Department of Urology, Wake Forest Baptist Medical Center, Winston Salem, NC, USA.
Investig Clin Urol. 2018 Jan;59(1):61-65. doi: 10.4111/icu.2018.59.1.61. Epub 2017 Dec 21.
Autologous platelet rich plasma (PRP) is used increasingly in a variety of settings. PRP injections have been used for decades to improve angiogenesis and wound healing. They have also been offered commercially in urology with little to no data on safety or efficacy. PRP could theoretically improve multiple urologic conditions, such as erectile dysfunction (ED), Peyronie's disease (PD), and stress urinary incontinence (SUI). A concern with PRP, however, is early washout, a situation potentially avoided by conversion to platelet rich fibrin matrix (PRFM). Before clinical trials can be performed, safety analysis is desirable. We reviewed an initial series of patients receiving PRFM for urologic pathology to assess safety and feasibility.
Data were reviewed for patients treated with PRFM at our center from November 2012 to July 2017. Patients were observed immediately post-injection and at follow-up for complications and tolerability. Where applicable, International Index of Erectile Function (IIEF-5) scores were reviewed before and after injections for ED and/or PD. Pad use data was collected pre/post injection for SUI.
Seventeen patients were identified, with a mean receipt of 2.1 injections per patient. Post-procedural minor adverse events were seen in 3 men, consisting of mild pain at injection site and mild penile bruising. No patients experienced complications at follow-up. No decline was observed in men completing pre/post IIEF-5 evaluations.
PRFM appears to be a safe and feasible treatment modality in patients with urologic disease. Further placebo-controlled trials are warranted.
自体富含血小板血浆(PRP)越来越多地用于各种情况下。PRP 注射已被用于改善血管生成和伤口愈合数十年。它们也已在泌尿科商业化提供,几乎没有关于安全性或疗效的数据。PRP 理论上可以改善多种泌尿科疾病,如勃起功能障碍(ED)、佩罗尼氏病(PD)和压力性尿失禁(SUI)。然而,PRP 的一个问题是早期冲洗,通过转化为富含血小板纤维蛋白基质(PRFM)可以避免这种情况。在可以进行临床试验之前,需要进行安全性分析。我们回顾了接受 PRFM 治疗泌尿科疾病的初始系列患者,以评估安全性和可行性。
我们回顾了 2012 年 11 月至 2017 年 7 月在我们中心接受 PRFM 治疗的患者的数据。患者在注射后立即和随访时观察并发症和耐受性。在适用的情况下,我们审查了勃起功能障碍(ED)和/或 PD 患者注射前后的国际勃起功能指数(IIEF-5)评分。收集了压力性尿失禁患者注射前后的垫使用数据。
确定了 17 名患者,每名患者平均接受 2.1 次注射。3 名男性出现轻微的术后不良反应,包括注射部位轻度疼痛和轻度阴茎瘀伤。没有患者在随访时出现并发症。完成 IIEF-5 评估的男性没有观察到评分下降。
PRFM 似乎是治疗泌尿科疾病患者的一种安全且可行的治疗方法。需要进一步进行安慰剂对照试验。