The Priapus Shot® procedure indicates a specific way of treating the penis with blood-derived growth factors extracted from the man’s own blood (autologous). Some people call these blood-derived growth factors platelet-rich plasma (PRP) but there may be growth factors in plasma we don’t yet know about that do not come from the platelets. The name “Priapus Shot®” is registered with the US Patent & Trademark office as a “service mark” to protect patients by indicating a specific protocol. The name is not a synonym for the injection of blood in to the penis—such a definition would not be specific enough to indicate any particular quality of care. and so would not warrant protection as intellectual property.
The trademark defines a specific method of that providers agree to follow and develop; this agreement offers quality control and is followed and developed by over 500 urologists, interventional radiologists, family practitioners, and internists in multiple countries and by faculty in medical schools where further studies are being done.
The Priapus Shot® procedure protocol also involves patient selection, patient evaluation & education (including explanation of consent), preparation of the PRP, local anesthesia, PRP injection, post injection use of a penis pump on a daily basis, and a daily dose of tadalafil (in come men). Other post injection steps can include: stopping smoking, CoQ10 (12), vitamin E (13), Trimix, and aerobic exercise. Protocol steps vary depending on the patient and those variations also comprise the Priapus Shot® protocol.
Patient selection includes identifying those who may need hormonal treatment, or family counseling, or vascular surgery, as well as those who may have co-morbidities or who may be taking drugs that interfere with sexual function. Some patients are not treated with the Priapus Shot® protocol because another treatment or no treatment is more appropriate.
The policy of most of our providers of the procedure offers a complete refund to any man who is not happy with the Priapus Shot® procedure.
Consulting with the patient includes informing him that unexpected side effects could occur and the results will vary with some patients seeing no benefit. Antibiotics fail in 1 in 5 people in the hospital with pneumonia—resulting in death. Antibiotics “work” but do not work for all people. The same can be said for most all procedures including the Priapus Shot procedure.
The preparation of the PRP involves a device approved by the FDA for isolating PRP from whole blood for autologous use. Since blood is not a drug, it is not governed by the FDA but the devices used to isolate PRP for injection back into the body are regulated by the FDA. Multiple kits have gained FDA approval. Some of the approved kits include Regen, Magellan, TruPRP, Eclipse, Pure Spin, Harvest, & Emcyte. There are over 8,000 research papers on pub med discussing the science of PRP, and not one serious side effect has been documented when FDA approved kits were used to prepare the PRP.
Most men find the procedure very comfortable if a topical lidocaine cream is applied to the penis about 15 minutes prior to the procedure. A very small needle (1/2 inches long, 30 gauge) needle is used for the injection. However, some men do ask for a dorsal nerve block which can easily be done using 2% lidocaine for a near painless procedure (this same block can be used for prosthesis placement—so it makes a 30 gauge needle completely painless for most men.
An early report that PRP may be useful in the penis appeared in a paper published in Urology in 2003 mentioning that, in animal models, using blood-derived growth factors injected into the penis successfully treated erectile dysfunction and also mentioned that such a strategy may be feasible in men— actually providing a way to correct the underlying pathology (1). In contrast, Viagra and Trimix do not correct the underlying pathology of decreased penile circulation.
Another animal study in 2010 showed that transferring adipocyte derived stem cells (ADSCs) into the penis caused endothelia cell growth (new blood flow) as well as increased nitric oxide activity in the dorsal nerve (harder erection). But, the ADSCs were tagged before injection (to keep up with them) and most of the injected stem cells died! So the improvement seen was not from maturation of the ADSCs but rather from recruitment and activation by growth factors of stem cells already in the body—indicating PRP may demonstrate a similar effect (2).
Dr. Virag (also a pioneer of Trimix injections) published research demonstrating improvement in erectile function, size, and correction of Peyronie’s disease with the use of PRP. His studies both published (and to be published) demonstrate a mean increase of 7 on the ED Intensity Score when PRP is injected into the plaque and into the corpus cavernosum of the human penis (3).
One of the growth factors found in PRP (over 20 known) includes vascular endothelial growth factor (VEGF). In one animal study, the animals were castrated causing a shutting off of testosterone to create a penis that demonstrated, on microscopy, atrophy of smooth muscle and nerves as well as endothelial cell pathology. Then another group received VEGF injections directly into the corpus cavernosum along with castration. VEGF injection into the penis at the time of castration prevented the atrophy as effectively as did testosterone replacement. Moreover, VEGF reversed cavernosoetric findings of leakage (4).
The above studies and others not cited indicate an improvement in the health, circulation, and strength (density) of penile tissue with injection of blood-derived growth factors into the penis.
In regards to improvement in erection firmness, the Priapus Shot® protocol also includes a recommendation of aerobic exercise which by meta analysis of 5 randomized controlled studies using the Erectile Function Scale showed an increase of 5 (5,6).
As previously stated, the complete Priapus Shot® protocol, also includes the use of a penis pump, which as a stand-alone therapy has been demonstrated to improve erection both as part of a penile rehabilitation program as well as an adjunct to other therapies (7,8).
This same penis pump strategy, even without the PRP, has been demonstrated to increase penis size by 2-3 cm, while traction (another physical therapy that can be included as part of the Priapus Shot® protocol) was shown to increase penis length by 1.5-2.5 cm (8, 9). Adding PRP to the protocol shows improved results according to data collected by urologists currently utilizing the Priapus Shot® protocol (to be presented). The 2.5 cm improvement seen with the penis pump alone is in the 10-20% growth range for the average sized penis. As previously stated, while patient results vary, any patients that are not happy with the procedure are given a complete refund.
Ultrasound studies of humans, post treatment, by Dr. Virag and by other physicians who offer the Priapus Shot® protocol demonstrate improved blood flow, an increase in endothelium (improved health), and decreased plaque size. Dr. Joseph Banno of Chicago recently presented a paper showing the Priapus Shot® procedure decreased venous leak as well as increased intra-penile arterial pressure.
Dr. Virag’s studies, using the injection of PRP as a stand-alone (without physical therapies), also demonstrate improvement in the angle of the penis in men suffering with Peyronie’s disease (3). Also, strict adherence to a penis pump regimen is part of the Priapus Shot® protocol and the pump alone improves the angle significantly in over one-half of those studied in one study in the British Journal of Urology (10). This same study demonstrated growth of the penis using the pump alone (without the PRP injection). The PRP alone, in Dr Virag’s study, out-performed the pump with demonstration of remodeling of the plaque. I recommend using both methods: vacuum pump and Priapus Shot®.
Studies show that the non-surgical treatment of Peyronie’s is most effective when a synergy of multiple modalities is engaged (11). So, the Priapus Shot® procedure includes the injection of PRP (demonstrated effective by Dr. Virag) combined with daily physical therapy using a penis pump for ten minutes twice a day and a daily low-dose of taladafil. Other modalities in the Priapus Shot® procedure that have been demonstrated to be synergistic include the following: stopping smoking, CoQ10 (12), vitamin E (13), trimix, and aerobic exercise. Such strategies are not intended to take the place of surgical correction or of the use of chemical surgery with collagenase—but rather to offer the man suffering with Peyronie’s disease the optimal non-surgical treatment as a first step with surgery reserved if non-surgical therapies fail.
The penis pump alone (part of the Priapus Shot® protocol) has been shown to improve the effectiveness of Cialis and of Trimix injections (8). We are seeing men decrease the dosage of Viagra and/or Trimix by about 50 percent when the complete Priapus Shot® protocol is used. The Priapus Shot® protocol does not intend to make any particular therapy obsolete (including surgery) but rather to offer a protocol for enhancing an overall, synergistic approach to correcting penile pathology. However the surgical treatment of Peyronie’s disease can be unsatisfying and lead to serious complications (14); we (the Priapus Shot® providers) are seeing the safety profile of PRP and the Priapus Shot® protocol as offering an appealing conservative and often effective step to take before proceeding to surgery. The risk from PRP is certainly much less than for surgery and less than for collagenase—offering another reason to start with the Priapus Shot® when treating Peyronie’s or erectile dysfunction.
When considering the duration of effectiveness of the Priapus Shot® procedure and risks involved, you may find it helpful to consider the nature of the cell biology employed. A review article considering the basic science of PRP discusses the fact that the autologous growth factors are exactly what’s generated to propagate healing should the man have surgery. The healing peptides, chemotactic factors, and pluripotent stem cells employed are exactly what’s generated by the normal healing process and offers no inherent risk for infection or allergy (16).
In over 8,000 papers published about PRP on pub med, there is not one serious sequelae reported that I can identify (multiple review articles address safety). This seems logical when you consider the material being injected is autologous and normally produced to help healing and to fight infection.
Wound care studies demonstrate the nature of multiple tissue types being regenerated (with no reported risk of neoplasia in multiple biopsy studies (17-20).
Moreover, in rat studies (where biopsy of the dorsal nerve is feasible), PRP has been shown to help regenerate nerve tissue and restore erectile function when prostate surgery is modeled with crush injury to the dorsal nerve (21,22). Some studies of stem cell therapies demonstrate that the stem cells do not actually mature into healthy tissue but rather signal for the improvement of the involved ganglion and nerve conduction by recruitment of stem cells to the area - exactly what happens with PRP.
Stem cells are not directly prepared as part of the Priapus Shot® procedure, but we are seeing similar results as what’s reported with stem cell studies. Stem Cell studies often use PRP as a carrier for the stem cells, bringing into question which is the active agent (23-24).
The idea of safety is further emphasized by the literature indicating that not only are there no reports of serious allergic reactions to PRP, but research also shows that PRP can attenuate the autoimmune response. One split-scalp study (with placebo control) showed improvement in alopecia areata, with the use of PRP, that out-performed triamcinolone (25). Another study using PRP in the genitalia of women, showed improvement in lichen sclerosus as determined by both patient survey and by 2 blinded dermatopathologists (26). This attribute of PRP (attenuation of the autoimmune response) could partly explain the effectiveness of the Priapus Shot® protocol for the treatment of both Peyronie’s disease and erectile dysfunction since Peyronie’s is thought to be partly caused by an autoimmune response.
In summary, multiple studies support the idea that blood-derived growth factors (when prepared in a proper way using a kit approved by the FDA for the preparation of PRP), as used in the Priapus Shot® protocol, support the health and function of the penis. Erectile dysfunction is associated with anhedonia, and successful treatment leads to better function, better relationships, and more pleasure in life (27).
Hope you find this helpful!
Peace & health,
Charles Runels, MD
Inventor of the Priapus Shot® Procedure
2. Garcia MM, Fandel TM, Lin G, Shindel AW, Banie L, LinC-S, and Lue TF. Treatment of erectile dysfunction in the obese type 2 diabetic ZDF rat with adipose tissue-derived stem cells. J Sex Med 2010;7:89–98
3. Virag R. A New Treatment of Lapeyronie’s Disease by Local Injections of Plasma Rich Platelets (PRP) and Hyaluronic Acid. Preliminary Results. e-mémoires de l'Académie Nationale de Chirurgie. 2014;13(3):96-100.
4. Rogers R. Intracavernosal vascular endothelial growth factor (VEGF) injection and adeno-associated virus-mediated VEGF gene therapy prevent and reverse venogenic erectile dysfunction in rats. International Journal of Impotence Research. 2003;15:S24-9.
5. Lamina S, Agbanusi E, Nwacha RC. Effects of Aerobic Exercise in the Management of Erectile Dysfunction: A Meta Analysis Study on Randomized Controlled Trials. Ethiopian Journal of Health Sciences. 2011;21(3):195-201.
6. Esposito K, Giugliano F, Di Palo C, et al. Effect of Lifestyle Changes on Erectile Dysfunction in Obese Men: A Randomized Controlled Trial. JAMA. 2004;291(24):2978-2984. doi:10.1001/jama.291.24.2978.
8. Pahlajani G,Raina R, Jones S, Ali M, and Zippe C. Vacuum erection devices revisited: Its emerging role in the treatment of erectile dysfunction and early penile rehabilitation following prostate cancer therapy. J Sex Med 2012;9:1182–1189.
12. Safarinejad M. Safety and efficacy of coenzyme Q10 supplementation in early chronic Peyronie’s disease: a double-blind, placebo-controlled randomized study. International Journal of Impotence Research. 2010;22(5):298-309.
16. Sanchez-Gonzales J. Platelet-Rich Plasma Peptides: Key for Regeneration. International Journal of Peptides. 2012;10:1-10.
18. Yuan T, Zhang C-Q, Wang JH-C. Augmenting tendon and ligament repair with platelet-rich plasma (PRP). Muscles, Ligaments and Tendons Journal. 2013;3(3):139-149.
20. Conde-Montero, E., Horcajada-Reales, C., Clavo, P., Delgado-Sillero, I. and Suárez-Fernández, R. (2014), Neuropathic ulcers in leprosy treated with intralesional platelet-rich plasma. Int Wound J. doi:10.1111/iwj.12359
24. Fandel T. Recruitment of Intracavernously Injected Adipose-Derived Stem Cells to the Major Pelvic Ganglion Improves Erectile Function in a Rat Model of Cavernous Nerve Injury. European Urology. 2012;61(1):201-210.
26. Goldstein A. ISSVD 2015 Abstracts. Autologous Platelet Rich Plasma (PRP) Intradermal Injections for the Treatment of Vulvar Lichen Sclerosus. Journal of Lower Genital Tract Disease. 2015;19(3):S1-S25.
First of all, what's much?
If you take the average-sized penis of 6" in length and you increase the circumference by 1 inch (2.5 cm), then you double the volume of the penis!
That's not enough that you're going to make a shocking display on the next porn movie, but it's definitely enough that your lover will be able to feel the difference.
First of all, nothing is 100% especially the Priapus Shot® procedure for size. I am first to tell you that it is very frustrating when I get a phone call from someone like I did a few months ago; a fellow tells me that his full erection is 2 inches long—2 inches long! His full erection is only 5 cm long and he's never been alone with a woman because he's embarrassed by the size of his penis.
With this man, the size of his penis is NOT just about being proud of his penis in the shower. He suffers with a social problem. Unfortunately, I cannot offer him a guaranteed solution. Just like with muscles, it appears that the more you have, the easier it is to grow. You can watch a guy who's already muscular and when he goes to the gym his biceps grow like crazy, while the man with little muscle tone struggles to increase arm size and strength.
The people who come to me who have a 6 inch penis, it's easier for them to grow to 7, than it is for the fellow with a 3 inch erection to grow to a 4.
I wish it weren't so, but my suspicion is that with the muscles and with the penis the results involve many factors (some not so obvious). But, what appears plain is that when we’re talking about cellular growth, then the more you start with, the more easily you’ll see noticeable growth—because it’s a percentage results based on your baseline cellular mass when you start.
In addition to starting cell mass, other factors affecting growth include nutrition.
Also, will the toxins from cigarette smoking be poisoning the new growth (why many surgeons won't do a face lift if the person smoked cigarettes with a week or two prior to surgery).
The same process that results in wound healing after surgery works as the way the penile tissue responds to the Priapus Shot® procedure—cellular growth & if the tissue struggles because of toxins, then it's not going to grow.
Another factor that affects the results of the Priapus Shot® procedure is the method by which the procedure is done. Does the person doing the shot use equipment approved by the FDA for the preparation of PRP in a method that makes the PRP sterile enough to go back into the body and does the kit actually isolate an adequate concentration of PRP. Multiple attorneys work with us around the world to shut down physicians and non-physicians who claim to be doing the Priapus Shot® procedure but who do not understand the method of injecting or the method of preparing the PRP. You may think that’s a rare occurrence, but it’s not.
If you’re a physician or physician extender, you can apply to become one of our providers here (click)<—
Not only has is the platelet plasma made, but does the person understand where to put the plasma, how to inject it into the corpus cavernosum of the penis?
Somewhere around 60% of the people across the world, (around 70% in my practice) see growth of the penis that's a half an inch or more (that’s in circumference and in length).
I treated 2 men who swore they grew 2 inches in length and 2 inches in circumference. I saw quite a few who grew an inch to an inch and a half, but routinely, after the first procedure, you'll see a full half an inch in circumference and then another half an inch in length. The circumference appears first (within 2-3 weeks) and then the length appears after that (within 6-12 weeks).
To understand how medicine works, consider antibiotics for people suffering with pneumonia in the hospital. That's a severe thing. One out of five of those people, 20% of people in the hospital with pneumonia die even on IV antibiotics, even with simultaneous dosing of our most strong, antibiotics-the infection kills them.
So, there's only an eight out of ten success rate with antibiotics for pneumonia in the hospital, but do antibiotics work?
Of course, they work! Just because 20% of the people who take them for pneumonia in the hospital still die from pneumonia doesn't mean that antibiotics don't work—they do work for 80% of people!
Should we quit using antibiotics for people because the antibiotics “don’t work” for some people? Are doctors tricking patients when they try to get people suffering with pneumonia well with antibiotics? Of course not!
But, sometimes I’ll get an email from someone who says the Priapus Shot didn't work! I was “ripped off!”
When I get emails like this, it makes me sad because I’m imagining a man who may suffer with sex & relationship problems and feel angry because he’s not yet well. I always want to help but because sexual function involves so many factors (with the penis, endocrine system, circulatory system, orgasm system, neurological system, psychology, social relations to his lover, & much more), there is no way for me to tell from an email or even a phone call what to do. All of these factors should be considered by the healer who is able to see the man on multiple occasions and to do a physical exam. He may even need a TEAM of providers to help guide him back to excellent physical and sexual health.
Do you smoke ciagarettes?
Do you smoke pot?
Do you use narcotics for pain or recreation?
Do you take blood pressure medicine?
Is your testosterone too low?
Is your growth hormone too low?
Do you have a high estradiol level?
Is your prolactin too high? (In the recording, I erroneously say “too high.”)
Is your nutrition adequate?
Is your blood flow down because you're suffering with Type 2 diabetes and uncontrolled hyperglycemia?
There's so many things that can go on to explain why the Priapus Shot® “didn’t work.”
Also, why did you get the Priapus Shot? Was it for growth?
Was it for erectile dysfunction, Peyronie’s, lichen sclerosus, post op for prostate surgery, or to grow your penis in length or girth?
The success rate varies tremendously depending upon why you were treated and on all the cofactor discussed.
Do weight lifts work for muscle growth? Of course, they do, but some people lift weights their whole life and still never really get that strong or big. Others, they're genetically inclined to larger muscles and so they seemassive growth when they lift weights.
Your possibility for most strength and size of musculature happens if you do lift weights. If you want ultimate growth of your muscles, then you would lift weights.
What else might you do to grow bigger & stronger muscles?
You would use anabolic steroids!
Would Arnold look like Arnold if he weren't genetically endowed-an Austrian man with an excellent bone structure?
Would he look like Arnold if he never used anabolic steroids?
He very says that he used large doses of anabolic steroids. Back in his days of Mr. Olympia competitions, in the '70s, anabolic steroids were treated almost like antibiotics. Your pharmacist would just almost give them to you without a prescription.
They weren't controlled (like a narcotic) by the DEA until the 1990s.
Also, along those same lines, physicians did not think (in the formal medical literature) that bodybuilders were actually strong! They thought that the body builders just added “water weight.” Of course, they were stronger.
In the late 1980s, the medical research finally stated that the combination of weights plus anabolic steroids do make you stronger—much stronger! Your strongest self happens when you combine the two. Arnold because Arnold not because of genetics, because of anabolic steroid, or because of gut-wrenching, vomiting-because-of-effort workouts. He became Arnold & Mr Olympia 7 times because of all 3 of those combined!
If you talk to NFL players, they'll say, "Yeah, there's only two kinds of NFL players. Those who use anabolic steroids and those who lie about it." I don't know how true that is, but that's what I hear when I talk to NFL athletes.
Do other methods work along with the Priapus Shot® and does the pump work alone?
Do weights work alone for muscles?
Yes, they do.
Do they work for everybody significantly?
No, they don't.
Do weights work better if you have growth hormones and steroids involved?
Yes, they do.
What's in platelet rich plasma?
One of the hormones in platelets is IGF-1 or somatomedin C, which is the active hormone we think that results from people who use growth hormone.
Growth hormone results in somatomedin C formation (also called insulin-like growth factor 1 or IGF-1) by the liver and other tissues.
That exact same growth factor (IGF-1) is released from platelets. When platelets are injected with a Priapus Shot® procedure.
Then, when you use the pump along with the Priapus Shot®, you're basically lifting weights and using steroids with your penis.
If the pump works, then how should I use it and for how long?
I have a link here (click) that takes you to a whole video and a whole transcript that gives you details about how to use the pump. There, I give you details that go along with research about how the pump works alone (without the Priapus Shot).
There you’ll find a paper showing growth with the pump alone—research published by the British Journal of Urology showing growth and straightening of the penis with a pump alone. In the study, men suffered with severe Peyronie's disease (enough that they planned surgery). Over half of them, canceled their surgery after 12 weeks of using a penis pump alone.
Anything physical with the penis is going to “work” if performed intelligently. The problem with the hand is you can't as accurately judge what pressure you're applying (with the pump, you can use a pressure gauge). Risk for lack of efficacy and for significant side effects increase with inconsistent application of traction and pressure.
More significantly, in seeing thousands of men in my office, for every one person I've seen who increased the size of their penis by jelqing (which is another word for using your hand) or by using a traction device, I saw 50 men who reported to me that they saw a growth of their penis using a pump.
Use a pump (with your doctor’s supervision) and you use it the way I describe on the video (click).
What makes the penis growth from a pump?
How does the penis decide how big to be?
It's a physics problem—think of a water balloon.
A balloon (including the penis) stops growing when the pressure inside equals the combined pressure of the atmosphere outside and the tensile or stretch on the wall of the penis (a mathematical model for the collective connective tissue of the penis).
If you're using your pump regularly, it just makes sense, just like if you stretch out a balloon, it becomes easier to blow it up, but also because of the tensile strength of the wall becomes less, it equalizes at a greater size.
That's the physics of it. So first the tensile strength from the penis goes down. Then the Priapus Shot helps with repair and growth.
If you lift weights, then you repair, then you lift weights again, then you see growth of muscles. And, If you lift weights too much, there's damage.
You can use that same idea to grow the penis.
Some of the growth from the pump can also be edema. When you use the pump for a significant time (even at 10 or 15 minutes), you may see that fluid comes out of the intravascular space into the extravascular space (leaves the blood vessels to fill the tissue outside the blood vessels). You can even see this edema under the skin when your erection goes flaccid. There's no harm from the edema.
Sometimes, after weeks of using a penis pump, you might see some darkening of the skin of the penis. That color change tends to reverse if you stop pumping or quit pumping on a daily basis.
Any time there's significant growth of a physical biological structure (your finger, your hair, your face, your penis, your nose, whatever), for true growth, you must cause cell growth by either enlargement of the individual cells or by proliferation in the numbers of the cells.
That cellular growth happens in multiple other tissues: straightening bone or elongating bone, in some orthopedic injuries with traction devices & with soft tissues like the nose or the ears.
We know that the combination of physical therapies with hormonal or biological therapies affect the most significant growth (rather than either one alone).
And, we know that growth varies with multiple factors about which some of we know and about which some we continue to be completely ignorant.
I hope this is helpful. There is no 100% satisfaction with any procedure. What I can promise you is that the combination of all the factors that go in with health and with a healthy penis that are covered in my materials and those who are the other Priapus Shot® providers will be a good chance at your best penis.
Just like exercising and good nutrition and all that goes with the growth of the rest of your body— whether it’s growing muscles, or growing heart, or growing vasculature when you exercise— will achieve your best overall aerobic health and personal musculature strength, in the same way, following these therapies will achieve your best penis.
I wish you the best and I hope these ideas help you.
Peace & health,
1. What hormones to use to make your penis grow like fertilizer to a plant.
2. How to raise the hormone naturally without seeing the physician and how to know if you need a physician.
3. How to find a physician who will do what you need done!
4. The penis workouts that really work and how to do them?
5. How large should you grow your penis?
6. What are the dangers and how to avoid them?
7. How to make the effects permanent.
8. What herbs work and which do not?
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