Background and Objectives: Peyronie's disease (PD) is a chronic fibrotic disorder of the tunica albuginea causing penile deformity and sexual dysfunction. Platelet-rich plasma (PRP) has been proposed as a regenerative therapy with potential disease-modifying properties, but evidence of its use in chronic PD is scarce. This study evaluated the efficacy and safety of intralesional PRP injections in men with stable PD. Materials and Methods: A single-center retrospective cohort study was conducted including men with chronic PD treated with three weekly intralesional PRP injections (April 2022-April 2025). Inclusion required curvature stability for ≥6 months and absence of prior PD therapy. The primary outcome was a change in penile curvature at 4 weeks post-treatment. Secondary outcomes included plaque thickness (ultrasound), erectile function (IIEF-5), and safety (Clavien-Dindo grading). Results: Thirty-six men (mean age 61.2 ± 10.4 years) completed the treatment. Mean penile curvature decreased from 30.5 ± 7.3° to 24.2 ± 8.3° (Δ = -6.3°, 95% CI -7.7 to -5.3; p < 0.001); 25% achieved a ≥10° reduction. Mean plaque thickness declined from 3.25 ± 0.69 mm to 2.91 ± 0.76 mm (Δ = -0.34 mm; p < 0.001). IIEF-5 increased modestly (+1.1; p = 0.142). Only mild, transient adverse events occurred (pain 5.6%, hematoma 2.8%). Conclusions: Intralesional PRP was safe and yielded statistically significant but modest reductions in penile curvature and plaque thickness in chronic PD. Clinically meaningful improvement occurred in a minority of patients. These findings support keeping PRP investigational pending well-designed randomized controlled trials with standardized protocols and longer follow-up.
Medicina (Kaunas, Lithuania). 2026 Jan 21*** epublish ***
Luigi Pucci, Celeste Manfredi, Catello Sansone, Simone Tammaro, Giorgio Stanziola, Nunzio Langella, Giuseppe Dachille, Davide Arcaniolo, Marco De Sio, Maurizio Carrino
Department of Urology, AORN Antonio Cardarelli, 80131 Naples, Italy., Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy., Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Napoli, Italy., Andrology and Kidney Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area Urology, University of Bari, 70121 Bari, Italy.