Treatment Of Erectile Dysfunction With Plasma Rich In Platelets And Growth Factors

Plasma rico en plaquetas

“Erectile dysfunction is a medical problem that affects more than 50% of all men over 40 years of age, causing multiple consequences in their sexual life and mental health.”

The cutting edge in erectile dysfunction treatment today is, by far, platelet-rich plasma. PRP is a technique still under development, but it will surely have a lot of weight in the present and future of andrology, speaking in general, and in our Seville office, in particular.

Platelet Rich Plasma (PRP) is a new and effective treatment that is, without a doubt, revolutionizing the way erectile dysfunction is managed along with many other degenerative diseases and also related to cellular aging.

Platelet-rich plasma has proven to be useful in the treatment of erectile dysfunction in men according to various scientific studies, in addition to complementing the traditional clinical management of this pathology in the most severe cases.

It is important to note that the practice of this therapy is currently classified as an experimental modality as a non-surgical treatment for this pathology according to the erectile dysfunction guideline of the American Urological Association (2018).

However, its results are quite promising, its long-lasting effects, its rapid application, and its complications, very infrequent.

andromedi causas de la impotencia sexual fisica 01

What is erectile dysfunction? Causes, diagnosis and treatment with PRP

The causes of this sexual pathology depend on a large number of factors ranging from the age of the patient, the lifestyles that he has and some history of neurological, endocrine and vascular diseases.

Most patients develop erectile dysfunction progressively over the years, so they do not perceive the dysfunction in its early stages and consult the doctor too late to stop the disease in a timely manner. Diagnosis of the disease is based on a medical interview (or anamnesis), physical examination of the patient, and possibly some medical imaging studies such as ultrasound of the penis.

However. The vast majority of treatments are aimed at treating the problem and not the cause of the dysfunction: the aging of the erectile tissues.

Some patients receive vasodilator drugs such as sildenafil, taladafil or vardenafil orally and that promote the blood supply of the corpora cavernosa during erection with relatively positive results (they may work in some patients, but not so much in others).

Less conventional treatments include intracavernous drug injection, penile reconstructive surgeries, penile implants, and even certain exercises and massages for the copula organ. However, the problem continues without going to the source.

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Platelet Rich Plasma (PRP)

What is Platelet Rich Plasma?

Platelet-rich plasma (PRP) is an autologous biological element (that is, extracted from the same patient to which it will be applied), non-toxic and without the ability to cause allergies that is isolated from venous blood and with conventional laboratory methods.

What is blood plasma?

Plasma is the liquid portion of the blood that contains cellular elements (red blood cells or red blood cells and white blood cells or leukocytes). It is basically made up of 90 percent water along with some proteins, mineral salts, fats, vitamins, sugars, clotting factors, growth factors, hormones, gases and certain metabolic products.

Many specialists consider plasma as a “perfect liquid” that maintains the composition of the blood and therefore the homeostatic balance of the body.

The chemical and volume balance of plasma is regulated by the liver (where proteins are synthesized and compounds are metabolized), the kidneys (where the blood is filtered) and the bone marrow (where the production of red blood cells and leukocytes occurs), among others organs and tissues.

On the other hand. Platelets (also called thrombocytes) are non-cellular fragments, because they lack a nucleus, which are found in the blood and are responsible for clotting in the event of bleeding or vascular injury.

Platelet rich plasma (PRP) is nothing more than a product obtained from ultracentrifugation of blood and that contains a high concentration of platelets or thrombocytes. It is liquid, yellowish and watery.

Why does the platelet rich for ED?

The injection (referred to as medically infiltration) of platelet-rich plasma to treat erectile dysfunction is a minimally invasive and almost painless procedure that is performed by drawing blood from the patient himself to produce the treatment in question.

Platelets that flow freely in the blood contain a large number of growth factors (which will be discussed in more detail later) and substances with amazing repairing, proliferative and healing properties in the tissues in which they are deposited.

Platelet Rich Plasma (PRP) therapy is usually a therapy that is very well tolerated by the body, something that does not happen as often with other conventional treatments (such as drugs to treat erectile problems, which can have many side effects).

Quickly: What is PRP therapy for ED?

The material that is injected in this therapy is isolated and manufactured from the patient’s own blood, so there is not the slightest risk of rejection or allergies. It is a completely natural treatment, without synthetic components or drugs with side effects.

This blood that is extracted from the patient’s veins (as if it were for a routine analysis) undergoes a high-tech physical process that helps separate platelets and plasma from the rest of the components of the blood (white and red blood cells , lipids, etc.).

Those platelets suspended in the plasma is what is used for infiltration into the corpora cavernosa of the penis, the place where the erection of the member occurs. That is, the problem is with the site of origin.

This infiltration of proliferative and repairing substances of the tissue is what allows the growth of new and better cells in the vascular endothelium of the blood vessels of the corpora cavernosa of the penis and, therefore, the erections that are produced are more powerful and durable.

Why do medications sometimes not work and this therapy does?

When the problem of erectile dysfunction is a long-standing problem (several years), even if drugs such as Viagra® are taken, the penis can lose its habit of erections as blood filling is promoted, the state of erection will be weak, not firm or it will last very little.

The fact that the erection lasts little is really frequent and could even end before ejaculation and orgasm, ruining the sexual act.

The growth factors contained in PRP therapy stimulate the formation of collagen fibers within the erectile tissue, which is why the limb’s ability to stretch when faced with high blood volumes is notably improved.

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How do I know if I need this treatment?

Among the indications for this treatment are:

However, in this article we place special emphasis on erectile dysfunction as it is one of the most frequent conditions in men over 50 years of age with many negative effects on the well-being of the individual and their partner.

Now, if you are not completely sure of your condition, these following conditions may indicate that there is a problem with the erection:

How can I prepare for treatment?

This treatment does not require a great previous preparation.

The patient consults with his doctor and evaluates the possibility of receiving the treatment.

This is the ideal time to talk about the procedure: what it consists of, how it works, what results to expect, etc.

On the day of treatment, the patient can go alone to the medical center or clinic (since it is a quick procedure that does not require observation or administration of general anesthesia).

It is also recommended that the patient properly clean the genital area to facilitate the doctor’s tasks. This toilet includes hygiene of the genitals with soap and water and also shaving the pubic hair.

Procedure: What is platelet-rich plasma treatment?

First of all, it is important to clarify that the treatment of erectile dysfunction (ED) with platelet rich plasma (PRP) is a fairly safe non-surgical outpatient procedure that does not require major prior preparation, application of general anesthesia or days of physical recovery. The patient can return home after each treatment session and continue with their daily life without any inconvenience.

The procedure consists of a series of steps that must be done correctly so that the treatment does not carry risks and fulfills its main objective: to reduce and correct erectile dysfunction (ED) due to vascular causes.

  1. The patient attends the primary evaluation for examination by the physician. There, the degree of erection dysfunction is taken into account, the personal and health history is known, and the appropriate approach is chosen. Some laboratory tests are also indicated to determine blood values ​​and make sure everything is in order.
  2. A certain amount of blood is drawn with a syringe, usually from the veins in the arm.
  3. The blood is taken to a laboratory to be centrifuged at high speed and thus isolate its components. In a cellular fraction (with red blood cells and leukocytes) and an acellular fraction (plasma).
  4. Plasma is drawn from the centrifuged sample and kept refrigerated until the time of injection, which is usually a couple of hours after the blood is drawn.
  5. At the time of the intervention, the patient must attend having had a correct hygiene of the genital area. Your doctor may recommend shaving your pubic hair to facilitate the injection of platelet-rich plasma (PRP) into the penis.
  6. The patient enters the specialized office and the genital area is disinfected with antiseptic solutions in order to reduce the risk of infection to a minimum.
  7. Local anesthesia is applied to the penis with non-invasive methods (anesthetic creams, sprays, etc.).
  8. The doctor injects a certain amount of platelet-rich plasma (PRP) and growth factors into each corpus cavernosum of the penis. Several punctures or a single puncture can be done. This depends on the needs of the patient.
  9. The patient waits while lying down for a few minutes on the surgical table or bed and can return home.
andromedi proceso de obtencion de PRP para disfuncion erectil 01

Proceso de obtencion de PRP para disfuncion erectil. Extracción.

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Proceso de obtencion de PRP para disfuncion erectil. Preparación.

Plasmarico en plaquetas para la impotencia. Resultado.

andromedi proceso de obtencion de PRP para disfuncion erectil 03

Proceso de obtencion de PRP para disfuncion erectil. Selección del plasma.

andromedi proceso de obtencion de PRP para disfuncion erectil 04

Proceso de obtencion de PRP para disfuncion erectil. Inyección del PRP.

What is the aftercare of platelet rich plasma treatment?

After the treatment, the patient must take care of the hygiene and physical integrity of his penis. Being careful when showering or avoiding blows.

What’s more. It is important for the patient to be aware that the penis may become bluish (bruised) after injection with PRP because some blood vessels in the corpora cavernosa rupture and release some blood into the interstitial space. These bruises disappear on their own after a few days.

Doctor con estetoscopio

Does PRP really work against impotence? Why?

Platelet-rich plasma (PRP) and growth factors is a novel treatment in the clinical management of erectile dysfunction but with amazing results.

This treatment is based on the ability of growth factors (naturally contained in blood plasma) to stimulate the multiplication and growth of skin cells responsible for producing collagen fibers and hyaluronic acid. These cells are known as fibroblasts.

Collagen and hyaluronic acid provide the tissues with consistency, firmness and elasticity. They are a fundamental part of the wall of the thin and numerous blood vessels that supply the corpora cavernosa of the penis, responsible for erection.

In addition, platelet rich plasma (PRP) contains a certain amount of fibrinogen and mesenchymal stem cells. These cells have the great property of promoting the repair of tissues and the reconstruction of erectile tissue by improving blood supply to the penis, the capacity for contractility and increasing the release of nitric oxide (a chemical that relaxes blood vessels and which is responsible for maintaining the erection.

What are the advantages of PRP over conventional ED treatments?

Although treatment with platelet rich plasma (PRP) is less practiced than others today, it is a highly effective, reliable, safe and with many advantages therapeutic option for erectile dysfunction that will surely be a trend in the future world of andrology and male sexual medicine.

Among the benefits of PRP therapy in men with erectile dysfunction, the following can be highlighted:

Men who undergo this treatment report quite positive physiological and emotional improvements, such as increased self-confidence and sexual satisfaction.

Erections that are achieved after treatment with platelet rich plasma tend to last much longer, allowing men to enjoy them until after ejaculation. Not before.

Also, erections are perceived as stronger.

This promising medical technique is completely safe and there is no risk of developing serious complications such as ergias since the infiltrated material comes from the same patient.

With conventional treatments (drugs, surgeries, etc.), it is possible to find side effects that platelet-rich plasma does not. For example, penis shortening or pain will never develop.

Platelet-rich plasma sessions to treat erectile dysfunction typically last less than 10 minutes, taking away the time it takes to draw blood and bring it to the lab for testing and preparation.

During this time of approximately one hour, the patient can wait comfortably. The entire session lasts less than two hours.

Platelet rich plasma is a great alternative to penile implant surgeries that also help repair the root problem but with greater consequences.

This is a minimally invasive technique that only involves inserting a small syringe into the penis. It is almost painless and quite fast.

This cellular treatment does not include the administration of medications or any chemical substance. All that is used is a plasma concentrate, stem cells that help regenerate the erectile tissues of the penis, and growth factors that stimulate the regeneration of collagen cells and fibers.

This repair provided by platelet-rich plasma in cases of long-standing erectile dysfunction or resistant to conventional treatments is natural, from the site where the problem occurs: the vascular cells of the corpora cavernosa of the penis.

It is not just another treatment to achieve and maintain erections but it restores the problem and the consequences in the medium and long term.

With the improvement that this treatment brings with it, it is unnecessary to have to take medications such as sildenafil before sexual intercourse or to have to use vacuum pumps (which are uncomfortable and can aggravate the problem).

In medical practice, platelet-rich plasma treatment of erectile dysfunction has few disadvantages compared to conventional treatments in terms of effectiveness and safety.

The latter is especially useful when considering the large number of side effects that conventional treatments bring with them, such as:

Erectile dysfunction medications such as sildenafil (marketed as Viagra®) or others such as taladafil or vardenafil have the disadvantage that their consumption is mandatory 30 minutes before sexual intercourse.

In some patients, such as those with coronary problems or heart disease, they cannot use these drugs.

Although many are available over the counter, it is necessary to visit the doctor so that, based on the patient’s health characteristics, the drug and the ideal dose are prescribed.

Vacuum pumps work by generating negative pressure around the penis to induce an erection, but they have two drawbacks.

The first is related to how cumbersome it can be given that the man with erectile dysfunction needs to use the device for no less than five minutes before penetration and it is possible that, if there is a venous leak (a common pathology), the erection may be decreased. before reaching orgasm.

The second drawback is medium and long-term, since vacuum pumps can further weaken and damage the damaged capillary endothelium of the corpora cavernosa. Making it more fragile and less sensitive to erectile dysfunction drugs.

Intracavernous injections consist of administering a vasoactive drug with a needle into the corpora cavernosa of the penis. This drug is known as alprostadil and it has dilating activity in the blood vessels in this area, thereby improving blood flow and stimulating erections.

However, it is not a definitive treatment and after a while, it is necessary to apply more of the drug to continue having the same effects.

Penile surgery to treat erectile dysfunction aims to insert two implants in each corpus cavernosum of the limb, along with a device that stores saline solution and fills the implants (made of silicone).

Technically, it is the definitive solution to erectile dysfunction and it has good results, however, it is a surgical procedure that must be performed by specialists and entails a longer recovery time.

investigador utilizando microscopio laboratorio

What is the treatment indicated for? What are its other medical applications?

Traditionally, platelet-rich plasma is a treatment used in aesthetic medicine (reduction of wrinkles, eyelids, lips, etc.), in regenerative medicine (sports injuries, degenerative diseases, osteoarthritis, etc.), in burn repair, wound healing and many other chronic pathologies that cursen with pain and loss of tissue integrity.

Treatment contraindications

The health conditions that totally or partially prohibit platelet-rich plasma treatment are the following:

Growth factors

What are Growth Factors? What is your function?

Growth factors or GF (for Growth Factor) are a large group of proteins secreted by the body and which are responsible for stimulating the proliferation, maturation, specialization and initiation of activity of the cells of some specific tissues. Some growth factors are responsible for some cells to migrate from place to place or change their functioning.

Growth factors are found in almost every tissue in the human body, from the nervous system to the cartilage of the joints.

What growth factors are contained in platelet-rich plasma? How do these plasma growth factors help treat erectile dysfunction?

During the preparation of blood in the laboratory to extract platelet-rich plasma, certain substances (thrombin and calcium chloride) are added to cause these cells (thrombocytes) to release the growth factors they store within.

Among the growth factors found in platelet-rich plasma are:

These growth factors favor, among other things, the recovery of the capillary endothelium of the corpora cavernosa of the penis, restoring elasticity and consistency to maintain blood for longer. Therefore, erections are firmer, longer lasting and the sensitivity of the organ is increased, increasing sexual pleasure.

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Frequently asked questions about plasma rich in platelets

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Are there risks from treatment with Platelet Rich Plasma? What are those risks?

Since the plasma, proteins, growth factors and thrombocytes of the platelet-rich plasma treatment come from the same patient where they will be used, there is not the slightest risk of generating adverse allergic reactions.

However, with the injection of this substance into the corpora cavernosa of the penis, some hematomas may appear on the penis that will gradually disappear over the days.

The risk of infection is minimal. Less than 1 percent.

Is the injection of platelet rich plasma into the corpora cavernosa painful? What does the specialist do to ensure that the procedure is completely painless?

Injection of platelet-rich plasma into the penis is little or not painful because local anesthetics are applied to the site of infiltration. This local anesthesia is applied in the form of creams, sprays or it could also be injected near the pudendal nerve (which transmits pain sensations from the genital area to the nervous system).

Is it necessary to take a recovery time? How long can I see the results?

After treatment with platelet-rich plasma and stem cells, each patient can resume their home or work activities as normal. It is not necessary to stay in the hospital or clinic. However, it is recommended not to do physical exercise in the 24 hours after injecting PRP into the penis (to avoid irritation or bumps that inflame the tissues).

However, the time of the results may vary. Some patients notice improvement almost instantly and others may wait up to three weeks to notice changes in the quality, hardness, and duration of their erections.

Can I have sex after platelet rich plasma treatment? How long should I wait?

The most advisable thing is sexual abstinence for a time that could vary between a day and a week, according to the urologist's convenience. This is in order to prevent the penis from becoming swollen and painful (which represents a urological emergency that must be treated as soon as possible).

What are the results of the treatment? What is the success rate of platelet rich plasma treatment?

Between 80 and 90 percent of men treated with platelet-rich plasma (PRP) man if they have gotten firmer and longer lasting erections. In our own experience at the Andromedi center on Paseo Colón in Seville, the results are very good. Although it is true that it is a treatment of higher economic cost than other alternatives, we affirm that it is worth it.

How many sessions are necessary before seeing results?

Typically, two to three treatment sessions are indicated within two months. Treatment (platelet-rich plasma application) may need to be renewed in one to two years. Results begin to be visible one month after the first application, although this time may vary from patient to patient.

Any downsides to platelet rich plasma treatment?

A disadvantage could be that treatment with plasma rich in platelets and growth factors is somewhat more cumbersome than traditional treatments (such as retardant drugs such as Viagra®, Cialis® or Levitra®) and of course more expensive than these.

Nevertheless. Treatment with PRP has more medium and long-term goals than drugs, so they can be combined in compound therapy, thus helping in each stage of the solution.

Medical references and bibliography

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Author

Dr. Natalio Cruz


Natalio Cruz MD, with 25 years of medical experience, has been until 2016 Head of the Andrology Unit in the Urology Service of the Virgen del Rocío Hospital in Seville, National Coordinator of Andrology in the Spanish Association of Urology (AEU) and General Secretary in the ESSM, positions that he has narrowed to focus squarely on this exciting project of offering a high-level private medical consultation in Seville, Madrid and Tenerife.

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