Peyronie's disease is characterized by the formation of one or more fibrotic plaques in the tunica albuginea of the corpora cavernosa, which causes penile curvature during erection and can significantly compromise the sexual function and quality of life of the patient affected. Although several therapeutic strategies are available, the treatment of Peyronie's disease in its stable phase still represents a significant clinical challenge. Intralesional infiltration of platelet-rich plasma (PRP) into the fibrotic plaque is an emerging and experimental therapeutic approach that uses growth factors released by platelets to modulate tissue repair and remodeling processes.
Our researchers conducted a prospective, bicentric pilot study on 38 patients with stable Peyronie's disease. All participants received two intralesional PRP injections (approximately 8 mL each) 4 weeks apart. The PRP was prepared using two different processing methods: double centrifugation for 22 patients and single centrifugation for 16 patients. One week after the first injection, all patients began a combined treatment protocol with 5 mg of tadalafil administered daily and penile traction using a vacuum device for 5-15 minutes per day. Clinical and instrumental evaluation was performed at baseline and after 3 months using dynamic penile color Doppler ultrasound and validated questionnaires for erectile function (IIEF) and the impact of Peyronie's disease (PDQ).
The results showed a statistically significant improvement in penile curvature in both groups. In the double centrifugation group, the median curvature decreased from 45° to 40°, while in the single centrifugation group it decreased from 60° to 50°. In the entire cohort, the median curvature decreased from 55° to 45°, with a median reduction of 10° (p less than 0.001). PDQ scores improved significantly in both groups (p ≤ 0.006), while erectile function parameters and ultrasound findings remained largely unchanged. Plaque size showed a clinically insignificant reduction. No treatment-related adverse events were reported. The clinical implications of this study are significant: trimodal therapy based on PRP injections has been shown to be safe and well tolerated, resulting in a modest but statistically significant improvement in penile curvature and quality of life scores in patients with stable Peyronie's disease. However, the extent of the reduction in curvature observed does not allow us to infer a relevant long-term clinical benefit, making it necessary to conduct randomized controlled trials on larger cohorts to validate these preliminary results.
Negri F, Pozzi E, Zahiti L, Birolini G, Raffo M, d’Arma A, Montorsi F, Mattei A, Salonia A. Trimodal Minimally Invasive Therapy for Stable-Phase Peyronie’s Disease: A Two-Center Real-Life Prospective Pilot Study. Andrology. 2026 Jan 14:e70176. doi: 10.1111/andr.70176. Epub ahead of print. PMID: 41531263.
