The P-Shot (Priapus Shot):

The P-Shot (Priapus Shot):

A Comprehensive Medical Analysis of PRP Therapy for Erectile Dysfunction

Medically Reviewed by Courtney LaSumner Bass, NP | Board-Certified Nurse Practitioner

Key Takeaways

• The P-Shot (Priapus Shot) is a regenerative therapy that uses platelet-rich plasma (PRP) derived from your own blood to potentially improve erectile function.

• Recent randomized controlled trials show promising results, with one 2021 study demonstrating 69% of PRP-treated patients achieving clinically meaningful improvement versus 27% for placebo.

• The American Urological Association (AUA) currently considers PRP therapy "experimental" and recommends it only within clinical research settings.

• No major adverse events have been reported in clinical trials, with mild side effects limited to temporary bruising or discomfort at injection sites.

• Evidence-based first-line treatments like PDE5 inhibitors (sildenafil, tadalafil) remain the gold standard for erectile dysfunction management.

Introduction: Understanding the P-Shot

Erectile dysfunction (ED) affects approximately 50% of men over the age of 50, significantly impacting quality of life, intimate relationships, and psychological well-being. While oral medications like sildenafil (Viagra) and tadalafil (Cialis) have revolutionized ED treatment, some men seek alternative or complementary therapies—particularly those who don't respond adequately to conventional treatments or experience intolerable side effects.

Enter the P-Shot, or Priapus Shot—a regenerative medicine approach that has gained significant attention in the men's health space. Named after Priapus, the Greek god of fertility, this treatment utilizes platelet-rich plasma (PRP) technology to potentially restore erectile function at the cellular level. But does the science support the hype? This comprehensive analysis examines the evidence.

What Is Platelet-Rich Plasma (PRP)?

Platelet-rich plasma is a concentrated form of blood plasma containing 3-5 times the normal concentration of platelets. Platelets are blood cells primarily known for their role in clotting, but they also contain hundreds of proteins called growth factors that are crucial for healing and tissue regeneration.

Key Growth Factors in PRP

• Platelet-Derived Growth Factor (PDGF): Stimulates cell growth and blood vessel formation

• Vascular Endothelial Growth Factor (VEGF): Promotes angiogenesis (new blood vessel development)

• Transforming Growth Factor-Beta (TGF-β): Regulates cell proliferation and differentiation

• Epidermal Growth Factor (EGF): Promotes tissue repair and wound healing

• Fibroblast Growth Factor (FGF): Supports tissue regeneration and cellular repair

PRP therapy has been FDA-approved for bone grafts and is used off-label in orthopedic medicine (treating tendon injuries, osteoarthritis), dermatology (hair restoration, facial rejuvenation), and increasingly in sexual medicine for both erectile dysfunction and Peyronie's disease.

How the P-Shot Procedure Works

The P-Shot procedure follows a standardized protocol that typically takes 30-60 minutes in a clinical setting:

Step-by-Step Procedure

1. Blood Draw: Approximately 30-60 mL of blood is drawn from your arm, similar to a routine blood test.

2. Centrifugation: The blood sample is processed in a centrifuge—a machine that spins at high speeds to separate blood components by density. This isolates the platelet-rich plasma from red blood cells and other components.

3. Activation: Calcium chloride solution may be added to activate the platelets, triggering the release of growth factors.

4. Topical Anesthesia: A numbing cream is applied to the penis for 20-30 minutes, and a local anesthetic may be injected to ensure comfort.

5. Injection: Using a fine needle, the concentrated PRP is injected into specific areas of the penis, typically the corpus cavernosum (the erectile tissue) at multiple sites.

6. Recovery: Patients can typically resume normal activities immediately. Sexual activity can usually resume within 24-48 hours.

Theoretical Mechanism of Action

The P-Shot theoretically addresses erectile dysfunction through several regenerative mechanisms:

• Neovascularization: Growth factors stimulate the formation of new blood vessels, potentially improving blood flow to erectile tissue

• Tissue Regeneration: PRP may promote repair of damaged smooth muscle and endothelial cells in the corpora cavernosa

• Nerve Regeneration: Animal studies suggest PRP has neurotrophic effects that may support cavernous nerve repair

• Reduced Fibrosis: Anti-inflammatory properties may help reduce scar tissue formation

Clinical Evidence: What the Research Shows

The scientific evidence for PRP in erectile dysfunction has evolved significantly in recent years. Here's an objective analysis of the current research landscape:

Randomized Controlled Trials (The Gold Standard)

Poulios et al. (2021) – Journal of Sexual Medicine

This landmark double-blind, randomized, placebo-controlled trial represents the highest-quality evidence to date:

• Study Design: 60 men with mild to moderate ED received either 10 mL PRP or placebo intracavernosal injections (two sessions, one month apart)

• Results: At 6 months, 69% of PRP patients achieved minimal clinically important difference (MCID) versus 27% for placebo (P < 0.001)

• IIEF-EF Improvement: Mean improvement of 3.9 points greater in PRP group compared to placebo

• Safety: No adverse events observed during the study period

Masterson et al. (2023) – Journal of Urology

This prospective, randomized, double-blind, placebo-controlled trial provided contrasting results:

• Study Design: 61 men with mild to moderate ED received either 2 PRP injections or placebo, one month apart

• Results: No significant difference between groups in MCID achievement at 1 month (58.3% PRP vs 53.6% placebo)

• Safety: No major adverse events; only 1 minor adverse event in each group

• Conclusion: Safe but not significantly different from placebo in this study

Meta-Analyses and Systematic Reviews

Several recent meta-analyses have attempted to synthesize the available evidence:

2024 Meta-Analysis (Translational Andrology and Urology)

• Included 7 non-randomized studies and 3 RCTs with 10 total studies

• Found significant IIEF-EF improvement at 1, 3, and 6 months (increases of 4.05, 3.73, and 3.92 points respectively)

• Concluded PRP shows efficacy compared to placebo, though quality of evidence varies

2024 Aging Male Journal Meta-Analysis

• Analyzed 4 RCTs involving 413 patients

• Found significant advantage for PRP at 1 month (P = 0.03) and 6 months (P = 0.008)

• No significant difference at 3 months (P = 0.19)

• Concluded: "PRP shows more effectiveness in treating ED compared to placebo"

What Major Medical Organizations Say

American Urological Association (AUA)

The AUA's official erectile dysfunction guidelines state:

"For men with ED, platelet-rich plasma (PRP) therapy should be considered experimental." — AUA ED Guidelines, Expert Opinion

This classification means the AUA does not recommend PRP as a standard treatment option outside of clinical research settings.

Sexual Medicine Society of North America (SMSNA)

The SMSNA, in conjunction with the AUA, recommends that PRP therapy "should not be offered to men with ED, unless it is administered in the context of an approved experimental clinical research study."

Why the Conservative Stance?

Despite some promising trial results, medical organizations remain cautious due to:

• Limited Sample Sizes: Most studies involve fewer than 100 participants

• Inconsistent Results: Some RCTs show benefit while others show no difference from placebo

• Lack of Standardization: No consensus on PRP preparation methods, concentration, injection sites, or treatment frequency

• Short Follow-Up: Most studies follow patients for only 6 months; long-term efficacy is unknown

• Established Alternatives: Proven treatments like PDE5 inhibitors exist with decades of safety and efficacy data

Safety Profile and Potential Side Effects

One consistent finding across all studies is the favorable safety profile of PRP therapy for ED.

Reported Side Effects

• Common (Mild): Temporary bruising, mild swelling, minor discomfort at injection site

• Uncommon: Ecchymosis (bruising), transient pain

• Rare: Hematoma formation

• Not Reported: No major adverse events, allergic reactions, or serious complications in any published clinical trial

Why the Low Risk Profile?

Because PRP is derived from the patient's own blood (autologous), the risk of allergic reactions, rejection, or disease transmission is essentially eliminated. The procedure uses only naturally occurring blood components without synthetic drugs or foreign materials.

Contraindications

PRP therapy may not be appropriate for patients with:

• Blood disorders or coagulopathies

• Active infections

• Cancer (particularly blood cancers)

• Chronic liver disease

• Anticoagulant therapy (relative contraindication)

• Low platelet counts (thrombocytopenia)

Cost Considerations

The P-Shot is typically not covered by insurance as it is considered an elective or experimental procedure. Cost factors include:

• Average Cost Per Treatment: $1,200–$1,800 (varies by provider and geographic location)

• Treatment Protocol: Many providers recommend 2 treatments spaced 4-8 weeks apart, with annual maintenance

• Total First-Year Investment: Approximately $2,400–$3,600 for initial treatment series

• Insurance Coverage: Generally not covered; HSA/FSA may be applicable in some cases

How the P-Shot Compares to Other ED Treatments

Treatment

Evidence Level

Efficacy

Best For

PDE5 Inhibitors (Sildenafil, Tadalafil)

High (Grade A)

60-80%

First-line for most men

Intracavernosal Injections (Trimix)

High (Grade B)

85-95%

PDE5i non-responders

P-Shot (PRP)

Experimental

27-69%*

Investigational/adjunct

Li-ESWT (Shockwave)

Investigational

Variable

Research setting

*Efficacy varies significantly between studies

PRP for Peyronie's Disease

The P-Shot has also been investigated for Peyronie's disease (PD), a condition causing penile curvature due to fibrous plaque formation in the tunica albuginea.

Current Evidence

• A 2025 prospective study of 72 patients showed significant reduction in penile curvature and plaque size with PRP injections

• Ongoing University of Miami randomized trial (NCT04512287) shows preliminary safety with 25% curvature reduction at 6 months

• Both AUA and EAU consider PRP for Peyronie's disease experimental and not recommended outside research settings

Who Might Consider the P-Shot?

Based on current evidence and expert opinion, men who might reasonably consider PRP therapy include:

• Those with mild to moderate ED who have tried conventional treatments

• Men who cannot tolerate PDE5 inhibitors due to side effects or contraindications

• Patients interested in regenerative approaches as an adjunct to existing therapy

• Men with Peyronie's disease who are exploring non-surgical options

• Individuals who understand the experimental nature and have realistic expectations

Important Considerations

• Not a miracle cure: Results vary significantly between individuals

• Not proven for severe ED: Most studies exclude men with severe erectile dysfunction

• May require multiple treatments: Optimal protocols are not established

• Effects may be temporary: Long-term durability beyond 12 months is unknown

The Arsenal Men's Health Approach

At Arsenal Men's Health, we believe in evidence-based medicine that prioritizes patient safety and proven outcomes. Our approach to erectile dysfunction follows established medical guidelines while keeping patients informed about emerging therapies.

Our Commitment

1. Evidence-First: We recommend treatments supported by high-quality clinical evidence

2. Transparent Communication: We clearly explain what is proven versus experimental

3. Personalized Care: Every treatment plan is tailored to your unique health profile

4. Guideline-Aligned: We follow AUA, SMSNA, and other major medical organization recommendations

Our ED Treatment Protocol

We offer proven, FDA-approved treatments for erectile dysfunction including:

• Oral PDE5 Inhibitors: Sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra)

• Testosterone Optimization: Comprehensive hormone evaluation and TRT when indicated

• Lifestyle Optimization: Weight management, cardiovascular health, and metabolic optimization

• Comprehensive Evaluation: Identifying and addressing underlying causes of ED

The Bottom Line

The P-Shot represents an intriguing area of regenerative medicine with some promising preliminary research. However, the current evidence is not strong enough to recommend it as a standard treatment for erectile dysfunction.

What we know: PRP therapy appears safe with minimal side effects. Some randomized trials show benefit over placebo, while others do not. The therapy is not FDA-approved for ED and is considered experimental by major medical organizations.

What we don't know: Long-term efficacy, optimal treatment protocols, which patients respond best, and how it compares to established treatments head-to-head.

If you're struggling with erectile dysfunction, the most important step is getting a comprehensive evaluation from a qualified men's health provider who can identify underlying causes and recommend evidence-based treatments tailored to your needs.

Ready to Address Your Sexual Health?

Schedule your confidential consultation with Arsenal Men's Health today.

Call: (385) 666-6292  |  arsenalmenshealth.com

Peer-Reviewed References

1. Poulios E, Mykoniatis I, Pyrgidis N, et al. Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial. J Sex Med. 2021;18(5):926-935. doi:10.1016/j.jsxm.2021.03.008

2. Masterson TA, Molina M, Ledesma B, et al. Platelet-rich Plasma for the Treatment of Erectile Dysfunction: A Prospective, Randomized, Double-blind, Placebo-controlled Clinical Trial. J Urol. 2023;210(1):154-161. doi:10.1097/JU.0000000000003469

3. Burnett AL, Nehra A, Breau RH, et al. Erectile Dysfunction: AUA Guideline. J Urol. 2018;200(3):633-641. doi:10.1016/j.juro.2018.05.004

4. Shaher H, Fathi A, Elbashir S, et al. Is Platelet Rich Plasma Safe and Effective in Treatment of Erectile Dysfunction? Randomized Controlled Study. Urology. 2023;175:114-119. doi:10.1016/j.urology.2023.01.028

5. Panunzio A, Labate C, Zacheo F, et al. Platelet-rich plasma intracavernosal injections for the treatment of primary organic erectile dysfunction: a systematic review and meta-analysis of contemporary controlled studies. Int J Impot Res. 2024;36(6):562-571. doi:10.1038/s41443-023-00798-y

6. Scott S, Roberts M, Chung E. Platelet-Rich Plasma and Treatment of Erectile Dysfunction: Critical Review of Literature and Global Trends in Platelet-Rich Plasma Clinics. Sex Med Rev. 2019;7(2):306-312. doi:10.1016/j.sxmr.2018.12.006

7. Ragheb AM, Salama N. Intracavernosal platelet-rich plasma therapy for erectile dysfunction: Current evidence and future directions. UroPrecision. 2025. doi:10.1002/uro2.70004

8. Matz EL, Pearlman AM, Terlecki RP. Safety and feasibility of platelet rich fibrin matrix injections for treatment of common urologic conditions. Investig Clin Urol. 2018;59(1):61-65. doi:10.4111/icu.2018.59.1.61

9. Epifanova MV, Chalyi ME, Krasnov AO. Platelet-Rich Plasma Therapy for Male Sexual Dysfunction: Myth or Reality? Sex Med Rev. 2020;8(1):106-113. doi:10.1016/j.sxmr.2019.02.002

10. Ferretti L, Iannalfi A, Ponce C, et al. Platelet-rich plasma for the treatment of erectile dysfunction and Peyronie's disease: a systematic review. World J Urol. 2024;42:337. doi:10.1007/s00345-024-05065-3

11. Yogiswara N, Rizaldi F, Soebadi MA. The potential role of intracavernosal injection of platelet-rich plasma for treating patients with mild to moderate erectile dysfunction: A GRADE-Assessed systematic review and meta-analysis of randomized controlled trials. Arch Ital Urol Androl. 2024;96(3):12687. doi:10.4081/aiua.2024.12687

12. Cocci A, Di Maida F, Russo GI, et al. Efficacy of platelet rich plasma injection in erectile dysfunction: A systematic review and meta-analysis. Transl Androl Urol. 2024;13(4):548-559. doi:10.21037/tau-24-30

13. Zhang Z, Wang Y, Chen Y, et al. The efficacy of platelet rich plasma in the treatment of erectile dysfunction: a systematic review and meta-analysis of randomized controlled trials. Aging Male. 2024;27(1):2358944. doi:10.1080/13685538.2024.2358944

14. Zhou Z, Wang Y, Xu Y, et al. The efficacy of platelet-rich plasma (PRP) alone or in combination with low intensity shock wave therapy (Li-SWT) in treating erectile dysfunction: a systematic review and meta-analysis of seven randomized controlled trials. Aging Male. 2025;28(1):2472786. doi:10.1080/13685538.2025.2472786

15. Tafuri A, Panunzio A, Rizzo FL, et al. Platelet-rich plasma for Peyronie's disease: A systematic review of clinical and preclinical evidence. Andrologia. 2024;56:e15211.

Medical Disclaimer

This article is for educational purposes only and does not constitute medical advice. The information provided should not be used to diagnose or treat any medical condition. Always consult with a qualified healthcare provider before starting any treatment for erectile dysfunction or other health conditions. Treatment decisions should be made by a licensed medical provider based on your individual health history, current medications, and specific clinical circumstances.

Arsenal Men's Health does not currently offer P-Shot/PRP therapy for erectile dysfunction. This article is provided for educational purposes to help patients understand the current state of evidence for this emerging therapy. Our clinical team can discuss evidence-based ED treatment options that may be appropriate for your situation.

About Arsenal Men's Health

Arsenal Men's Health is a premium telehealth men's health clinic serving Utah. Led by board-certified nurse practitioner Courtney LaSumner Bass, we specialize in evidence-based hormone optimization, sexual health, mental wellness, and medical weight management. Our mission is to help Utah men optimize their health with discretion, expertise, and personalized care.

Contact us: (385) 666-6292 | info@arsenalmenshealth.com

Location: 489 South Jordan Parkway, Suite #254, South Jordan, UT 84095

Hours: Mon-Fri 8:00 AM - 6:00 PM | Sat 8:00 AM - 1:00 PM

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