Cavernous nerve injury is a complication of radical prostatectomy and other major pelvic surgeries that can lead to erectile dysfunction (ED). Regenerative medicine, including platelet-rich plasma (PRP), has been considered a potential therapy for addressing this issue. However, in vivo studies on platelet-rich plasma for erectile dysfunction (PRP-ED) have been limited and scarce, making it crucial to assess the effectiveness of PRP interventions in cases of cavernous nerve injury (CNI). This meta-analysis aims to address these gaps.

This systematic review with meta-analysis followed PRISMA guidelines and used the PICO framework as an eligibility guide. Statistical analysis was performed using R Studio 2024.09.0+375 with the metacont code and subgroup analysis of reported outcome means. Studies included in the review were assessed using the SYRCLE tools.

This meta-analysis demonstrated a significant reduction in intracavernous pressure (ICP), with a pooled mean difference (MD) of 45.61 (95% CI: 34.15–57.07). Additionally, morphological changes were observed in the PRP-treated group, including an increase in myelinated axons, proliferations of corporal smooth muscle cells, and an increased ratio of nNOS/β-III-tubulin, along with a reduction in fibrosis. Despite its potential efficacy, high heterogeneity among the included studies (I² = 91%) was observed, likely due to variations in PRP administration protocols and patient characteristics.

This study highlights the promising role of PRP in treating CNI-related ED, while also emphasizing the importance of developing standardized protocols and conducting further research to optimize its application and ensure consistent outcomes for patients.