Evaluation of intralesional injection of platelet derived growth factors PDGF ma in patients with Peyronie's disease

Background: Platelets which are the storage pool of growth factors, when they interact with exposed endothelium within wounds or the damaged tissue, these factors are released and work together in harmony with tissue-repair mechanisms such as chemotaxis, angiogenesis cell proliferation, extracellular matrix deposition, and remodeling to promote appropriate wound healing. Aim: To evaluate the effect of the effect of intralesional lyophilized Platelet Derived Growth Factors (PDGF) in patients with Peyronie's disease (PD). Patients and methods: This study was carried out on 42 patients that were recruited in the period from June 2022 till October 2023 with four patients lost at follow-up. An informed consent was taken, and the followings were done history taking, physical examination, Sexual health inventory for men (SHIM), Erection Hardness Score (EHS), Peyronie's Disease Questionnaire (PDQ), intracorporeal injection and penile duplex. All Patients received intra-lesional injections with 6 vials of LGF (lyophilized growth factor), one vial every two weeks for 12 weeks. Outcome: Assessment and follow up of plaque size and penile curvature through a Penile duplex with a 1cc PGE1 (20 micrograms) solution was performed 6 & 12 weeks after the first intra-lesional injection with LGF. Results: The study showed a significant decrease in the angle of curvature by 23.22° with a mean curvature angle 34.62° ± 16.37° before treatment, and 11.40° ± 8.84° after end of injections. It also showed statistically significant improvement in plaque size with average plaque size before treatment 2.70 ± 0.87 cm, which significantly decreased to 1.43 ± 0.44 cm. In addition, PDQ questionnaire showed a respective improvement of 9.18 points for domain 1, 14.74 for domain 2 and 8.3 for domain 3. Regarding EHS before injection there was two patients with E1 response, six patients with E2 response, while After injection there was no E1or E2 response. Clinical implications: Injection of LGF can result in improvement of early cases of Peyronie's disease. Strengths & Limitations: It is the first study objectively the effect of LGF as a line of treatment of early cases of Peyronie's disease. Additional studies are mandated to assess its efficacy in a shame-controlled manner. Conclusions: Findings of intralesional usage of lyophilized Platelet Derived Growth Factors preliminary in cases with Peyronie’s disease suggest a potential role for the treatment.