Trimodal Mini‐Invasive Therapy for Stable‐Phase Peyronie's Disease: A Two‐Center Real‐Life Prospective Pilot Study

ABSTRACT Introduction Platelet‐rich plasma (PRP) injection into penile plaques is an emerging, investigational approach for treating acquired penile curvature in men with stable‐phase Peyronie's Disease (PD). We report preliminary findings from a two‐center prospective pilot study. Material and Methods Thirty‐eight men with stable PD underwent two PRP injections (≈8 mL each), 4 weeks apart. PRP was prepared using either double or single centrifugation (2‐cycle vs. 1‐cycle group). All patients initiated tadalafil 5 mg daily and penile stretching with a vacuum device (5–15 min/day) 1 week after the first injection. Baseline and 3‐month follow‐up assessments included dynamic penile color doppler‐duplex ultrasound (CDDU), International Index of Erectile Function (IIEF), and Peyronie's disease questionnaire (PDQ). Results Twenty‐two patients (57.9%) received 2‐cycle PRP; 16 (42.1%) received 1‐cycle PRP. Baseline penile curvature was 45° (37–70) in the 2‐cycle group and 60° (50–66) in the 1‐cycle group, decreasing to 40° (30–50) and 50° (40–56), respectively ( p = 0.002 and p = 0.008). Overall, median curvature decreased from 55° (45–70) to 45° (30–55), with a median reduction of 10° (0–15) ( p < 0.001). PDQ scores improved significantly in both groups ( p ≤ 0.006), while IIEF‐EF and CDDU parameters remained unchanged. Plaque diameter showed a non‐significant reduction. No treatment‐emergent adverse events occurred. Conclusions PRP injections appear safe and may modestly improve penile curvature and PDQ scores in men with stable‐phase PD. However, the observed curvature reduction is insufficient to infer clinically meaningful long‐term outcomes. Larger controlled studies are warranted.