Therapeutic Efficacy and Safety of Injectable Platelet-Rich Plasma in Women with Stress Urinary Incontinence: A Systematic Review and Meta-Analysis

Bobby Indra Utama^1*Arif Bima Al Birru¹Kevin Nathaniel Cuandra²Ratna Puspita³Stevan Arianto⁴Galih Pranowo⁵Qanita Saifana⁶Made Aditya Krisnanta Gandhy⁷Karisya Puteri⁸Rafhy Mifindra²Gabriela Husodho⁹Rio Alexander¹⁰Meda Yuliani¹¹Boenga NurCita¹²Christopher Daniel Tristan¹³

• ¹Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Andalas, Padang, Indonesia, Padang, Indonesia
• ²Department of Medicine, Faculty of Medicine, Universitas Andalas, Padang, Indonesia, Padang, Indonesia
• ³Department of Biochemistry, Faculty of Medicine, Universitas Pembangunan Nasional Veteran Jakarta, Jakarta, Indonesia, Jakarta, Indonesia
• ⁴Department of Medical Laboratory Technology, Politeknik Kesehatan Hermina, Jakarta, Indonesia, Jakarta, Indonesia
• ⁵Department of Medicine, Faculty of Medicine, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia, Yogyakarta, Indonesia
• ⁶Department of Medicine, Faculty of Medicine, Universitas Yarsi, Jakarta, Indonesia, Jakarta, Indonesia
• ⁷Universitas Gadjah Mada Fakultas Kedokteran Kesehatan Masyarakat dan Keperawatan, Yogyakarta, Indonesia
• ⁸Department of Medicine, Faculty of Medicine, Universitas Brawijaya, East Java, Indonesia, Malang, Indonesia
• ⁹Department of Medicine, Faculty of Medicine, Universitas Diponegoro, Central Java, Indonesia, Semarang, Indonesia
• ¹⁰Department of Fiscal Administration Science, Faculty of Administrative Sciences, Universitas Indonesia, Jakarta, Indonesia, Jakarta, Indonesia
• ¹¹Department of Midwifery, Faculty of Health Sciences, Universitas Bhakti Kencana Bandung, Bandung, Indonesia, Bandung, Indonesia
• ¹²Department of Histology, Faculty of Medicine, Universitas Pembangunan Nasional Veteran Jakarta, Jakarta, Indonesia, Jakarta, Indonesia
• ¹³Department of Medicine, Faculty of Medicine, Universitas Sebelas Maret, Central Java, Indonesia, Surakarta, Indonesia

Background: Stress urinary incontinence (SUI) is a prevalent pelvic floor disorder with significant effects on women's quality of life. While surgical and non-surgical interventions exist, limitations underscore the need for alternative therapies. Injectable platelet-rich plasma (PRP) has emerged as a regenerative approach targeting tissue restoration. This study aimed to systematically evaluate the efficacy and safety of PRP injections for female SUI. Methods: This systematic review and meta-analysis adhered to the PRISMA guidelines. Comprehensive searches of PubMed, Scopus, and Cochrane Library up to April 2025 identified randomized controlled trials (RCTs) and quasi-experimental studies assessing PRP for SUI. The review protocol was prospectively registered in the International Prospective Register of Systematic Reviews (CRD420251118485). Eligible studies reported outcomes on symptom severity, urodynamic parameters, quality of life, or adverse events. Risk of bias was assessed using Cochrane RoB 2.0 for RCTs and the NHLBI tool for before–and–after studies. Pooled effect sizes were calculated using random-or fixed-effects models as appropriate. Results: Eight studies (three RCTs and five quasi-experimental; n=257) were included. PRP significantly improved symptom severity, with pooled reductions in UDI-6 and ICIQ-SF scores at 1– 3 months. Urodynamic analysis revealed significant increases in abdominal leak point pressure (MD=51.07; 95% CI: 36.21–65.93; p<0.0001), while functional profile length remained unchanged. Quality-of-life scores (IIQ-7, ICIQ-SF) showed consistent improvement. Reported adverse events were mild and self-limiting, with no serious complications observed. Conclusions: Injectable PRP demonstrates promising short-term efficacy in reducing symptoms, improving urodynamic function, and enhancing quality of life in women with SUI, with a favorable safety profile. Larger, standardized RCTs with longer follow-up are needed to validate durability and define its role relative to established therapies.