Platelet-Rich Plasma in Pediatric Urology: A Narrative Review of Emerging Clinical and Experimental Applications

Abstract

Context: The role of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in pediatric urology remains underdeveloped, and the available literature is limited and heterogeneous. This review aimed to identify and summarize applications of PRP and/or PRF, determine which applications have become accepted treatments, and identify those that are under investigation or remain purely experimental. Evidence Acquisition: A systematic search of the relevant literature in PubMed/MEDLINE published between 1980 and August 2025 was conducted. The search was limited to English-language reports investigating PRP and/or PRF in any condition related to pediatric urology or the peri-urological environment. Pediatric clinical trials were prioritized; however, reports based on data from adult subjects or animals were also considered. Results: Few pediatric clinical studies of PRP/PRF were identified. Most of the studies were small, nonrandomized, and had several characteristics associated with a high risk of bias. There appears to be some supportive evidence in hypospadias repair indicating that the use of PRP as an additional tissue layer may decrease fistula formation and overall procedure-related complications. For all other indications, there are limited or no data supporting the use of PRP or PRF. Additionally, although the majority of the studies reviewed reported the adverse effects of PRP/PRF, many did not do so in a systematic manner. Conclusions: PRP shows promise as an adjunct in selected pediatric urologic surgeries, particularly hypospadias. However, most indications remain investigational. Standardized PRP protocols and adequately powered pediatric RCTs are needed; priorities include hypospadias revision/fistula prevention and feasibility pilot studies for bladder reconstruction and vesicoureteral reflux (VUR). Until such data exist, PRP use in children should be considered within research settings or in carefully audited clinical practice.