Clinical Trial Looks at Platelet-Rich Plasma as Peyronie's Treatment
While the source of the penile scarring associated with Peyronie's disease has long been a mystery in the medical community—whether it's physical trauma or the cumulative effects of microtears during sex—a study at the University of Miami Miller School of Medicine aims to discover a new way of treating the condition with human plasma.
Platelet-rich plasma (PRP) has rarely been used to treat Peyronie's, said lead researcher Ranjith Ramasamy, M.D., associate professor and director of reproductive urology at the Miller School.
However, PRP has a proven track record as a treatment in sports medicine—for orthopedic and joint recovery—and as a hair-growth stimulant. Achilles tendinitis, knee osteoarthritis, partial ulnar collateral ligament tears and rotator cuff injuries are just a few of the conditions for which PRP has been used as a treatment. Such sports world luminaries as golfer Tiger Woods (knee), tennis player Rafael Nadal (knee) and former baseball player Alex Rodriguez (hip) all underwent PRP injections for chronic ailments.
Treatment for Peyronie's
Peyronie's disease is a condition in which scar tissue builds up inside the penis and creates curvature in erections. Peyronie's can cause erectile dysfunction (ED) and painful intercourse. About 1 in 100 men in the United States have been diagnosed with Peyronie's, but it's believed the disease is vastly underreported.
Typical Peyronie's treatments include injections with the drug Xiaflex at the site of the penile scar tissue or oral medications in mild cases. Severe cases, in which the curvature is more than 60 degrees, require surgery or a traction device to help correct the curvature.
With all of these treatments providing limited success—the best offers 50 percent improvement in curvature, according to Ramasamy—PRP could be a game-changer if the ongoing clinical trial proves effective.
Goals of the study
During the study, researchers will draw a patient's blood and put it in a centrifuge to separate the platelets, which naturally prevent and/or block scar tissue formation. Researchers will look at the results from injecting a patient's own platelet-rich plasma into penile scar tissue. They hope to find that the platelets will work to naturally rid the area of scar tissue, reducing or eliminating the curvature, according to a university news release.
"The greatest thing about the therapy is you're taking PRP from the patients themselves, avoiding concerns about rejection or need for immunosuppression that can occur when using outside agents," study coauthor Kevin Chu, M.D., an incoming reproductive urology fellow at the Miller School, said in the release.
They hope to find that the platelets will work to naturally rid the area of scar tissue, reducing or eliminating the curvature, according to a university news release.
The 12-month study includes trial subjects ranging in age from 18 to 75 and whose penile curvature ranges from 30 degrees to 120 degrees. It is a randomized, double-blind crossover trial, meaning one set of patients will get two PRP injections while the others get a placebo. Six months later, the patient groups will switch. All participants will receive PRP and be monitored during that 12-month span.
Ramasamy is also the lead researcher on a concurrent study using PRP to help restore erectile function, and he said early signs for this application are promising.
While it's too early to comment on the Peyronie's disease clinical trial, the goal is to find a way for PRP to bring relief to patients.
"[We hope] this could be a good treatment to show anti-inflammatory effects," Ramasamy said.
