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NCT Number: NCT07602608

Platelet-Rich Plasma With or Without Tadalafil for Erectile Dysfunction

Platelet-rich plasma is being studied as a regenerative treatment option for erectile dysfunction, but it is unclear whether adding daily tadalafil gives additional benefit over platelet-rich plasma alone. This study evaluates adult men with mild to mild-moderate erectile dysfunction who had an inadequate response to previous phosphodiesterase type 5 inhibitor treatment.

Participants were randomly assigned to receive either intracavernosal platelet-rich plasma injections combined with oral tadalafil 5 milligrams once daily, or intracavernosal platelet-rich plasma injections alone. The platelet-rich plasma injection protocol consisted of three intracavernosal treatment sessions spaced two weeks apart. Erectile function was assessed using the International Index of Erectile Function-5 questionnaire at baseline and during follow-up at 1, 3, and 6 months. Penile duplex Doppler ultrasound was performed at baseline and after 6 months to assess erectile blood-flow parameters.

The study hypothesis is that adding daily tadalafil to intracavernosal platelet-rich plasma may produce greater improvement in patient-reported erectile function compared with platelet-rich plasma alone, while also allowing assessment of whether this improvement is accompanied by measurable changes in penile Doppler parameters. The study included 156 participants in the final analysis, with 78 participants in each treatment group.

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Key information

Conditions

Erectile Dysfunction Genital Diseases Genital Diseases, Male Male Urogenital Diseases Mental Disorders Sexual Dysfunction, Physiological Sexual Dysfunctions, Psychological Urogenital Diseases

Age range

18 year and older

Sex eligibility

Male

Study type

Interventional

Phase

Phase 4

Primary location

Benha University Hospital

Banhā, Qalyubia Governorate, 13511, Egypt

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adult men aged 18 years or older.
  • Diagnosis of mild to mild-moderate erectile dysfunction according to the International Index of Erectile Function-5.
  • Inadequate response to previous phosphodiesterase type 5 inhibitor treatment.
  • Eligible for intracavernosal platelet-rich plasma injection.
  • Eligible for oral tadalafil treatment.
  • Baseline penile duplex Doppler ultrasound assessment available.

Exclusion criteria

  • Severe erectile dysfunction.
  • Peyronie's disease.
  • Previous major pelvic surgery.
  • Previous pelvic trauma.
  • Known bleeding or coagulation disorder.
  • Contraindication to phosphodiesterase type 5 inhibitors, including nitrate therapy.
  • Significant cardiac disease contraindicating tadalafil use.
  • Total testosterone less than 300 nanograms per deciliter.
  • Refusal or inability to provide written informed consent.

Treatment and study plan

Tadalafil

Drug

Tadalafil was administered orally as a 5 milligram tablet once daily in combination with intracavernosal platelet-rich plasma injections. It was used as adjunct pharmacologic therapy to support erectile function during the study follow-up period.

Intracavernosal Platelet-Rich Plasma Injection

Procedure

Autologous platelet-rich plasma was prepared from whole blood using a two-step centrifugation technique and activated with calcium chloride before administration. It was injected intracavernosally using a fine-gauge needle after topical local anesthesia. The treatment protocol included three intracavernosal injection sessions spaced two weeks apart.

Primary outcomes

  1. Change in International Index of Erectile Function-5 Score

    Time frame: Baseline, 1 month, 3 months, and 6 months after treatment initiation

    Erectile function was assessed using the International Index of Erectile Function-5 questionnaire. The total score ranges from 5 to 25, with higher scores indicating better erectile function. Scores were compared over time between the platelet-rich plasma plus tadalafil group and the platelet-rich plasma alone group.

Secondary outcomes

  1. Change in Penile Peak Systolic Velocity

    Time frame: Baseline and 6 months after treatment initiation

    Peak systolic velocity was measured by penile duplex Doppler ultrasound after pharmacologic stimulation. It was used to assess arterial penile blood flow. Higher values indicate better arterial inflow.

  2. Change in Penile End-Diastolic Velocity

    Time frame: Baseline and 6 months after treatment initiation

    End-diastolic velocity was measured by penile duplex Doppler ultrasound after pharmacologic stimulation. It was used to assess venous outflow status during erection.

  3. Change in Penile Resistive Index

    Time frame: Baseline and 6 months after treatment initiation

    Resistive index was calculated from penile duplex Doppler ultrasound parameters after pharmacologic stimulation. It was used as an additional measure of penile vascular resistance and erectile hemodynamics.

Sponsors and collaborators

Lead sponsor

Benha University

Other

Registry information

Official study title

Efficacy of Intracavernosal Injection of Platelet-Rich Plasma Alone Versus Combined With Oral Tadalafil in The Management of Erectile Dysfunction; A Prospective Randomized Study

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
May 22, 2026
Registry last updated
May 22, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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