Having a healthy sex life is an important part of a fulfilling existence since it impacts both physical as well as mental well-being of an individual. Erectile dysfunction (ED) is a fairly common cause of a malfunctional sex life, causing depression among many. Some patients are even hesitant to seek medical help, which prolongs their problem. Peyronie’s disease (PD) is an uncommon cause of this condition, in which plaque (scar tissue) buildup under the penile skin can lead to bending of the penis. This bending usually occurs during erection, making sexual intercourse difficult, and even painful.
The scar tissue growth, characteristic of PD, occurs in an elastic membrane present inside the penis, that functions to stiffen the penis during an erection. Bending is a consequence of the plaque/scar tissue growth in this membrane, as it pulls on the surrounding tissues. This plaque buildup can be felt like a flat hard lump on the shaft of the penis. Moreover, other deformities such as indentations, narrowing, and shortening of the penile shaft have also been reported. It is pertinent to note that this scar tissue growth which causes penile deformity is benign and non-cancerous.
It is not yet clear as to what causes Peyronie’s disease but a few risk factors, for instance, trauma to the penis, any connective tissue disorders, and diabetes are often mentioned. Scientific evidence has also highlighted the likelihood of genetic influence in making a person more susceptible to this disease.
Owing to the additional psychological burden associated with this condition, it is highly recommended to attempt for a complete recovery. Several medical treatment options are employed, however, none of them could fully cure the disease. Although reserved for severe cases, surgery is the ultimate choice when other options fail to make any improvement.
What Is Platelet-rich Plasma (PRP)?
Our blood is majorly composed of two parts, one is cellular and the other is fluid. The fluid part is commonly known as plasma. Many substances that are vital for the proper functioning of our body are suspended in it, and platelets are one of those. Platelets are not true cells but rather fragments that break away from special kinds of cells produced in the bone marrow. They are usually known for their ability to stop bleeding, though are capable of doing much more. The chemicals produced by platelets are now known to possess prodigious rejuvenating powers.
As the name indicates, PRP is the fluid part of blood, having a high concentration of platelets. PRP involves drawing the patient’s blood, which is not more than what is required for a routine blood test. This blood is then put into a centrifuge machine that separates it into several layers based on the difference in densities. Consequently, the platelets are left aggregated, all into a single layer. This layer of plasma which is rich in platelets is separated and can be further used to treat several conditions where tissue healing and regeneration are needed.
Many studies have advocated its efficacy, and this mode of therapy is increasingly being used in medical disciplines like dermatology, orthopedics, plastic, and reconstructive surgery, to name a few. It has the potential to be used as a standalone procedure while supplementing many others at the same time.
Treatment of Peyronie’s Disease with PRP
It is a non-complex procedure that does not require a hospital setting. Once the PRP extract is prepared using a centrifuge machine, it can be injected into the areas of the penis where normal tissue is destroyed by scar. This PRP will initiate the healing process by stimulating the regrowth of normal tissue in the elastic membrane of the penis.
The details of the procedure done for Peyronie’s disease are listed below:
- The patient is taken to a sterile space, where PRP is freshly prepared after taking the patient’s blood.
- Areas to be injected are disinfected
- Local anesthesia is administered, and penile block serves to avoid any discomfort to the patient during the whole procedure.
- Imaging techniques like ultrasound may guide the doctor in proper placement of injection, whilst precluding any additional damages to the injection site
- Before injecting the suspension, doctors mechanically create holes inside the scar tissue using needles
- This mechanical action of needles creates canal-like spaces in the fibrotic scar tissue, in which PRP is injected which stimulates healing and regrowth of normal tissue.
- The slightly compressive dressing can be applied to the injection site to prompt healing.
Your doctor may advise against having intercourse for a day or two. Some patients might need repeated therapy, depending upon the severity of the disease.
Outcomes of the PRP Therapy
PRP therapy focuses on restoring normal tissue of the membrane inside the penis. The high concentration of platelets present in this formulation secretes a variety of growth factors like FGF (fibroblast growth factor), VEGF (vascular endothelial growth factor), IGF (insulin-like growth factor), and more. These growth factors enhance tissue regeneration by initiating a cascade of reactions. Evidence has demonstrated the potential of PRP becoming the line treatment for Peyronie’s disease. According to a study, the patients reported subjective improvement in the degree of penile curvature following PRP therapy.
Another study tested PRP and hyaluronic acid together in patients who previously had received no treatment for PD and the results were promising. The thickness of the membrane due to scar tissue growth decreased substantially, and penile bending also reduced considerably. Patients experienced better erections and finally an enhanced sexual experience.
There were not any significant changes for patients who had developed calcifications in their plaques over time, but for some, they disappeared. It should be noted that both traumas to the penis and the duration of PD did not have any marked effect on the outcomes so even those suffering from the disease for a long time can benefit from the beneficial effects of PRP.
The Future of PRP
Pharmacological therapy over the long term is not a feasible solution for many as it comes with certain side effects. Low compliance and cost mounting over the years are some other notable issues. Surgery is not a viable option for everyone considering the health restrictions and adverse effects associated with it. All these factors contribute to the rising popularity of PRP therapy during recent years. This technique of managing several chronic disorders by only using the weapons provided by nature is an important milestone in the history of medicine. The nonexistence of any exogenous chemicals in this formulation is what makes it superior to other pharmacological options, as there is little to no potential for any allergic reactions, making it exceptionally safe.
In addition, the drawbacks of this therapy are close to a minimum with most of the existing ones being injection or anesthesia related. Since it is noninvasive, the risks that come along with surgery can be avoided as well.
Although the use of PRP in the treatment of PD is still under study, considering the evidence which is currently present, the future of PRP therapy in treating PD looks bright. This new mode of treatment undoubtedly has the potential of becoming the first-line therapy in the treatment of PD. It can replace surgery, which has its own set of limitations and liabilities, and patients fear undergoing one too. Some of the approved treatment options appear to be more costly than PRP therapy when compared in the long run so PRP is also cost-effective.