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富血小板血浆(P-shot®)经阴茎海绵体内注射治疗血管性勃起功能障碍的初步研究。

Pilot study of intra-cavernous injections of platelet-rich plasma (P-shot®) in the treatment of vascular erectile dysfunction.

机构信息

Service d'urologie, hôpitaux universitaires Henri-Mondor, CHU Henri Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre- de- Tassigny, 94010 Créteil, France.

Université Paris Est Créteil, Inserm, IMRB, CEpiA Team, 94010 Créteil, France; AP-HP, Hôpital Henri Mondor, Unité de Recherche Clinique (URC Mondor), 94010 Créteil, France.

出版信息

Prog Urol. 2022 Dec;32(16):1440-1445. doi: 10.1016/j.purol.2022.05.002. Epub 2022 Jun 10.

Abstract

INTRODUCTION

Intracavernosal injections of platelet-rich plasma (PRP) or P-shot® are increasingly proposed as a curative treatment for organic sexual dysfunction despite the lack of evidence of effectiveness.

OBJECTIVES

We conducted a pilot study to evaluate the safety and efficacy of intracavernous PRP injections in patients with vascular erectile dysfunction (ED).

METHODS

Three intracavernosal injections of PRP were performed 15days apart in 15 patients with vascular ED unresponsive to medical treatment with 5-phosphodiesterase inhibitors and/or prostaglandin E instillations or injections. Questionnaires assessing erectile function (IIEF-EF, EHS, SEP, Sexual discomfort score) were completed prior to treatment and 1, 3 and 6 months after the last injection.

RESULTS

No side effects were noted during the study period. The IIEF-EF score was significantly improved after treatment (P<0.001) with a gain of 5 points at 1month, 4 points at 3months and 3 points at 6months (respectively P=0.001, P=0.003 and P=0.022). The other questionnaires did not change significantly. In total, 20% of patients considered that the erection lasted long enough to have a sexual intercourse (SEP score) before P-shot® versus 26.7% after the treatment (P=1).

CONCLUSION

This study suggests that the effect of P-Shot® remains moderate in cases of ED with vascular origin. Larger clinical studies are needed to determine the real effectiveness of this therapeutic strategy.

LEVEL OF PROOF

摘要

简介

尽管缺乏有效性证据,富血小板血浆(PRP)或 P-shot®的海绵体内注射被越来越多地提出作为治疗器质性性功能障碍的方法。

目的

我们进行了一项初步研究,以评估海绵体内 PRP 注射在对 5 型磷酸二酯酶抑制剂和/或前列腺素 E 滴注或注射治疗反应不佳的血管性勃起功能障碍(ED)患者中的安全性和疗效。

方法

15 例血管性 ED 患者在 15 天内接受 3 次海绵体内 PRP 注射,这些患者对 5 型磷酸二酯酶抑制剂和/或前列腺素 E 滴注或注射治疗反应不佳。在治疗前以及最后一次注射后 1、3 和 6 个月,使用评估勃起功能的问卷(IIEF-EF、EHS、SEP、性不适评分)进行评估。

结果

研究期间未观察到不良反应。治疗后 IIEF-EF 评分显著改善(P<0.001),1 个月时增加 5 分,3 个月时增加 4 分,6 个月时增加 3 分(分别为 P=0.001、P=0.003 和 P=0.022)。其他问卷没有显著变化。在总共 20%的患者中,在接受 P-Shot®治疗之前,认为勃起足以进行性交(SEP 评分),而在治疗后这一比例为 26.7%(P=1)。

结论

本研究表明,在血管性 ED 病例中,P-Shot®的效果仍然是中度的。需要更大的临床研究来确定这种治疗策略的真正效果。

证据水平

2

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