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Efficacy of Platelet-Rich Plasma in Interstitial Cystitis/Bladder Pain Syndrome: A Systematic Review and
Fawad Ali1, Abdul Haseeb2, Hira Bakhtiar Khan3
1University Hospital Kerry, Kerry, Ireland.
Introduction And Hypothesis:
Interstitial cystitis/bladder pain syndrome (IC/BPS) has been recognized as a chronic, debilitating disorder characterized by pelvic pain and urinary dysfunction, for which current therapies have offered limited long-term effectiveness. Recently, platelet-rich plasma (PRP), a biologic therapy rich in growth factors, has been investigated as a regenerative treatment option.
Materials And Methods:
This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This review was prospectively registered in the International Prospective Register of Systematic Reviews (CRD420251084131). Eight studies evaluating intravesical PRP for IC/BPS were included. Data were extracted from PubMed, Web of Science, CINAHL, and Cochrane Central Register of Controlled Trials. Risk of bias was evaluated using the RoB 2.0 tool for randomized controlled trial (RCTs) and the Newcastle-Ottawa Scale for observational studies.
Results:
Platelet-rich plasma therapy led to significant improvements in patient-reported outcomes. Pain scores (visual analog scale) showed a pooled standardized mean difference (SMD) of -0.78 (95% CI -1.15 to -0.41; p < 0.0001), whereas Interstitial Cystitis Symptom Index, Interstitial Cystitis Problem Index, and O'Leary-Sant Symptom scores demonstrated SMDs of -0.79, -0.84, and -1.18 respectively (all p < 0.0001). Functional bladder capacity (FBC) and uroflowmetry values improved, with FBC increasing from 267.6 ml to 322.0 ml and Qmax from 10.9 ml/s to 18.4 ml/s in some studies. Improvements were sustained up to 6 months. A low incidence of mild adverse events (dysuria, hematuria, UTIs) was reported. Symptom relief was consistent across short- and long-term follow-up groups, with no statistically significant differences between durations.
Conclusions:
Intravesical PRP significantly improves pain, urinary symptoms, and bladder function in patients with IC/BPS, while maintaining a low risk of adverse effects. However, larger, well-designed RCTs are needed to confirm long-term efficacy and optimize treatment protocols.
