Efficacy of autologous adipose-derived stromal vascular fraction and platelet-rich plasma intracavernous injections in patients with erectile dysfunction: a retrospective comparative study
4 affiliations
- 1Urology Department, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital
- 2School of Medicine, Urology Department, Nisantasi University
- 3Orion Surgery Center, Plastic and Reconstructive Surgery Department
- 4School of Medicine, Plastic and Reconstructive Surgery Department, Okan University
Abstract
Background Vasculogenic erectile dysfunction (ED) is primarily driven by impaired penile hemodynamics, and conventional phosphodiesterase type 5 inhibitors (PDE5i) may offer limited benefit in patients with persistent endothelial dysfunction. Regenerative therapies such as platelet-rich plasma (PRP) and adipose-derived stromal vascular fraction (AD-SVF) have emerged as potential alternatives; however, comparative clinical data remain limited. Methods This retrospective study included 60 men with non-severe, PDE5i-refractory vasculogenic ED (International Index of Erectile Function-5 [IIEF-5] > 10) treated with either PRP (n = 30) or AD-SVF (n = 30) between April and September 2022. Changes in erectile function and penile hemodynamics were evaluated using IIEF-5 scores and peak systolic velocity (PSV) using penile Doppler ultrasonography at 3, 6, and 12 months following treatment. Results Both treatment modalities were associated with significant improvements in erectile function over time. At 3 months, PRP resulted in greater short-term improvement in IIEF-5 scores compared with AD-SVF (+ 3.7 ± 2.4 vs. +1.0 ± 1.3; p < 0.001). At 6 months, AD-SVF demonstrated significantly greater improvements in IIEF-5 (+ 5.2 ± 1.7 vs. +3.7 ± 2.4; p = 0.007) and PSV (+ 3.0 ± 1.5 vs. +0.9 ± 1.1 cm/s; p < 0.001), with PRP outcomes remaining stable from 3 months onwards, indicating early functional plateau. At 12 months, AD-SVF gains were maintained (ΔIIEF-5: +5.4 ± 2.0 vs. +3.7 ± 2.4; p = 0.004; ΔPSV: +3.2 ± 1.7 vs. +1.0 ± 1.1 cm/s; p < 0.001). Subgroup analyses suggested more pronounced vascular benefits of AD-SVF in patients with hypertension and hyperlipidemia, whereas PRP showed a more uniform, moderate effect across subgroups. No serious adverse events were observed. Conclusions In this retrospective, real-world analysis of men with PDE5i-refractory vasculogenic ED, PRP was associated with faster short-term functional improvement, whereas AD-SVF demonstrated greater and more sustained gains from 6 months onwards. These findings should be interpreted as exploratory and hypothesis-generating, underscoring the need for prospective, controlled trials to better define the role of regenerative therapies in vasculogenic ED.
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BibTeX
@article{albayrak2026efficacy,
title = {{Efficacy of autologous adipose-derived stromal vascular fraction and platelet-rich plasma intracavernous injections in patients with erectile dysfunction: a retrospective comparative study}},
author = {Ahmet Tevfik Albayrak and Yasar Basaga and Mehmet Comert and Melih Can Sezgic and Kadir Cem Gunay and İbrahim Halil Baloglu and Sinan Levent Kirecci},
journal = {BMC Urology},
year = {2026},
month = jul,
doi = {10.1186/s12894-026-02270-7},
url = {https://doi.org/10.1186/s12894-026-02270-7},
note = {CC BY},
}
RIS
TY - JOUR
TI - Efficacy of autologous adipose-derived stromal vascular fraction and platelet-rich plasma intracavernous injections in patients with erectile dysfunction: a retrospective comparative study
AU - Ahmet Tevfik Albayrak
AU - Yasar Basaga
AU - Mehmet Comert
AU - Melih Can Sezgic
AU - Kadir Cem Gunay
AU - İbrahim Halil Baloglu
AU - Sinan Levent Kirecci
PY - 2026
DA - 2026/07/01
JO - BMC Urology
DO - 10.1186/s12894-026-02270-7
UR - https://doi.org/10.1186/s12894-026-02270-7
AB - Background Vasculogenic erectile dysfunction (ED) is primarily driven by impaired penile hemodynamics, and conventional phosphodiesterase type 5 inhibitors (PDE5i) may offer limited benefit in patients with persistent endothelial dysfunction. Regenerative therapies such as platelet-rich plasma (PRP) and adipose-derived stromal vascular fraction (AD-SVF) have emerged as potential alternatives; however, comparative clinical data remain limited. Methods This retrospective study included 60 men with non-severe, PDE5i-refractory vasculogenic ED (International Index of Erectile Function-5 [IIEF-5] > 10) treated with either PRP (n = 30) or AD-SVF (n = 30) between April and September 2022. Changes in erectile function and penile hemodynamics were evaluated using IIEF-5 scores and peak systolic velocity (PSV) using penile Doppler ultrasonography at 3, 6, and 12 months following treatment. Results Both treatment modalities were associated with significant improvements in erectile function over time. At 3 months, PRP resulted in greater short-term improvement in IIEF-5 scores compared with AD-SVF (+ 3.7 ± 2.4 vs. +1.0 ± 1.3; p < 0.001). At 6 months, AD-SVF demonstrated significantly greater improvements in IIEF-5 (+ 5.2 ± 1.7 vs. +3.7 ± 2.4; p = 0.007) and PSV (+ 3.0 ± 1.5 vs. +0.9 ± 1.1 cm/s; p < 0.001), with PRP outcomes remaining stable from 3 months onwards, indicating early functional plateau. At 12 months, AD-SVF gains were maintained (ΔIIEF-5: +5.4 ± 2.0 vs. +3.7 ± 2.4; p = 0.004; ΔPSV: +3.2 ± 1.7 vs. +1.0 ± 1.1 cm/s; p < 0.001). Subgroup analyses suggested more pronounced vascular benefits of AD-SVF in patients with hypertension and hyperlipidemia, whereas PRP showed a more uniform, moderate effect across subgroups. No serious adverse events were observed. Conclusions In this retrospective, real-world analysis of men with PDE5i-refractory vasculogenic ED, PRP was associated with faster short-term functional improvement, whereas AD-SVF demonstrated greater and more sustained gains from 6 months onwards. These findings should be interpreted as exploratory and hypothesis-generating, underscoring the need for prospective, controlled trials to better define the role of regenerative therapies in vasculogenic ED.
SN - 1471-2490
ER -