To analyze the therapeutic potential and safety outcomes of platelet-rich plasma (PRP) therapy in managing mild to moderate erectile dysfunction, with an observational follow-up spanning two years.

Thirty-five patients with mild to moderate erectile dysfunction (as per the IIEF-EF score) were administered three injections of autologous PRP (3 ml per corpus), spaced two weeks apart. The patients were followed up at 1, 3, and 6 months, and then every 6 months for 2 years. After 6 months, the PRP group (18 patients) continued receiving PRP injections (one session) every 6 months, while the saline group (17 patients) received saline injections at the same intervals as the PRP group.

A total of 35 patients were categorized into two groups: 18 received PRP treatment, while 17 were assigned to the saline group.
As we were conducting a 2-year follow up of the patients who have achieved satisfactory results upon receiving 3 doses of PRP . During the first 6 months following the initial three injections, no significant differences were observed between the two groups. However, after 6 months, the PRP group showed continuous improvement in all parameters regarding cavernousal artery diameter, peak systolic velocity, end diastolic velocity, IIEF-EF, SEP Q3, IIEF intercourse satisfaction Q6, 7,8 and IIEF overall satisfaction Q13, 14 up to 2 years of follow up, while the saline group exhibited a gradual decline in all parameters, although still better than baseline. None of the patients exhibited plaque formation, subcutaneous bruising, or any other significant adverse effects.

The results of this study showed that participants in the PRP group, who received maintenance doses at regular intervals, were able to sustain the improvements in erectile function that were initially achieved from the primary injections. These improvements were reflected in the follow-up parameters. Alternatively, subjects in saline group, who did not receive maintenance doses of PRP and were given saline instead, gradually lost their improvements over the 2 years of follow-up.

Platelet rich plasma can be relied on as a long-term choice for improving of erectile dysfunction with satisfying function and outcomes and no serious adverse event. However, more extended studies and larger cohorts are required to support this evidence.