34 while EAU reports p = 0.034; this discrepancy precludes asserting that efficacy disappeared at two years.[12][37] EAU 2026 describes primary bulbar strictures under 1.5 cm and reports grade-1 complications in 70% with PRP and 79% with saline.[37] It gives a Weak recommendation to use intralesional injections after DVIU only within a clinical trial.[37] The AUA 2023 stricture guideline does not include PRP among its recommendations.[54]
  • Aydın 2020 rat urethral-trauma model: PRP reduced mucosal inflammation, spongiofibrosis, and edema[13]
  • Tavukcu 2018. PRP normalized the collagen I:III ratio toward uninjured controls in a rat urethral-injury model[14]
  • Gul 2016 hypothesis. Gul proposed TGF-β1-antibody-modified PRP to reduce urethral fibrosis and recurrence after urethrotomy; this has not been tested in a urethral cohort[15]

PRP contains the profibrotic mediator TGF-β1, although a small rat urethral-injury study found a collagen ratio closer to uninjured controls after PRP.[14][15] The balance of these effects in human urethral tissue remains unknown; TGF-β1-neutralized PRP remains a proposed, untested clinical adjunct.[15]

Stress urinary incontinence​

Female SUI​

Utama 2026 systematic review and meta-analysis included eight studies (three RCTs and five uncontrolled before/after studies), including a 62-woman cohort treated with PRP plus fractional CO₂ laser; it did not include the Grigoriadis 2024 saline-controlled RCT.[16][39][52] It reported short-term reductions in UDI-6 and ICIQ-SF scores, but its pooled ALPP estimate came from two small uncontrolled cohorts.[16] Reported outcomes include:

  • Abdominal leak-point pressure increased at three months in a pooled analysis of 26 women and 35 mixed-sex patients, including 21 after prostatectomy (MD +51.07 cmH₂O; 95% CI 36.21–65.93; p < 0.001).[16][51]
  • Significant reduction in 1-hour pad weight
  • Significant improvement in patient-reported symptoms
StudynKey finding
Saraluck 2024 RCT (single-blind assessment)64 randomized (32/arm); 60 analyzed (31 vs 29)A-PRP (2 injections) + PFMT vs PFMT alone — A-PRP arm had about 8 g greater reduction in 1-h pad weight at 5 mo; symptom improvement sustained at 2 and 5 mo; no AEs reported[17]
Grigoriadis 2024 saline-controlled RCT50 (25 vs 25)Two periurethral PRP injections versus saline: subjective cure 32% versus 4% during six-month follow-up; one-hour pad loss also favored PRP at 6 mo.[39]
Ashton 2024 saline-controlled RCT50 (25 vs 25)One 5-mL anterior vaginal-wall injection versus saline: no significant difference in 6-mo composite success (negative cough stress test and PGI-I much or very much better).[40]
Chiang & Kuo 2022 (uncontrolled)26 ISD4 monthly urethral-sphincter injections — GRA ≥ 2 50%; complete dryness 46.2% at 3 mo / 26.9% at 12 mo; ALPP 109.9 → 155.6 cmH₂O at 3 mo after treatment (p < 0.001; table value differs from the abstract)[18]
Long 2021 (pilot, uncontrolled)20Anterior vaginal wall / mid-urethral A-PRP injection — significant symptom improvement at 1 and 6 mo; trend toward better outcomes in younger patients (p = 0.07)[19]

Male post-prostatectomy incontinence​

Yang 2026, a later uncontrolled same-center series, reported GRA ≥ 2 in 29/71 (40.8%) three months after four monthly injections; cohort overlap with the 2021 study is unclear.[45] Lee 2021 prospective, uncontrolled (n = 28 PPI, 4 monthly urethral-sphincter injections):[20]

  • Complete continence (pad-free): 21.4%
  • GRA ≥ 2 success rate: 71.4%
  • GRA ≥ 1 clinical improvement: 92.9%
  • VAS SUI from 6.5 to 3.5 (p < 0.001)

Erectile dysfunction — conflicting RCTs​

The AUA 2018 ED guideline states that PRP should be considered experimental and not offered outside an IRB-approved research protocol ; it also treats stem-cell and shockwave therapy as investigational.[38] ED trials since then have conflicting results. Masterson 2023 is not the only double-blind placebo-controlled RCT: Poulios 2021 randomized 60 men to 10 mL PRP or placebo (two sessions) and reported a 6-month IIEF-EF MCID in 20/29 (69%) versus 7/26 (27%) assessed men (single center, one separation system).[32] EAU still restricts intracavernosal PRP to clinical trials.[31][32]

Masterson 2023 (negative RCT)[21]​

Double-blind placebo-controlled (n = 61 mild-to-moderate ED, 2 intracavernosal PRP versus placebo):

  • No difference in one-month IIEF-EF MCID achievement among assessed men (14/24 [58.3%] PRP versus 15/28 [53.6%] placebo; p = 0.730)[21]
  • No difference in IIEF-EF scores at any timepoint
  • No change in penile Doppler parameters
  • No major adverse events occurred in this 61-man trial, and PRP did not outperform placebo on the prespecified one-month endpoint[21]

Shaher 2023 (positive RCT)[22]​

Double-blind randomized trial (109 allocated; 100 analyzed, 50 per arm; three PRP or saline injections 15 days apart): IIEF-EF, SEP Q2/Q3, and duplex parameters favored PRP at 1, 3, and 6 months; MCID was 76% versus 18% at 1 month and 70% versus 16% at 6 months.

Du 2024 meta-analysis[23]​

Du pooled 11 controlled studies (n = 991, including one retrospective) and single-arm cohorts (n = 377). Ten controlled studies (n = 932) contributed to the IIEF SMD +0.59 (95% CI 0.34–0.84), and six (n = 503) to the MCID RR 1.94 (95% CI 1.33–2.83). The synthesis mixed PRP monotherapy with PRP plus shockwave therapy and reported heterogeneous results; the authors called for higher-quality trials.

Practical interpretation: differences in preparation, eligibility, co-treatment and analysis limit comparison. Randomized-trial-only reviews published in 2026 give differing pooled estimates: Jacob found no consistent, clinically meaningful IIEF benefit for PRP monotherapy versus placebo; de Amorim found no overall IIEF advantage for PRP/PRFM at one, three or six months but a six-month MCID signal from three trials; Savira found an IIEF signal at six months or later in six PRP/PRFM trials[42][43][44] See PDE5 inhibitors for the established pharmacologic first-line.[31]

Peyronie's disease — early signal​

Ledesma 2024 Phase 2 RCT randomized 41 men to PRP–placebo or placebo–PRP sequences; no adverse events were reported among the 28 included in the preliminary analysis. PRP–placebo sequence: median curvature changed from 40° at baseline to 25° at six months after crossover (within-sequence p = 0.047). Placebo-PRP group: curvature to 32.5° (p = 0.490); PDQ reduction significant (p = 0.020); a delayed effect was hypothesized.[24]

Asmundo 2024 systematic review. PRP studies for PD generally showed small-to-moderate benefits with mild transient side effects; protocol variation, small samples, and short follow-up limit interpretation.[4] EAU 2026 gives a Strong recommendation to counsel patients that intralesional PRP evidence for reducing pain or curvature remains limited.[49]

See Peyronie's disease agents for the Dachille 2025 and Zugail 2024 PRP data alongside CCH, IFN, and verapamil.

Vulvar lichen sclerosus​

PRP remains investigational for genital LS. The controlled evidence should take precedence over satisfaction rates from uncontrolled series.

  • Goldstein 2019 placebo-controlled RCT: 30 women randomized 2:1 to PRP or saline; 29 completed treatment. After two injections six weeks apart, histological inflammation improved in 5/19 PRP recipients and 5/10 controls, with no between-group difference (p = 0.542). Patient symptom scores also showed no advantage (p = 0.654).[34] Bruising was the only reported adverse effect.[34]
  • El Attar 2026 review: one RCT alongside predominantly uncontrolled reports.[25]
  • Boero 2024 and Medina Garrido 2023: uncontrolled studies in refractory vulvar LS reported symptom improvement; the Boero pilot's 100% satisfaction result is not a comparative efficacy estimate.[26][27]
  • Tedesco 2020: exploratory disease-stage findings with adipose stromal vascular fraction plus PRP.[28]

The German S3 guideline gives PRP in women and men with genital LS an open recommendation (no recommendation for or against), and a strong recommendation against PRP in girls and boys.[35] See clinical LS for the laser comparisons and topical corticosteroids for first-line treatment. Neither symptom improvement nor an autologous source removes the need for inflammation control and surveillance.

Hypospadias repair — complication prevention​

Eryilmaz 2020 compared PRP graft use during primary mid-penile TIP repair in 40 children (20 per group) and reported lower early and long-term fistula, stenosis, and infection rates; its abstract gives no effect sizes, follow-up duration, or randomization method.[29] In a 2026 RCT of 160 selected distal repairs with healthy wide urethral plates, adding a PRP layer to a dartos flap reduced fistulae at six months (3/80 versus 12/80) and wound infections (2/80 versus 10/80).[46] A separate 2026 RCT of 50 distal/mid-penile repairs found 8/25 versus 12/25 fistulae at three months (p = 0.25); a 2026 meta-analysis of seven controlled studies (562 children; five RCTs) pooled different autologous platelet products, limiting PRP-specific inference.[47][48]

One cautionary preclinical signal — renal ischemia-reperfusion​

Martín-Solé 2016 compared subcapsular PRP with saline in 30 monorrenal rats during 45 minutes of renal ischemia. At day seven, renal-artery maximum velocity was lower with PRP (73.08 versus 87.1 cm/s; p = 0.045) and histologic injury was greater (p < 0.0001); three of 15 PRP-treated rats died before day seven versus none of 15 controls (survival p = 0.073).[30]

Safety — limited detection of uncommon harms​

DomainSignal
Reported AEsDysuria, hematuria, micturition pain, and UTI have been reported[1][20][21]
Serious AEs—
Infection / reactionsAutologous sourcing does not replace sterile processing; additives and procedure-related harms must be considered[33]
Preparation standardizationPoor across studies — the main source of heterogeneity[4]
Renal IR cautionary signalPreclinical (Martín-Solé 2016): subcapsular PRP in a 30-rat renal ischemia–reperfusion study was associated with lower day-seven renal-artery maximum velocity and greater histologic injury versus saline[30]

Summary by indication​

IndicationRouteBest evidenceKey outcomeVerdict
IC/BPS (refractory)Intravesical injection2 meta-analyses; Jiang 2020, 2022; Xu 2026VAS SMD −0.78; GRA ≥ 2: 48.3% pooled in Simões (128 women in five uncontrolled studies; 1–3 mo after treatment); Jiang reported 28/40 (70%) at 1 mo and 27/40 (67.5%) at 3 mo after the fourth injectionInvestigational; mostly uncontrolled improvement[1][2][9][10]
Urethral strictureSubmucosal at IUTwo small randomized studies (Rezaei; Choudhury)Rezaei: 9% vs 27% recurrence at 12 mo; Choudhury: higher Qmax at 6 mo, recurrence unestablishedInvestigational; see Antimitotics[12][41]
Female SUIPeriurethral / sphincterUtama 2026 meta; Saraluck 2024 RCT; two saline-controlled RCTsALPP +51 cmH₂O at 3 mo from two uncontrolled cohorts (26 women and 35 mixed-sex participants, including 21 after prostatectomy); Saraluck 1-h pad weight about 8 g lower at 5 mo versus PFMT aloneInvestigational; one saline-controlled trial favored PRP on subjective cure, while another found no significant composite-success difference at 6 mo[16][17][39][40]
Male PPIUrethral-sphincter injectionUncontrolled same-center series (28 men in 2021; 71 in 2026)GRA ≥ 2 three months after four injections: 20/28 (71.4%) and 29/71 (40.8%), respectively; Lee also reported 6/28 (21.4%) pad-freeInvestigational; cohorts may overlap and neither had a control[20][45]
Erectile dysfunctionIntracavernosalConflicting placebo-controlled trialsInconsistent efficacyEAU clinical-trial-only use[21][22][32]
Peyronie's diseaseIntralesionalLedesma 2024 Phase 2 RCT (preliminary)PRP-then-placebo sequence: within-sequence median curvature 40° to 25° at 6 mo after crossover (preliminary analysis of 28 patients across both sequences)Preliminary crossover findings; see Peyronie's disease agents[24]
Vulvar lichen sclerosusIntralesionalSmall saline-controlled RCT plus uncontrolled reportsNo histological or symptom advantage in the RCTInvestigational[25][34]
Hypospadias TIP repairPRP graft or other platelet-product adjunctEryilmaz 2020 (40 children); seven-study 2026 meta-analysis (562 children; five RCTs); two later PRP RCTsEryilmaz reported fewer fistulae, stenoses and infections; pooled platelet-product fistula OR 0.51 (95% CI 0.29–0.91), while later PRP trials differedInvestigational; mixed products and short follow-up limit routine use[29][46][47][48]
Renal ischemia-reperfusionSubcapsular injection in ratsPreclinical (15 PRP, 15 saline; Martín-Solé 2016)Lower renal-artery maximum velocity and greater histologic injury at day sevenRat safety signal; no human outcome estimate[30]

Evidence Summary​

IndicationEvidence and limitsKey source
IC/BPSPredominantly uncontrolled before/after studiesAli 2026[1]; Simões 2026[2]; Jiang 2020[9]
Urethral strictureTwo small randomized studies with different endpoints; recurrence benefit needs replicationRezaei 2019[12]; Choudhury 2026[41]
Female SUISmall trials and heterogeneous synthesisUtama 2026[16]; Saraluck 2024[17]
Male PPIUncontrolled same-center series; GRA ≥ 2 estimates vary from 20/28 (71.4%) to 29/71 (40.8%)Lee 2021[20]; Yang 2026[45]
EDConflicting placebo-controlled RCTsMasterson 2023 negative[21]; Shaher 2023 positive[22]
Peyronie'sEarly phase 2 trial evidenceLedesma 2024[24]
Vulvar LSSmall negative placebo-controlled RCT; uncontrolled studies remain exploratoryGoldstein 2019[34]; El Attar 2026[25]
HypospadiasSmall controlled studies of differing platelet products; two newer PRP RCTs differ on fistula benefit and lack long-term follow-upEryilmaz 2020[29]; Xiao 2026[48]; Elghamry 2026[46]; Dudhani 2026[47]
Renal IR cautionPreclinicalMartín-Solé 2016[30]

Clinical Positioning​

  • Keep PRP within research-oriented care rather than a routine treatment step. In ED, current EAU guidance explicitly limits intracavernosal PRP to clinical trials.[31]
  • PRP bladder-wall injection has no established standard IC/BPS regimen.[1][2][1][2]
  • Do not position PRP routinely before AUS, instead of a sling, or as a substitute for urethral reconstruction. The cited SUI and PPI and stricture studies are too small or uncontrolled to establish those treatment sequences.[12][16][17][20]
  • Peyronie and genital LS applications remain preliminary, and PRP in hypospadias repair remains investigational.[24][25][29][46][47][48]
  • Record preparation, additives, dose, injection sites and outcomes in any protocol; counsel about uncertain benefit and procedure-related risks.[4]
  • Autologous does not mean infection-proof. CDC documented probable HIV transmission associated with unsafe PRP cosmetic procedures.[33]
  • The renal ischemia-reperfusion harm signal is preclinical and does not justify empiric renal-parenchymal treatment.[30]

See Also​

References​

1. Ali F, Haseeb A, Khan HB, Maaz M, Mohammed W. "Efficacy of platelet-rich plasma in interstitial cystitis/bladder pain syndrome: a systematic review and meta-analysis." Int Urogynecol J. 2026. doi:10.1007/s00192-026-06579-7

2. Simões GCS, de Oliveira C, Gon LM, Riccetto CLZ. "Intravesical platelet-rich plasma injection for refractory interstitial cystitis/painful bladder syndrome: a systematic review and meta-analysis." Int Urogynecol J. 2026. doi:10.1007/s00192-026-06515-9

3. Sheean AJ, Anz AW, Bradley JP. "Platelet-rich plasma: fundamentals and clinical applications." Arthroscopy. 2021;37(9):2732–2734. doi:10.1016/j.arthro.2021.07.003

4. Asmundo MG, Durukan E, von Rohden E, et al. "Platelet-rich plasma therapy in erectile dysfunction and Peyronie's disease: a systematic review of the literature." World J Urol. 2024;42(1):359. doi:10.1007/s00345-024-05065-3

5. Etulain J. "Platelets in wound healing and regenerative medicine." Platelets. 2018;29(6):556–568. doi:10.1080/09537104.2018.1430357

6. Dos Santos RG, Santos GS, Alkass N, et al. "The regenerative mechanisms of platelet-rich plasma: a review." Cytokine. 2021;144:155560. doi:10.1016/j.cyto.2021.155560

7. Moraes VY, Lenza M, Tamaoki MJ, Faloppa F, Belloti JC. "Platelet-rich therapies for musculoskeletal soft tissue injuries." Cochrane Database Syst Rev. 2014;(4):CD010071. doi:10.1002/14651858.CD010071.pub3

8. Marín Fermín T, Calcei JG, Della Vedova F, et al. "Review of Dohan Ehrenfest et al. (2009) on 'Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF).'" J ISAKOS. 2024;9(2):215–220. doi:10.1016/j.jisako.2023.07.010

9. Jiang YH, Kuo YC, Jhang JF, et al. "Repeated intravesical injections of platelet-rich plasma improve symptoms and alter urinary functional proteins in patients with refractory interstitial cystitis." Sci Rep. 2020;10(1):15218. doi:10.1038/s41598-020-72292-0

10. Xu S, Zhu Q, Wang C, et al. "Two-phase intravesical injection of apheresis-derived platelet-rich plasma for non-ulcerative primary bladder pain syndrome: a prospective single-center study." Urology. 2026;210:24–29. doi:10.1016/j.urology.2026.02.007

11. Jiang YH, Jhang JF, Lin TY, et al. "Therapeutic efficacy of intravesical platelet-rich plasma injections for interstitial cystitis/bladder pain syndrome — a comparative study of different injection number, additives and concentrations." Front Pharmacol. 2022;13:853776. doi:10.3389/fphar.2022.853776

12. Rezaei M, Badiei R, Badiei R. "The effect of platelet-rich plasma injection on post-internal-urethrotomy stricture recurrence." World J Urol. 2019;37(9):1959–1964. doi:10.1007/s00345-018-2597-8

13. Aydın A, Sönmez MG, Oltulu P, et al. "Histopathologic evaluation of the effects of intraurethral platelet-rich plasma in urethral trauma experimentally induced in rat model." Urology. 2020;141:187.e9–187.e14. doi:10.1016/j.urology.2020.03.025

14. Tavukcu HH, Aytaç Ö, Atuğ F, et al. "Protective effect of platelet-rich plasma on urethral injury model of male rats." Neurourol Urodyn. 2018;37(4):1286–1293. doi:10.1002/nau.23460

15. Gul M. "Modified platelet-rich plasma with transforming growth factor β1 neutralization antibody injection may reduce recurrence rate of urethral stricture." Med Hypotheses. 2016;97:1–3. doi:10.1016/j.mehy.2016.10.007

16. Utama BI, Birru ABA, Cuandra KN, et al. "Therapeutic efficacy and safety of injectable platelet-rich plasma in women with stress urinary incontinence: a systematic review and meta-analysis." Front Med. 2026;13:1728478. doi:10.3389/fmed.2026.1728478

17. Saraluck A, Chinthakanan O, Kijmanawat A, et al. "Autologous platelet-rich plasma (A-PRP) combined with pelvic-floor muscle training for the treatment of female stress urinary incontinence: a randomized controlled clinical trial." Neurourol Urodyn. 2024;43(2):342–353. doi:10.1002/nau.25365

18. Chiang CH, Kuo HC. "The efficacy and mid-term durability of urethral sphincter injections of platelet-rich plasma in treatment of female stress urinary incontinence." Front Pharmacol. 2022;13:847520. doi:10.3389/fphar.2022.847520

19. Long CY, Lin KL, Shen CR, et al. "A pilot study: effectiveness of local injection of autologous platelet-rich plasma in treating women with stress urinary incontinence." Sci Rep. 2021;11(1):1584. doi:10.1038/s41598-020-80598-2

20. Lee PJ, Jiang YH, Kuo HC. "A novel management for post-prostatectomy urinary incontinence: platelet-rich plasma urethral sphincter injection." Sci Rep. 2021;11(1):5371. doi:10.1038/s41598-021-84923-1

21. Masterson TA, Molina M, Ledesma B, et al. "Platelet-rich plasma for the treatment of erectile dysfunction: a prospective, randomized, double-blind, placebo-controlled clinical trial." J Urol. 2023;210(1):154–161. doi:10.1097/JU.0000000000003481

22. Shaher H, Fathi A, Elbashir S, Abdelbaki SA, Soliman T. "Is platelet-rich plasma safe and effective in treatment of erectile dysfunction? Randomized controlled study." Urology. 2023;175:114–119. doi:10.1016/j.urology.2023.01.028

23. Du S, Sun S, Guo F, Liu H. "Efficacy of platelet-rich plasma in the treatment of erectile dysfunction: a meta-analysis of controlled and single-arm trials." PLoS One. 2024;19(11):e0313074. doi:10.1371/journal.pone.0313074

24. Ledesma BR, Velasquez DA, Egemba C, et al. "A Phase 2 randomized, placebo-controlled crossover trial to evaluate safety and efficacy of platelet-rich plasma injections for Peyronie's disease: clinical trial update." Int J Impot Res. 2024;36(8):813–817. doi:10.1038/s41443-024-00844-3

25. El Attar A, DeLucia C, Landau M, Kroumpouzos G. "Platelet-rich plasma in the management of genital lichen sclerosus: a review of mechanisms, evidence, and future directions." Clin Dermatol. 2026;44(2):356–362. doi:10.1016/j.clindermatol.2026.02.001

26. Boero V, Cetera GE, Caia C, et al. "Is there a role for platelet-rich plasma injection in vulvar lichen sclerosus? A self-controlled pilot study." Arch Gynecol Obstet. 2024;309(6):2719–2726. doi:10.1007/s00404-024-07424-2

27. Medina Garrido C, Cano García A, de la Cruz Cea L, Oreja Cuesta AB. "Mid-term symptomatic relief after platelet-rich plasma infiltration in vulvar lichen sclerosus." Arch Dermatol Res. 2023;315(6):1527–1532. doi:10.1007/s00403-023-02529-1

28. Tedesco M, Bellei B, Garelli V, et al. "Adipose tissue stromal vascular fraction and adipose tissue stromal vascular fraction plus platelet-rich plasma grafting: new regenerative perspectives in genital lichen sclerosus." Dermatol Ther. 2020;33(6):e14277. doi:10.1111/dth.14277

29. Eryilmaz R, Şimşek M, Aslan R, et al. "The effect of platelet-rich plasma graft on post-operative complications in mid-penile hypospadias." Andrologia. 2020;52(7):e13652. doi:10.1111/and.13652

30. Martín-Solé O, Rodó J, García-Aparicio L, et al. "Effects of platelet-rich plasma (PRP) on a model of renal ischemia-reperfusion in rats." PLoS One. 2016;11(8):e0160703. doi:10.1371/journal.pone.0160703

31. EAU. Guidelines on Sexual and Reproductive Health, Limited Update March 2026, section 5.6.8.a.2 (platelet-rich plasma for erectile dysfunction) and 5.6.12. Guideline.

32. Poulios E, Mykoniatis I, Pyrgidis N, et al. Platelet-rich plasma improves erectile function: a double-blind, randomized, placebo-controlled clinical trial. J Sex Med. 2021;18:926–935. doi:10.1016/j.jsxm.2021.03.008.

33. Stadelman-Behar AM, Gehre MN, Atallah L, et al. Investigation of presumptive HIV transmission associated with receipt of platelet-rich plasma microneedling facials at a spa among former spa clients—New Mexico, 2018–2023. MMWR Morb Mortal Wkly Rep. 2024;73(16):372–376. doi:10.15585/mmwr.mm7316a3. Report.

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