Patient-reported Outcomes of Regenerative Therapies for Erectile Dysfunction: A Systematic Review and Meta-analysis

Background: Erectile dysfunction (ED) is a common condition among aging men, with limited response to first-line therapies in certain populations. This study aimed to systematically review and compare the efficacy of regenerative treatments such as platelet-rich plasma (PRP), low-intensity shockwave therapy (Li-SWT), and stem cell therapy (SCT) in improving erectile function in men with ED. Materials and methods: This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Eligible studies were controlled trials involving adult men with ED of any etiology, treated with PRP, Li-SWT, or SCT, and reporting mean changes in International Index of Erectile Function (IIEF) scores. Non-human and unrelated studies were excluded. Meta-analysis was conducted using RevMan to calculate pooled mean differences (MDs) with 95% confidence intervals (CIs). Results: Thirteen studies involving 494 participants met the inclusion criteria. At 3 months, Li-SWT demonstrated a significant improvement in IIEF scores compared with placebo (MD 3.39; 95% CI 2.36–4.42; p < 0.001), whereas PRP did not reach statistical significance (MD 1.44; 95% CI 0.21–3.09; p = 0.09). At 6 months, PRP showed a significant improvement vs. placebo (MD 2.03; 95% CI 0.26–3.81; p = 0.02), while Li-SWT did not. Conclusion: Compared with placebo, PRP showed a sustained improvement at 6 months; however, the available evidence remains limited.