The Regenerative Frontier: Consolidating the Evidence for Platelet-Rich Plasma in the Management of Mixed Urinary Incontinence

Abstract

Mixed urinary incontinence (MUI) presents a formidable therapeutic challenge, requiring a strategy that simultaneously addresses the anatomical defect of stress urinary incontinence (SUI) and the functional disorder of urgency urinary incontinence (UUI). While surgical and pharmacological interventions exist, they often target a single component and carry significant limitations. Platelet-rich plasma (PRP), an autologous concentrate of growth factors, has emerged as a promising regenerative therapy. Recent pioneering work has introduced a novel dual-target approach, combining intra-sphincteric injections for SUI with intravesical instillations for UUI. This review synthesizes the current evidence on PRP for urinary incontinence, with a specific focus on the efficacy, safety, and clinical implications of this combined technique for MUI, as recently demonstrated in a landmark prospective trial. The findings indicate that dual-target PRP therapy yields significant and sustained subjective and objective improvements in MUI patients over a six-month period, with a favorable safety profile. This approach represents a paradigm shift in MUI management, offering a minimally invasive, holistic treatment. While these results are compelling, further validation through large-scale, randomized controlled trials is essential to solidify its role in the urological armamentarium.