Growth factors interacting with cells

Platelet-Rich Fibrin Matrix: A Revolutionary Treatment or a Hidden Risk in Urology?

Lena Voss in Health & Wellness August 2025 • 4 min read.

"Exploring the Safety and Efficacy of Platelet-Rich Fibrin Injections for Common Urologic Conditions and Post-Prostatectomy Care"

The field of urology is constantly evolving, with researchers exploring innovative treatments for common conditions such as erectile dysfunction (ED). One such treatment that has garnered attention is the use of platelet-rich fibrin matrix (PRFM) injections. A recent study highlighted the potential of PRFM as a safe and effective modality for addressing various urologic issues.

Platelet-rich fibrin matrix is derived from a patient's own blood and contains a high concentration of growth factors, which are known to promote tissue regeneration and healing. In the context of urology, PRFM injections have shown promise in facilitating nerve regeneration and improving erectile function, particularly in cases where nerve damage has occurred.

However, questions arise regarding the safety of using platelet-rich concentrates in patients who have undergone radical prostatectomy for cancer. Radical prostatectomy involves the surgical removal of the prostate gland, and while it is an effective treatment for prostate cancer, it can sometimes lead to complications such as ED. Considering that PRFM contains growth factors that could potentially stimulate tumor growth, it is essential to carefully evaluate the risks and benefits of using this treatment in post-prostatectomy patients.

Growth Factors: A Double-Edged Sword?

Platelet-rich concentrates have gained recognition as effective tools for tissue regeneration, yet their safety regarding tumorigenicity and cancer recurrence remains a topic of ongoing research. Multiple studies focusing on cancer growth, progression, recurrence, and postoperative survival rates have highlighted the critical role of the tumor stroma—the microenvironment surrounding the tumor—in cancer development. Therefore, understanding how platelet-derived growth factors impact this environment is crucial.

The secretory proteins within platelets' alpha-granules, including PDGF-AA, BB, and AB isomers, transforming growth factor-β, vascular endothelial growth factor, epidermal growth factor, and platelet-derived endothelial growth factor, stimulate angiogenesis, enhance tumor lymphangiogenesis, and regulate cell biology processes like proliferation, survival, differentiation, migration, and apoptosis.

Stimulating Angiogenesis: Encouraging the formation of new blood vessels, which can supply nutrients to tumors.
Enhancing Tumor Lymphangiogenesis: Promoting the development of lymphatic vessels around tumors, potentially aiding metastasis.
Regulating Cell Biology Processes: Influencing cell differentiation, migration, and even survival, which can impact tumor growth and spread.

Given these factors, the question arises: Is it safe to consider platelet-rich plasma (PRP) as a helpful treatment for post-radical prostatectomy ED, or could it inadvertently pose risks?

Future Directions: Balancing Hope and Caution

Further research is needed to fully understand the role of PRP in nerve regeneration after tumor excision. Future investigations should include experimental studies and large-scale prospective randomized clinical trials to rigorously evaluate both the potential benefits and risks. Using novel in vivo tumor models could help elucidate the complex processes triggered by oncogene activation and provide insights into the interplay between tumor cells and their microenvironment. By continuing to explore these critical questions, we can ensure that innovative treatments are both effective and safe for all patients.

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This article is based on research published under:

DOI-LINK: 10.4111/icu.2018.59.4.280, Alternate LINK

Title: Letter To The Editor: Safety And Feasibility Of Platelet Rich Fibrin Matrix Injections For Treatment Of Common Urologic Conditions

Subject: Urology

Journal: Investigative and Clinical Urology

Publisher: The Korean Urological Association

Authors: Eleftherios Spartalis, Diamantis I. Tsilimigras, Stavros Sfoungaristos

Published: 2018-01-01

Everything You Need To Know

What is platelet-rich fibrin matrix (PRFM), and how is it used in urology?

Platelet-rich fibrin matrix (PRFM) is a concentrate derived from a patient's own blood, rich in growth factors that promote tissue regeneration and healing. In urology, PRFM injections are explored for their potential to facilitate nerve regeneration and improve erectile function, especially in cases of nerve damage. The growth factors found within platelet-rich fibrin matrix include PDGF-AA, BB, and AB isomers, transforming growth factor-β, vascular endothelial growth factor, epidermal growth factor, and platelet-derived endothelial growth factor.

What are the potential benefits of using platelet-rich fibrin matrix (PRFM) injections for erectile dysfunction (ED) after a prostatectomy?

Platelet-rich fibrin matrix (PRFM) injections contain high concentrations of growth factors, which can stimulate tissue regeneration and potentially improve nerve function. Following a prostatectomy, nerve damage can lead to erectile dysfunction. The growth factors present in platelet-rich fibrin matrix, such as PDGF-AA, BB, and AB isomers, transforming growth factor-β, vascular endothelial growth factor, epidermal growth factor, and platelet-derived endothelial growth factor, aim to encourage nerve regeneration and improve erectile function. However, the safety of platelet-rich fibrin matrix in this context requires careful evaluation due to concerns about tumor growth.

Why is there concern about using platelet-rich fibrin matrix (PRFM) in patients who have undergone radical prostatectomy for cancer?

The primary concern lies in the growth factors present in platelet-rich fibrin matrix (PRFM). Radical prostatectomy involves the surgical removal of the prostate gland to treat cancer, but platelet-rich fibrin matrix's growth factors like PDGF-AA, BB, and AB isomers, transforming growth factor-β, vascular endothelial growth factor, epidermal growth factor, and platelet-derived endothelial growth factor could potentially stimulate tumor growth or recurrence. It's vital to balance the potential benefits of tissue regeneration against the risk of inadvertently promoting cancer development. The tumor stroma and its interaction with these growth factors play a crucial role in this assessment.

What role do growth factors play in tumor development, and how does this relate to the use of platelet-rich fibrin matrix (PRFM)?

Growth factors, such as PDGF-AA, BB, and AB isomers, transforming growth factor-β, vascular endothelial growth factor, epidermal growth factor, and platelet-derived endothelial growth factor, stimulate angiogenesis, enhance tumor lymphangiogenesis, and regulate cell biology processes like proliferation, survival, differentiation, migration, and apoptosis. Angiogenesis provides nutrients to tumors, while lymphangiogenesis can aid metastasis. These factors impact the tumor stroma, influencing cancer growth and spread. Given that platelet-rich fibrin matrix (PRFM) contains high concentrations of these growth factors, there's a need for caution, especially in post-prostatectomy patients, to avoid unintended stimulation of any remaining cancer cells.

What further research is needed to determine the safety and efficacy of platelet-rich fibrin matrix (PRFM) in post-prostatectomy care and other urologic conditions?

Future research should include experimental studies and large-scale prospective randomized clinical trials to rigorously evaluate both the potential benefits and risks of platelet-rich fibrin matrix. Novel in vivo tumor models could help elucidate the complex processes triggered by oncogene activation and provide insights into the interplay between tumor cells and their microenvironment. Such studies should focus on cancer growth, progression, recurrence, and postoperative survival rates, considering the impact of growth factors such as PDGF-AA, BB, and AB isomers, transforming growth factor-β, vascular endothelial growth factor, epidermal growth factor, and platelet-derived endothelial growth factor. The goal is to ensure innovative treatments are both effective and safe for all patients.