A recent systematic review and meta-analysis presented at the Sexual Medicine Society of North America (SMSNA) 2024 Fall Scientific Meeting suggests that regenerative treatments, including low-intensity shockwave therapy (LiSWT) and platelet-rich plasma (PRP) injections, are effective in treating erectile dysfunction (ED). The study, conducted by researchers at Baylor College of Medicine, indicates that both LiSWT and PRP, either independently or in combination, are associated with significantly improved International Index of Erectile Function (IIEF) scores compared to control therapies.
The analysis, led by Dr. David E. Hinojosa-Gonzalez, aimed to evaluate the efficacy of PRP injections, LiSWT, and stem cell therapy in treating ED based on IIEF scores. The team conducted a systematic search of clinical databases to gather relevant data on ED treatment outcomes with these regenerative therapies.
Key Findings from the Meta-Analysis
The meta-analysis included 16 studies involving 907 patients. Among them, 370 patients received LiSWT, 100 received PRP, 10 received stem cell therapy, and 427 served as controls. The results indicated that LiSWT was the most effective standalone treatment, with a mean difference of 3.4 on the IIEF score compared to the control group (95% CI, 2.1 – 4.9). PRP was associated with a mean difference of 3.2 (95% CI, 0.58 – 5.8). Notably, the combination of PRP and LiSWT showed the most significant improvement, with a mean difference of 8.2 (95% CI, 3.8 – 13.0).
Although stem cell therapy showed a mean difference of 4.3 versus control on IIEF outcomes, this difference was not statistically significant due to limited patient data (95% CI -1.1 to 9.7).
Specific Regimens and Their Impact
The investigators identified three specific regimens of regenerative treatment that significantly improved IIEF scores compared to the control group:
- LiSWT 0.09 mJ/mm2 (3.0; 95% CI, 1.3 – 4.8)
- LiWST 0.15 mJ/mm2 (5.4; 95% CI, 2.5 – 8.6)
- LiSWT 0.15 mJ/mm2 plus once-weekly PRP (10.0; 95% CI, 16.0)
Implications and Future Research
"The findings suggest that PRP and LiSWT may offer improvements in erectile function, though the clinical relevance and extent of their impact remain questionable," Hinojosa-Gonzalez and colleagues wrote. They emphasized the need for further research to determine the efficacy of stem cell therapies for erectile function and to validate the observed benefits of LiSWT and PRP, either alone or in combination.
These findings support previous research highlighting the safety of combining LiSWT and PRP injections for ED treatment, providing a foundation for further clinical trials to explore the potential of this regenerative therapy strategy.
