Trimodal Mini-Invasive Therapy for Stable-Phase Peyronie's Disease: A Two-Center Real-Life Prospective Pilot Study

Platelet-rich plasma (PRP) injection into penile plaques is an emerging, investigational approach for treating acquired penile curvature in men with stable-phase Peyronie's Disease (PD). We report preliminary findings from a two-center prospective pilot study.

Thirty-eight men with stable PD underwent two PRP injections (≈8 mL each), 4 weeks apart. PRP was prepared using either double or single centrifugation (2-cycle vs. 1-cycle group). All patients initiated tadalafil 5 mg daily and penile stretching with a vacuum device (5-15 min/day) 1 week after the first injection. Baseline and 3-month follow-up assessments included dynamic penile color doppler-duplex ultrasound (CDDU), International Index of Erectile Function (IIEF), and Peyronie's disease questionnaire (PDQ).

Twenty-two patients (57.9%) received 2-cycle PRP; 16 (42.1%) received 1-cycle PRP. Baseline penile curvature was 45° (37-70) in the 2-cycle group and 60° (50-66) in the 1-cycle group, decreasing to 40° (30-50) and 50° (40-56), respectively (p = 0.002 and p = 0.008). Overall, median curvature decreased from 55° (45-70) to 45° (30-55), with a median reduction of 10° (0-15) (p < 0.001). PDQ scores improved significantly in both groups (p ≤ 0.006), while IIEF-EF and CDDU parameters remained unchanged. Plaque diameter showed a non-significant reduction. No treatment-emergent adverse events occurred.

PRP injections appear safe and may modestly improve penile curvature and PDQ scores in men with stable-phase PD. However, the observed curvature reduction is insufficient to infer clinically meaningful long-term outcomes. Larger controlled studies are warranted.