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Purpose <p>Post-prostatectomy incontinence (PPI) is a well-recognized complication of transurethral or radical prostatectomy. Platelet-rich plasma (PRP) has been used in regenerative medicine. This study aimed to evaluate the therapeutic efficacy of repeated PRP injections into the urethral sphincter for PPI.</p> Methods <p>Totally 71 patients with PPI refractory to conservative treatments. Each patient received four monthly PRP injections into the urethral sphincter. The primary endpoint was the Global Response Assessment (GRA) score for urinary incontinence improvement. Secondary endpoints included changes in the visual analog scale (VAS) for urinary incontinence, the Urogenital Distress Inventory (UDI-6), the Incontinence Impact Questionnaire (IIQ-7), daily pad usage, and urodynamic parameters three months after the fourth PRP injection.</p> Results <p>The mean age was 71.0 ± 7.2&#xa0;years, with a mean PPI duration of 35.5 ± 36.8&#xa0;months. After PRP injections, the mean GRA score was 1.30 ± 1.23. A GRA score of 2 or 3 was reported in 29 (40.8%) patients, and a GRA score of = 1 was reported in 27 (38.0%), and 15 (21.1%) showed no improvement or reported worsening. Significant improvements were observed in the VAS score, UDI-6 score, and abdominal leak point pressure (ALPP). The increase in ALPP was significantly greater in the successful group than in the failed group (49.3 ± 78.3 vs. 4.9 ± 52.4 cmH2O,<i> p</i> = 0.028). Baseline cystometric bladder capacity (CBC) was identified as a significant predictor of a successful outcome (<i>p</i> = 0.047).</p> Conclusions <p>Repeated urethral sphincter PRP injections can reduce the severity of PPI and increase ALPP in 40.8% patients with PPI. The results of this study support PRP as an exceptional therapy with low success but few complications.</p>

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Therapeutic efficacy and predictive factors for a successful outcome after platelet-rich plasma injections in men with post-prostatectomy urinary incontinence

  • 期刊论文

  • 发表日期：

    2026年5月20日

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  • Chia-Cheng Yang,
  • Yuan-Hong Jiang,
  • Hann-Chorng Kuo

摘要

Purpose

Post-prostatectomy incontinence (PPI) is a well-recognized complication of transurethral or radical prostatectomy. Platelet-rich plasma (PRP) has been used in regenerative medicine. This study aimed to evaluate the therapeutic efficacy of repeated PRP injections into the urethral sphincter for PPI.

Methods

Totally 71 patients with PPI refractory to conservative treatments. Each patient received four monthly PRP injections into the urethral sphincter. The primary endpoint was the Global Response Assessment (GRA) score for urinary incontinence improvement. Secondary endpoints included changes in the visual analog scale (VAS) for urinary incontinence, the Urogenital Distress Inventory (UDI-6), the Incontinence Impact Questionnaire (IIQ-7), daily pad usage, and urodynamic parameters three months after the fourth PRP injection.

Results

The mean age was 71.0 ± 7.2 years, with a mean PPI duration of 35.5 ± 36.8 months. After PRP injections, the mean GRA score was 1.30 ± 1.23. A GRA score of 2 or 3 was reported in 29 (40.8%) patients, and a GRA score of = 1 was reported in 27 (38.0%), and 15 (21.1%) showed no improvement or reported worsening. Significant improvements were observed in the VAS score, UDI-6 score, and abdominal leak point pressure (ALPP). The increase in ALPP was significantly greater in the successful group than in the failed group (49.3 ± 78.3 vs. 4.9 ± 52.4 cmH2O, p = 0.028). Baseline cystometric bladder capacity (CBC) was identified as a significant predictor of a successful outcome (p = 0.047).

Conclusions

Repeated urethral sphincter PRP injections can reduce the severity of PPI and increase ALPP in 40.8% patients with PPI. The results of this study support PRP as an exceptional therapy with low success but few complications.