Platelet-rich plasma (PRP) is an emerging regenerative therapy increasingly explored in urology. This systematic review assessed evidence on intravesical PRP for benign bladder diseases, including bladder pain syndrome (BPS), recurrent urinary tract infections (UTI), overactive bladder (OAB), and ketamine-induced bladder dysfunction (KIBD). The review followed PRISMA guidelines and was registered in PROSPERO (CRD42024563156). Searches were conducted in PubMed, Scopus, and the Cochrane Library in August 2024 and updated in April 2025. Eligible studies were prospective or retrospective clinical trials evaluating PRP for BPS, recurrent UTI, OAB, or KIBD. Two reviewers screened articles, extracted data, and assessed bias risk using ROBINS-I. Extracted variables included study design, population, PRP preparation, administration method, outcomes, follow-up, and safety. Owing to methodological heterogeneity, findings were synthesized descriptively. Seven studies involving 284 patients were included. Six assessed PRP for BPS and one for recurrent UTI; none examined OAB or KIBD. PRP was generally well tolerated and associated with improvements in pain and urinary symptoms. Current evidence suggests possible benefit of PRP in BPS and recurrent UTI; however, conclusions are severely limited by small sample sizes, lack of control groups and methodological heterogeneity. Larger randomized trials are needed before PRP can be adopted into clinical practice.
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