James Weinberger MD MBA, Chris Shangyang, Jesse Mills MD, Sriram Eleswarapu MD PhD
Platelet-Rich Plasma and Stem Cell Therapy for Erectile Dysfunction: Characterization of Market Forces In a Major Metropolitan Area
Introduction: The prevalence of erectile dysfunction (ED) continues to rise, particularly among young men. A robust industry focusing on non-guidelines-based treatments has emerged to cater to men experiencing ED. Independent providers promote so-called “regenerative” or “restorative” therapies, such as platelet-rich plasma (PRP) or stem cells. Despite a paucity of scientific evidence, direct-to-consumer marketing efforts emphasize the potential for tissue regeneration. No clinical trial currently supports the use of these technologies beyond an investigational role. With no guidance on dosage or frequency of treatment, a variety of ad hoc treatment schemes exist.
Objective: To characterize the landscape of PRP and stem cell treatments for ED by evaluating trends in marketing and deployment of these therapies in a large metropolitan area. We aim to describe the costs of treatments, the training and qualifications of providers, and the level of standardization across treatment plans.
Methods: Using Google Search (www.google.com), we identified regenerative medicine treatment providers in the Los Angeles, California, metropolitan area. Search terms included: “PRP ED in Los Angeles”; “P shot Los Angeles”; “PRP erectile dysfunction Los Angeles”; “Priapus shot Los Angeles.” After identification of clinics offering these treatments, each clinic was called to collect information regarding administering provider qualifications, pricing for treatments, and duration of treatments.
Results: Twenty-five clinics provide PRP and/or stem cell treatments for ED in the LA metropolitan area. Information was available for 20 of 25 clinics identified. Fifteen percent of providers had formal urology training. A summary of the 20 providers is shown in Table 1. The average price of PRP injections was $1368 per injection (range $800-$2500). Stem cell therapy was offered by six providers, with an average cost of $3817 per treatment (range $2,600-$5,000, depending on stem cell source, e.g., placental or adipose). Treatment duration ranged from one injection to indefinite injections based on individual patient circumstance.
Conclusions: PRP and stem cell treatments for ED suffer from substantial inconsistency and lack of standardization. Non-urologists predominate, and costs and frequency of therapy appear to be market-driven without evidence base. Advertised outcomes vary widely: some clinics suggest a single injection will be sufficient for cure, while others recommend repeat injections for indefinite time periods. The SMSNA and AUA classify these treatments as experimental and state explicitly that providers should not charge patients for these treatments. A stronger role for organized urology may be needed to address the proliferation of non-guidelines-based treatments for ED.