P-Shot: What Is It and How Is It Done? PRP Treatment for Erectile Dysfunction
P-Shot (Priapus Shot) is a regenerative injection treatment performed on penile tissue using PRP (Platelet Rich Plasma) obtained from the patient’s own blood. Developed by Dr. Charles Runels in the early 2010s, this procedure is emerging as an increasingly widespread minimally invasive option for erectile dysfunction, Peyronie’s disease, and general sexual performance.
How Does P-Shot Work? Mechanism
PRP is a plasma fraction obtained by centrifuging blood to increase the platelet concentration. The platelet concentration in normal blood (150,000–400,000/μL) is 4–10 times higher in PRP.
Platelets contain growth factor stores:
| Growth Factor | Effect |
|---|---|
| PDGF (Platelet-Derived Growth Factor) | Cell proliferation, angiogenesis |
| VEGF (Vascular Endothelial Growth Factor) | New vessel formation (neovascularization) |
| TGF-β | Tissue repair, collagen synthesis |
| EGF (Epidermal Growth Factor) | Cell renewal |
| IGF-1 | Smooth muscle regeneration |
| FGF (Fibroblast Growth Factor) | Vascular endothelial repair |
Penile erection depends on the harmony of nerve, smooth muscle, and vascular tissue that benefits from these growth factors. P-Shot targets the regeneration of these tissues.
How Is P-Shot Performed? Step by Step
1. Blood Draw
30–60 mL of blood is drawn from the arm — like a standard blood test.
2. Centrifugation
Spun in a special centrifuge device at 3,000–4,000 rpm for 10–15 minutes, separating blood into fractions:
- Bottom layer: Erythrocytes (red blood cells)
- Middle layer: Leukocytes (white blood cells)
- Top layer: Platelet-Rich Plasma (PRP)
3. PRP Activation
In some protocols, PRP is activated with calcium chloride or thrombin; growth factor release is initiated.
4. Anesthesia
- Topical EMLA cream (lidocaine + prilocaine) is applied for 30–45 minutes
- Some practitioners add a dorsal nerve block
5. Injection
- With a fine needle (27–30 G), PRP is injected into the corpora cavernosa and around the glans
- Total volume: 5–15 mL PRP
- Duration: 10–15 minutes
6. Vacuum Device (Optional)
In some protocols, brief vacuum pump use after injection improves PRP distribution.
Who Is P-Shot Applied To?
Indications
| Condition | P-Shot’s Role |
|---|---|
| Mild-moderate vascular ED | Endothelial and vascular regeneration |
| Inadequate response to PDE5 inhibitors | Adjuvant or alternative |
| Peyronie’s disease | Plaque softening + curvature reduction |
| Post-radiotherapy/prostatectomy ED | Neural regeneration support |
| Diabetic ED | Neurovascular healing |
| Sexual performance enhancement (mild problems) | General tissue quality improvement |
Contraindications
- Thrombocytopenia (low platelet count)
- Active cancer treatment (chemotherapy, radiotherapy)
- Active genital infection
- Severe anemia
- Anticoagulant treatment (temporary discontinuation required)
- Platelet function disorders
Scientific Evidence: How Effective Is P-Shot?
Clinical Studies
| Study | Result |
|---|---|
| Matz et al. (2018) | PRP injection produced significant increase in IIEF score in ED patients |
| Epifanova et al. (2020) | Improvement in orgasmic function and IIEF; superior to placebo group |
| Pavlovic et al. (2021) | 60–70% improvement rate after 3 PRP sessions in vascular ED |
| Shan et al. (2022) | PRP + ESWT combination shown to be superior to PRP alone |
Evidence Level Assessment
| Parameter | Assessment |
|---|---|
| General evidence level | Moderate (Level IIb–III) |
| FDA approval | None (off-label use) |
| In EAU/AUA guidelines | Classified as experimental |
| Expected response rate | 55–75% (in mild-moderate ED) |
| Effect in severe vascular ED | Limited |
P-Shot, while an evidence-supported treatment, is still in the research phase. It has a smaller evidence base compared to PDE5 inhibitors.
P-Shot Combined with ESWT
In recent years, the combination of P-Shot with shockwave therapy (ESWT) has entered the research agenda. Mechanism:
- ESWT → Growth factor release + angiogenesis stimulation with micro-damage
- P-Shot → Exogenous growth factor supplementation
Studies showing that these two treatments that support each other synergistically yield better results than individual application are increasing.
How Many Sessions Are Required and When Does the Effect Begin?
| Parameter | Standard Protocol |
|---|---|
| Number of sessions | 3 sessions (1–2 sessions in some protocols) |
| Time between sessions | 4–6 weeks |
| Onset of effect | 4–12 weeks |
| Maximum effect | 3–6 months |
| Need for repetition | Evaluation every 12–18 months |
Side Effects and Risks
| Side Effect | Frequency | Duration |
|---|---|---|
| Bruising at injection site | Common | 3–7 days |
| Mild swelling | Common | 1–3 days |
| Temporary increase/decrease in sensitivity | Rare | A few weeks |
| Infection | Very rare | Preventable with sterile technique |
| Fibrotic reaction | Very rare | — |
| Hematoma | Rare | Spontaneous resorption |
Since P-Shot is obtained autologously (from the person’s own blood), the risk of allergic reaction is negligible.
What to Pay Attention to After P-Shot
- First 24–48 hours: Sexual activity, masturbation prohibited
- First 7 days: Heavy physical activity restricted
- First 24 hours: Hot bath, sauna, Turkish bath prohibited
- Optional: Vacuum device use may support tissue renewal (according to practitioner recommendation)
2026 Turkey Prices
| Clinic Type | P-Shot (single session) | 3-Session Package |
|---|---|---|
| Private andrology clinic | 4,000–8,000 ₺ | 10,000–20,000 ₺ |
| University hospital | 3,000–6,000 ₺ | Variable |
| Medical aesthetic clinic | 3,500–7,000 ₺ | 9,000–18,000 ₺ |
Not covered by public health insurance. Prices vary depending on the quality of the PRP preparation kit and practitioner experience.
Often Confused with P-Shot: Difference Between O-Shot and Priapus Shot
- P-Shot (Priapus Shot): Specific to men; penile regeneration
- O-Shot (Orgasm Shot): Specific to women; vaginal and clitoral PRP injection
- Both were developed by Dr. Charles Runels and are FDA-unapproved off-label procedures
Frequently Asked Questions
Is P-Shot painful? With EMLA cream and/or local anesthesia, the procedure is generally painless. A feeling of pressure during injection is normal.
What ages can P-Shot be applied to? There is no age limit over 18. Although vascular ED is generally seen in those over 40, it can also be applied in younger men.
Can P-Shot replace Viagra? P-Shot and PDE5 inhibitors work by different mechanisms. While P-Shot targets long-term tissue regeneration, Viagra/Cialis acts immediately. Combination is often more effective.
Is P-Shot effective for Peyronie’s disease? There is limited but promising evidence. Combination with collagenase injection or ESWT is recommended.
Within what time period are results achieved with P-Shot? In most patients, improvement becomes apparent within 4–12 weeks. Maximum effect is seen at months 3–6.
Is P-Shot permanent? No. Its effect can last 12–18 months. Repeated sessions or ESWT combination may be needed for long-term effect.
Which specialist can perform P-Shot? A urology specialist or andrologist. In Turkey, medical injection procedures must be performed by a licensed physician.
Related Articles
- Shockwave Therapy (ESWT): What Is It? →
- Stem Cell Therapy for Erectile Dysfunction →
- What Is Exosome Therapy? →
- Erectile Dysfunction Treatment Costs 2026 →
- Which Medication Is Most Effective for Erectile Dysfunction? →
Important Note: This content is for general informational purposes. P-Shot is a treatment in the research phase and is not FDA-approved. Consult a urology or andrology specialist for treatment decisions.