In full disclosure, I only perform procedures and surgeries for incontinence that are FDA approved and covered by insurance.  This means that these procedures have some research (although not always as much as I would like) supporting them.  It also means that I may be biased against the other procedures out there that either aren’t FDA approved or covered by insurance.  These procedures all show some promise but the data to date is limited. These procedures are also expensive. PRP (platelet-rich plasma) is one such procedure. Can PRP treat stress urinary incontinence? (Click here if you aren’t sure about the types of leaking.)

What is PRP?

In PRP, a small amount of blood is taken from your arm.  The blood is then spun twice in a centrifuge. This activity separates the red blood cells from the other cells. A concentrate of plasma that is rich in platelets is created. The vagina is then numbed. The PRP is injected in the vagina near the opening of the urethra.  PRP contains cell regenerating growth factors that theoretically trigger increased blood flow and healthy tissue growth which enhances healing and improved tissue quality.  It appeals to all of us because it is “natural” and uses your own tissue. PRP injections are a fairly quick and easy procedure (more info about PRP here).  But what do the data say?

PRP to treat incontinence

There are very few studies on PRP and the treatment of urinary incontinence.  One study showed that 20% of women where dry after the injection and 40% were better.  There are few complications and it seems to work better in younger patients.  It isn’t clear how long this injection would last.  That is the extent of what has been proven with research.

PRP in other specialties

Orthopedics and plastic surgery use PRP with optimism.  The data in these specialties is also lacking.  A review published in 2017 found that there is data to support the use of PRP in knee osteoarthritis and lateral epicondylitis but not for the other 6 injuries studied.  It does not seem to help in conditions like rotator cuff repairs and hamstring injuries.  In the plastics world, there is some very subjective data to support PRP use in skin rejuvenation, hair growth, wound healing, and fat graft take.  The data is somewhat murky since there isn’t a standard way to prepare the PRP.  Again, not overwhelming data although lots of people believe that it subjectively helps.

Take-away points about PRP to treat urinary incontinence

PRP is marketed as being natural with few complications.  That is true.  Practices that use vaginal injections of PRP claim that it is a treatment for decreased libido, stress incontinence, dryness, and ability to orgasm (among other things).  Physiologically, there is no way to explain how it could impact all of these different functions unless through a placebo effect.  I think this marketing really plays on our personal insecurities and overpromises.  Afterall, even if you have a great sex life, most women would be happy with an even better one. And while it isn’t going to hurt you, PRP likely won’t help much to treat your incontinence.  Although it may hurt your wallet as it will likely cost between 1,200 and 2,500 dollars.

Long CY et al A pilot study: effectiveness of local injection of autologous platelet-rich plasma in treating women with stress urinary incontinence. Sci Rep  2021;11(1):1584.

Chamata ES, platelet-rich plasma:evolving role in plastic surgery.  Plastics and reconstructive e surgery 2021:147(1):219-30.

Hussain N et al. An evidence-based evaluation on the use of platelet rich plasma in orthopedics – a review of the literature SICOT J 2017, 3, 57

Jiang Y-H et al.Therapeutic Efficacy of Urethral Sphincter Injections of Platelet-Rich Plasma for the Treatment of Stress Urinary Incontinence due to Intrinsic Sphincter Deficiency – A Proof of Concept Clinical Trial Int Neurourol J 2021 ;doi: 10.5213/inj.2040272.136. Online ahead of print