Tag: priapus shot

  • JCPM2025.05.20 | Peyronie’s Disease | Scleroderma | PRF vs. PRP

    Journal Club with Pearls & Marketing 2025.05.20                   Cellular Medicine Association

    JCPM2025.05.20

    The following is an edited transcript of the Journal Club with Pearls & Marketing (JCPM) of May 20, 2025, with Charles Runels, MD.  

    >-> The PDF of this live journal club can be seen here <-<

    Topics Covered

    • PRP vs. PRF
    • Why Cleft Palate Repair Matters Even if You Only Care for Adult Women
    • PRP to Help with Chemotherapy
    • PRP Derived Exosomes for Wounds
    • When to Go With the Flow (and the Physician as a Person)
    • O-Shot® for Scleroderma
    • P-Shot® Procedure for Peyronie’s Disease
    • Here’s an Email You Could Send
    • References
    • Useful Links
    Charles Runels, MD

    Charles Runels, MD
    Author, researcher, and inventor of the Vampire Facelift®, Orchid Shot® (O-Shot®), Priapus Shot® (P-Shot®), Priapus Toxin®, Vampire Breast Lift®, and Vampire Wing Lift®, & Clitoxin® procedures.

    Transcript

    Welcome to our Journal Club.

    We have two very good, landmark, supportive papers of what we do and others of interest.

    Especially if you’re doing the P-Shot® or the O-Shot® procedures, you’re going to find today very encouraging.

    PRP vs. PRF

    In this first paper, I get so many questions about PRP versus PRF, and I include it here because of those questions.[1] 

    I like for us to think about all the different ideas. And part of the advantage of our group is that we are modifying our procedures as new science comes out and as our members think of new techniques. The dentistry profession was doing PRP at least a decade before we were with the idea that they had often hard to heal tissue with poor vascularization. And so they, out of necessity, went looking for ways to help with their surgery. And those in the GYN and the urology and facial plastic surgery space didn’t have to deal with that.

    So when I first picked up platelet-rich plasma in 2010, early 2010 when it was starting to make its way into cosmetic medicine, but not yet into sexual medicine, when I would speak with a dentist or veterinarians or even equestrians, they knew all about platelet-rich plasma. And the sports medicine people knew and the athletes knew, but most gynecologists did not know what it was about.

    For example, I taught a class up in Maine near the L.L. Bean store, and there was a lady who showed up as a model and she said, “Oh, we’ve been using this in our horses for years. So yes, I see what it does. I want an O-Shot®.”

    And so I like watching the dental research because they are a decade ahead of us. They quit wondering if platelet-rich plasma does anything and they’re more focused on the variations that might be used to make it work better.

    So I’m putting this here and it’ll be in the handouts when I shut down the meeting today. But clinically, my advantage of course is that I’m listening to our 2000-plus members and I’m hearing multiple problems arising when PRF is used with our procedures.

    => Apply for Online Training for Multiple PRP Procedures <=

    I’m still of the mind that PRF is more useful in wound care than in an O-Shot® or a P-Shot® or even cosmetic medicine.

    Problems with PRF

    One of our providers had a near miss with some signs of vascular occlusion when he put PRF in the lip and was able to recover circulation. But there were a few moments there of worry. And we don’t see that with PRP.

    It’s the same with the P-Shot®. I’ve received multiple emails from both patients and doctors describing problems with PRF that we don’t see with PRP.

    =>Next Hands-On Workshops with Live Models<=

    I’m not saying we don’t keep track of it, and I’m not saying there’s not usefulness in it, but so far I think if you’re doing P-Shots® or O-Shots® especially, and also for the Vampire Facelift®, I think you’re better off sticking with PRP instead of PRF.

    And I concede that at least something I say today will be proven wrong and absolutely wrong sometime in the future. But that’s what I’m seeing from the research, and I wanted you to have that.

    Why Cleft Palate Repair Matters Even if You Only Care for Adult Women

    Most of us don’t do cleft palate repair, but this is another paper that talks about how useful PRP is in that situation.[2] 

    And the reason I like these papers, even for those who are not doing facial plastic surgery, is of course we have similar problems when you’re treating an episiotomy scar or scarring of any kind: for example, the chronic sclerosis and scarring that happens with lichen sclerosus, in some ways Peyronie’s disease is remodeling a scar, and then sometimes we’re just treating scars where someone had an umbilical piercing or a surgical scar. I’ve treated basal cell scars from skin grafts, zoster scars, and of course acne scars.

    So I think it’s encouraging to see these papers come out that support that idea of using PRP to help with scars. I think one of the hindrances to medical progress is people, all of us, especially me, I try to force myself not to do this, but being caught in our fish tank, so to speak. And we’re looking at the research in our arena and not noticing other arenas.

    Of course, the same thing happens in business. So often the people who are successful in business just take an idea that’s succeeded in a different kind of business and just drag it over into theirs. When I started doing PRP in the genitalia, I was just treating the genitalia with the same idea that if causes neovascularization and neurogenesis and scar remodeling in the face, then it should happen with the scarring and vascular problems that happen in the vagina and the penis. And turns out that was a useful direction to go in. So having these papers, even if you’re not doing cleft palate repair, I think, is reassuring.

    PRP to Help with Chemotherapy

    This one, again, I don’t have as much of a direct usefulness for it too, but I’ve not seen anything in this category before: PRP for the side effects of chemotherapy.[3] 

    The effect of autologous cytokine-rich serum and platelet-rich plasma on oxidative status minerals and pro-inflammatory cytokines in the brain and serum and cyclophosphamide-induced ovarian failure. They took rats and they injected PRP and they documented: PRP therapies from the patient’s own blood have a potential as supportive or chemopreventive strategies with reduced side effects and treatment costs.

    So this is so early on, I’m not sure what to do with it, but I wanted us to be aware of it. And especially since we have so many types of physicians and some of you’re treating cancer, I wanted this on our radar so that some of you will actually come up with some good ideas. I think the fun thing that happens, as I just mentioned, is if you have your toe in two different arenas, then you might see things that others don’t see looking just in their fishbowl.

    Our variable backgrounds makes us able to come up with ideas that seem plain to one and not obvious to the other, I think that’s part of what happened with our Clitoxin® idea by having almost two decades of history of treating migraines and cosmetic use of botulinum toxin and thinking about how it might be working and reading that literature, and it became more obvious that it might be helpful for orgasm and sexual function in women when thinking about the feedback loops.[4] 

    And had I been sticking strictly to gynecology and didn’t have that two-decade history, it wouldn’t have been so obvious.

    Again, some of you are doing oncology, and you’ll think of ways to use this information that would never occur to me. So I just wanted to put it out there.

    PRP Derived Exosomes for Wounds

    And then a lot of you are talking about exosomes, so I wanted to show you this other paper. When I hear people talk about exosomes, to me it still feels even more misunderstood or poorly defined or ill-defined, I guess. Vaguely defined. More vaguely defined even than PRP because exosomes, are they homologous? Are they plant-based? Are they non-homologous or excuse me, autologous? Are they autologous, non-autologous, plant-based? Where are they coming from?

    => Apply for Online Training for Multiple PRP Procedures <=

    So they looked here at PRP and PRP-derived exosomes in wound healing.[5] 

    Some of you are using a source of exosomes that uses autologously derived exosomes with an outside processing company, and some of you are using plant-based exosomes that are something different. I think that the literature is leaning towards this strategy. Some of you are doing something called the Super Shot®, finding other ways to enhance the effects of our platelet-rich plasma.

    I don’t buy into the idea that if you’re over a certain age, your PRP is not at all effective, else if you did surgery, the skin wouldn’t heal. You couldn’t do a cholecystectomy on an 80-year-old. But I do agree that we need to keep looking for ways to enhance what we’re doing. And there’s an infinite number of variables.

    If you look on PubMed, there are now over 18,000 papers that come up if you put platelet-rich plasma in the search bar. When I first started doing and thinking about PRP in 2010, there were about 5,000.

     And already this year, we’re not halfway through the year, but we have half as many studies as we did last year. So there is a non-linear increase in the amount of research that’s being done. I think being tagged into our group and helping think about it, you are truly part of a revolution where regenerative therapies are not only becoming commonly done, but they’re becoming part of the standard protocols, but yet there’s still great need for understanding infinite number of variabilities in which they could be done.

    So this is just something to look at. I am still not doing exosomes when I do my O-Shot® and P-Shot® and I am getting great results, but I know some of you’re using it for hair or using it in place of PRP. I haven’t seen a study.

    The bottom line is the verdict is still out about we don’t have an answer about which actually works the best. And so I’m sticking with what I know has worked for over now almost a decade and a half, but keeping track of the rest of it.

    When to Go With the Flow

    I spoke with one of our providers and she says, “Everybody wants PRF now with their Vampire Facial®.” Okay, if you’re smearing it on the face and microneedling, does it really matter? They sell something on TikTok and that’s what they want. You just give it to them. It’s okay? But if you try to squirt that through a needle into the clitoris, then I think it’s a different thing. So sometimes you have to go with what they’re thinking.

    There was an old mentor of mine back in the days of medical school in the eighties who said, “Always try to integrate….” Actually, it was also in the book called The Physician Himself, which was written in 1882, said that you always try to integrate into your therapies what the patient wants.

    If they think that somehow taking vitamin C and smearing gravel from the street on their ear lobe will help their otitis media and you don’t see any harm to it, then you include it. Many things that were in the health food store, at which physicians scoffed, are now are prescription drugs.

    =>Next Hands-On Workshops with Live Models<=

    I try to integrate what I can without doing harm, without increasing expense if a patient wants something. And so yeah, I think it’s perfectly acceptable to use PRF if someone saw that on TikTok. But I think when you start trying to squirt it into the lip or the clitoris, you’re risking complications.

    O-Shot® for Scleroderma

    Okay, this one I brought out just because I have now heard even more people talk about our O-Shot® helping scleroderma. Of course, this is nanofat for cutaneous fibrosis and scleroderma, and they talk about using it in that instance, but it’s more support for what we’re seeing, which is that when you have someone coming to you for dyspareunia and dryness and the things that happen with scleroderma with female sexual function, it’s a indirect support of that.[6] We need more studies. If you want a low-hanging fruit, do a study and inject 50 women with dyspareunia and scleroderma and just do our regular O-Shot® and you’ll have a landmark study. But this would be support for that study.

    P-Shot® Procedure for Peyronie’s Disease

    I saved the best for last. They treated Peyronie’s disease and rapidly showed improvement with the injection of PRP.[7] And when they say rapid, this is rapid. If you remember the first study that I know of that came out about using our P-Shot® techniques for Peyronie’s disease was from Ronald Virag, out of Paris.[8] He was treating patients every once a week for six weeks. And these people just got treated three times.

    And so it went, first injection and then after two weeks, second injection, four weeks, and four weeks after the third injection, they measured. So they’re going not a long time. And the penile curvature, the plaque size, all improved.

    This one, they did not show improvement in erectile function that was statistical. If you look, here was the score.

    If you remember, our P-Shot® full effect is not until 12 weeks. So it was really early on for the neovascularization and neurogenesis, but there was still rapid plaque resolution with improvement. And there was no complications like are common with Xiaflex with penile fracture. So the side effect was a slight but not statistical improvement in erectile dysfunction, which is a good thing. They’d used an Angel systems, so it was a double spin centrifuge and they did inject the plaque.

    Now, many people in our group, some of them very high-volume injectors, are just doing a regular P-Shot® and combining it with the pump and seeing excellent results.

    You can palpate the plaque. So it’s not a big deal to do a regular P-Shot®, save a CC and just inject as if you were trying to inject intradermally. So when your needle goes into that plaque, you can feel it’s hard to push. So if you puncture it a few times and inject as you’re going through it, you can feel it. You don’t need an ultrasound. You can feel it. But for that, you will need to do a block. Otherwise, it’s tormenting.

    Even though they didn’t do it in this study, of course, because it would involve more than one variable and make it harder to reach statistical conclusions, we, as part of our protocol, combine the P-Shot® with a vacuum pump.

    In one study in the British Journal of Urology, 51% of men canceled their surgery just using the pump for 10 minutes a day for 12 weeks.[9] 

    And I spoke with Ronald Virag. We were at a meeting in Venice and I shared the podium with him. And he said, yes, in his study, he just used platelet-rich plasma. He used Regen, which is a single spin. But in clinical practice he combines it with a vacuum pump. I’ll show it to you. For the full protocol that I’m recommending, and until we have enough research to change it, can be found here<=

    If I’m treating someone for Peyronie’s, I send them to this page and tell them, “Do everything on the page.”

    The page includes a little video. I’ll have to add this paper, but includes links to the research supporting the ideas of what we’re doing.

    The seven-step plan talks about the pump, and there’s a link to the research. We actually have studies showing that CoQ10 and vitamin E that dose improve results.

    And then I have a protocol here. 

    Do the P-Shot®, wait six weeks. I think when you’re looking at the wound care studies, they’re usually separated by eight to 12 weeks. So if you’re pushing them that close together a week or two apart, you get results more quickly for your research paper, but if you are trying to preserve the patient’s time and money, it could be that if you separated it by six weeks, you’ll find what many of us have found, six to eight weeks, that they often don’t need a second or a third shot. They’re happy with it. So those are suggested timeframes between the injections.

    Low testosterone is associated with Peyronie’s. Adding testosterone hasn’t been shown to treat it, I don’t think. But because it’s associated, replace it.

    And then these others have more to do with erectile function. And again, aerobic fitness or VO2 max is associated with Peyronie’s disease, having low aerobic capacity, as is smoking. And not just with increased blood flow.

    There are some physiological reasons why Cialis every day could help not just the erection, but with resolution of Peyronie’s.

    So that’s the seven-step process. I’ll add this paper to the research.

    Here’s an Email You Could Send

    Remember, people don’t really care about an ad, but they like to read letters from you that include news. Because it’s news, if you are a P-Shot® provider, you could send them an email that talks about this new research and offer to help them (if you are not a P-Shot® provider, you can apply for online training here< ). Here’s a quick way to do get the email done:

    1. Copy and paste the following message into a new Word document.
    2. Then edit it so that it sounds like you.
    3. Add a story or a personal observation if you have time.
    4. Then, fill in the information with your phone number, etc., and send it to your patients.

    Envelope with solid fill

    Hello,

    Peyronie’s disease (a bending of the male genitalia) can be very serious and damage a marriage and the psychological well-being of man. New research just came out showing that using our P-Shot® ideas, you can improve male function and correct the curvature that can be so damaging to a family.

    Even better, it is truly shocking how fast it works.

    Here’s the research<=

    Here’s more about the whole protocol<=

    And you can see the side effects were none except for a slight increase in function. That was not statistic at this short interval.

    Also exciting, instead of risking the genitalia fracture that happens with Xiaflex (which is no longer approved for use in Canada, Europe, Japan, or Australia). And if you paid cash for Xiaflex, it would be a series of injections that would cost $27,000. Our procedure costs much less and has never caused a penile fracture.

    If you think this may help you or someone you love, please contact us.

    Sincerely,

    (your name)
    (your picture)
    (your website)
    (your phone number)
    (your email address)

    ____________________________________

    And as always, I offer people their money back if they’re not delighted.

    I know that frightens some people, but when you have a procedure that works the vast majority of the time, you still come out good.

    If you already know the patient and they’re familiar to you, let’s say that you’re their family practice doctor, you’ve already talked about the erectile dysfunction, I made a slight modification in the pricing. In that case, you could do that first injection for 997 or a thousand bucks if you want. But for a new patient coming in, you have to spend time with that person. And there’s going to be no insurance reimbursement if you’re all cash practice. And remember, the massage therapist gets 350 bucks for a six-month course. And you have to spin blood. You have cost of goods and your time. So 1800 is a very good price. It’s less than a new set of tires.

    But if you wanted to drop it for one of your current patients whom you already know, that would be okay. And we all do things for free, but we should all be advertising and telling people over the phone those prices so we’re not competing on price.

    And of course, if you add in our new ideas with Priapus Toxin® and putting a hundred units of Xeomin or some botulinum toxin similar into the penis along with your PRP, that would help with erectile dysfunction or could help as the studies show.[10] [11] [12] [13] [14]

    And that would be extra cost. I think that should be somewhere around an extra a thousand dollars to do that, a thousand to 1500, more if you’re in a town where it costs more money to turn on the lights. Let’s see. I think that’s all the questions, I think, and we come in right at 30 minutes. So hopefully that was helpful to you. Thank you for being here. See you next week.

    => Apply for Online Training for Multiple PRP Procedures <=

    =>Next Hands-On Workshops with Live Models<=

    References

    Acerra, Alfonso, Mario Caggiano, Andrea Chiacchio, Bruno Scognamiglio, and Francesco D’Ambrosio. “PRF and PRP in Dentistry: An Umbrella Review.” Journal of Clinical Medicine 14, no. 9 (May 6, 2025): 3224. https://doi.org/10.3390/jcm14093224.

    Dachille, Giuseppe, Andrea Panunzio, Leonardo Bizzotto, Maria Valeria D’Agostino, Federico Greco, Giuseppe Guglielmi, Umberto Carbonara, et al. “Platelet-Rich Plasma Intra-Plaque Injections Rapidly Reduce Penile Curvature and Improve Sexual Function in Peyronie’s Disease Patients: Results from a Prospective Large-Cohort Study.” World Journal of Urology 43, no. 1 (May 15, 2025): 306. https://doi.org/10.1007/s00345-025-05691-5.

    Elsamna, Samer T., Fayssal Alqudrah, Mahnoor Khan, Teagen Smith, Jon Robitschek, and Julia Toman. “Platelet Rich Products in Cleft Palate Repair.” The Cleft Palate Craniofacial Journal, May 16, 2025, 10556656251342003. https://doi.org/10.1177/10556656251342003.

    El-Shaer, Waleed, Hussein Ghanem, Tamer Diab, Ahmed Abo-Taleb, and Wael Kandeel. “Intra-Cavernous Injection of BOTOX® (50 and 100 Units) for Treatment of Vasculogenic Erectile Dysfunction: Randomized Controlled Trial.” Andrology 9, no. 4 (2021): 1166–75. https://doi.org/10.1111/andr.13010.

    Ermiş, Mustafa, Erol Karakaş, Hanifi Erol, Gökhan Akcakavak, Recai Aci, Furkan Ümit, Özhan Karatas, and Gülay Çiftci. “Effect of Autologous Cytokine-Rich Serum and Platelet-Rich Plasma Administration on Oxidative Status, Minerals and Proinflammatory Cytokines in Brain and Serum in Cyclophosphamide-Induced Ovarian Failure.” Journal of Molecular Histology 56, no. 3 (May 19, 2025): 159. https://doi.org/10.1007/s10735-025-10448-w.

    Giuliano, Francois, Pierre Denys, and Charles Joussain. “Effectiveness and Safety of Intracavernosal IncobotulinumtoxinA (Xeomin®) 100 U as an Add-on Therapy to Standard Pharmacological Treatment for Difficult-to-Treat Erectile Dysfunction: A Case Series.” Toxins 14, no. 4 (April 16, 2022): 286. https://doi.org/10.3390/toxins14040286.

    Habashy, Engy, and Tobias S. Köhler. “Botox for Erectile Dysfunction.” The Journal of Sexual Medicine 19, no. 7 (July 2022): 1061–63. https://doi.org/10.1016/j.jsxm.2022.03.216.

    He, Ling, Nan Zhao, Xiaoling Chen, Wenjie Zhang, Kun Lv, and Yuanhong Xu. “Platelet-Rich Plasma-Derived Exosomes Accelerate the Healing of Diabetic Foot Ulcers by Promoting Macrophage Polarization toward the M2 Phenotype.” Clinical and Experimental Medicine 25, no. 1 (May 15, 2025): 163. https://doi.org/10.1007/s10238-025-01651-w.

    Porter, Dr Mark. “Botox: The New Viagra? It’s One Way to Treat Erectile Dysfunction,” sec. times2. Accessed November 8, 2022. https://www.thetimes.co.uk/article/botox-could-help-men-beat-erectile-dysfunction-here-s-what-to-know-8x2vvt9c7.

    Raheem, Amr Abdel, Giulio Garaffa, Tarek Abdel Raheem, Michelle Dixon, Amanda Kayes, Nim Christopher, and David Ralph. “The Role of Vacuum Pump Therapy to Mechanically Straighten the Penis in Peyronie’s Disease.” BJU International 106, no. 8 (2010): 1178–80. https://doi.org/10.1111/j.1464-410X.2010.09365.x.

    Runels, Charles, and Alexandra Runnels. “The Clitoral Injection of IncobotulinumtoxinA for the Improvement of Arousal, Orgasm & Sexual Satisfaction- A Specific Method and the Effects on Women.” Journal of Women’s Health Care 13, no. 3 No. 715 (March 20, 2024). https://doi.org/10.35248/2167-0420.24.13.715.

    Shehri, Zaed Ghassan, Issam Alkhouri, Mohammad Y Hajeer, Ibrahim Haddad, and Mohamad Husam Abu Hawa. “Evaluation of the Efficacy of Low-Dose Botulinum Toxin Injection Into the Masseter Muscle for the Treatment of Nocturnal Bruxism: A Randomized Controlled Clinical Trial.” Cureus, December 4, 2022. https://doi.org/10.7759/cureus.32180.

    Toro, Giuseppe Di, Angelo Alito, Giulia Leonardi, Fiorenza Giulia Di Toro, and Simona Portaro. “Nanofat and Lipofilling for Cutaneous Fibrosis in Scleroderma: Current Evidence and Future Directions,” n.d.

    Virag, Ronald, Hélène Sussman, Sandrine Lambion, and Valérie de Fourmestraux. “Evaluation of the Benefit of Using a Combination of Autologous Platelet Rich-Plasma and Hyaluronic Acid for the Treatment of Peyronie’s Disease.” Sexual Health Issues 1, no. 1 (2017). https://doi.org/10.15761/SHI.1000102.

    Tags

    P-Shot®, O-Shot®, PRP, PRF, platelet-rich plasma, Peyronie’s disease, erectile dysfunction, scleroderma, dyspareunia, cleft palate, wound healing, sexual medicine, cosmetic medicine, exosomes, regenerative medicine, PRP vs PRF, platelet-rich fibrin, PRP side effects, penile curvature, vacuum pump, Priapus Shot®, Vampire Facial®, Angel system, double spin centrifuge, Xiaflex alternatives, neurogenesis, neovascularization, autologous serum, cytokines, oxidative stress, chemotherapy side effects, facial plastic surgery, scar treatment, lichen sclerosis, episiotomy scars, acne scars, botulinum toxin, Priapus Toxin®, sexual function, testosterone, CoQ10, vitamin E, aerobic fitness, VO2 max, smoking and ED, PRP pricing, PRP injection protocol, regenerative protocols, PRP research, PRP in oncology, PRP and scleroderma, PRP complications, PRP enhancements, PRP marketing strategies, PRP for hair, autologous exosomes, Charles Runels

    Helpful Links

    => Next Hands-On Workshops with Live Models <=

    => Dr. Runels Botulinum Blastoff Course <=

    => The Cellular Medicine Association (who we are) <=

    => Apply for Online Training for Multiple PRP Procedures <=

    => FSFI Online Administrator and Calculator <=

    => 5-Notes Expert System for Doctors <=

    => Help with Logging into Membership Websites <=

    => The software I use to send emails: ONTRAPORT (free trial) <= 

    => Sell O-Shot® products: You make 10% with links you place; shipped by the manufacturer), this explains and here’s where to apply <=

    Charles Runels, MD             888-920-5311              CellularMedicineAssociation.org

    Page  of


    [1] Acerra et al., “PRF and PRP in Dentistry.”

    [2] Elsamna et al., “Platelet Rich Products in Cleft Palate Repair.”

    [3] Ermiş et al., “Effect of Autologous Cytokine-Rich Serum and Platelet-Rich Plasma Administration on Oxidative Status, Minerals and Proinflammatory Cytokines in Brain and Serum in Cyclophosphamide-Induced Ovarian Failure.”

    [4] Runels and Runnels, “The Clitoral Injection of IncobotulinumtoxinA for the Improvement of Arousal, Orgasm & Sexual Satisfaction- A Specific Method and the Effects on Women.”

    [5] He et al., “Platelet-Rich Plasma-Derived Exosomes Accelerate the Healing of Diabetic Foot Ulcers by Promoting Macrophage Polarization toward the M2 Phenotype.”

    [6] Toro et al., “Nanofat and Lipofilling for Cutaneous Fibrosis in Scleroderma: Current Evidence and Future Directions.”

    [7] Dachille et al., “Platelet-Rich Plasma Intra-Plaque Injections Rapidly Reduce Penile Curvature and Improve Sexual Function in Peyronie’s Disease Patients.”

    [8] Virag et al., “Evaluation of the Benefit of Using a Combination of Autologous Platelet Rich-Plasma and Hyaluronic Acid for the Treatment of Peyronie’s Disease.”

    [9] Raheem et al., “The Role of Vacuum Pump Therapy to Mechanically Straighten the Penis in Peyronie’s Disease.”

    [10] Porter, “Botox.”

    [11] Habashy and Köhler, “Botox for Erectile Dysfunction.”

    [12] Shehri et al., “Evaluation of the Efficacy of Low-Dose Botulinum Toxin Injection Into the Masseter Muscle for the Treatment of Nocturnal Bruxism.”

    [13] Giuliano, Denys, and Joussain, “Effectiveness and Safety of Intracavernosal IncobotulinumtoxinA (Xeomin®) 100 U as an Add-on Therapy to Standard Pharmacological Treatment for Difficult-to-Treat Erectile Dysfunction.”

    [14] El-Shaer et al., “Intra-Cavernous Injection of BOTOX® (50 and 100 Units) for Treatment of Vasculogenic Erectile Dysfunction.”

  • New Research Shows Alternative Protocol to be Inferior to the P-Shot® (Priapus Shot®) Procedure

    New Research Shows Alternative Protocol to be Inferior to the P-Shot® (Priapus Shot®) Procedure

    Researchers (Masterson, 2023) recently used a protocol (that differs from the P-Shot® procedure) and measured the effect on erectile function of injections of the penis with platelet-rich plasma (PRP).

    Their protocol was less effective than what previous studies have shown. You can read the article here<–

    Before reviewing their research and their deviations from the P-Shot® protocol, consider what the P-Shot® is: The P-Shot® (Priapus Shot®) is a service mark that names a procedure that requires training in the standard protocol and an agreement to follow the protocol that has been used (with improvements) for the past 13 years.

    The ways Masterson, et al changed the procedure (from that of the P-Shot® procedure) for their study include at least all of the following:

    1. They used a different injection technique than what is used with the P-Shot® procedure; their technique limited the exposure of the penis to less than 1/2 of the tissue treated by the P-Shot® procedure.
    2. They used a centrifuge that is not on the recommended list of devices approved by the FDA for the preparation of PRP for injection back into the body. Their centrifuge also differs from what was used in other studies that showed benefits.  The centrifuge used can have dramatic effects on not only the number of platelets but also the number of white blood cells and red blood cells in the sample–all of which is important in regard to results.
    3. They injected 1/2 the volume of PRP usually injected. They injected a total of 5 cc instead of 10 or more cc’s. So not only did their injection technique limit the distribution, but the volume injected limited the treatment area and the number of platelets.
    4. They did not activate the PRP with Calcium Chloride (or with any agent at all). Without activation, the PRP is more prone to washout, and the growth factors in their 1/2 dose are further limited by being more shortlived than with the P-Shot® procedure. There is a huge difference between the growth factor spectrum and the duration of effect when the activation is modified.
      PRP can be modified by varying leukocyte count, platelet concentration, method of activation, and red blood cell count. (Sheean, 2021)

    Other points about the study:

    1. They calculated sample size based on the assumption that the placebo group would have a 15% rate of attaining MCID, not the observed 50%; so the study was grossly underpowered and conclusions invalid.  Still, we can look at more…


    2. Even though they saw less response (with their altered protocol) than what has been shown in other studies, they still saw improvement in erectile function after injection of PRP; the change was just not significantly greater than saline. Both showed improvement.


    3. Also, what they called a placebo, saline, has been shown to have regenerative properties when injected directly into tissue. When injected iv to compare with a drug, saline is an adequate placebo. When injected into tissue, it has been shown to help improve joint disease and help with leishmaniasis, granuloma annulare, and atrophic acne scars–saline, when injected into soft tissue, is not a placebo.

    “Even when used as a control, saline exerts some therapeutic action in different dermatological indications, including warts, acne scars, and rejuvenation.” (El-Amawy, 2020)


    4. In previous double-blind, placebo studies of PRP for ED, PDE5is were discontinued. In one study, the placebo response (still using saline) was only 15%. Masterson, et al allowed participants to continue their Viagra drugs, which could account for the higher placebo response. The high placebo response also attenuates the power of the study.


    5. The study is also compromised mathematically by a 15% dropout rate in an already small sample size.


    6. In their introduction, Masterson et. al writes the following: “Even without supporting data, numerous clinics in the largest metropolitan areas of the United States are charging patients for PRP treatments for ED.”

    Yet, there IS “supporting data.” Previous studies indeed have shown that PRP does help with ED and with Peyronie’s disease One of those studies was even done by Dr. Ronald Virag, the pioneer in urology who came up with the idea that became “tri-mix” injections for erection and changed urology forever.

    The near disappearance of plaque seen in Peyronie’s disease after injection with PRP (Virag, 2017)

    The authors failed to recognize all of those studies by stating there is “no supporting data.”


    7. They do, later in their discussion, contradict/correct their own statement (“no supporting data”) by making reference to two of many articles that support the P-Shot® procedure and the injection of PRP for ED.

    Then, they reference an article in JAMA that later required a printed correction; but make no reference to the correction, which undermines their point.


    8. Also, the authors fail to point out, in their worries about the money being charged, that the P-Shot® procedure has fewer side effects than Viagra (which has been shown to cause blindness in some) and its cousin drugs and that the cost of a P-Shot® can be less than pharmaceutical alternatives (over time), much less invasive and less expensive than a penile implant, and that P-Shot® providers have agreed to refund the money of anyone not helped by the procedure.

    The P-Shot® in no way makes these alternative treatments not useful and needed. But, the P-Shot® should be part of the tools available for treatment, and a man should be able to try the P-Shot® before proceeding to implant.


    9. Moreover, the Priapus Shot® procedure is NOT just to give a shot. The procedure includes an evaluation to see if the shot is appropriate. There must be phlebotomy (usually another skilled employee’s time and expense) and processing of blood using FDA kits approved for processing blood for autologous reinjection (not cheap). The cost to the patient helps covers these expenses.


    10. Other studies have shown a greater improvement in erectile function than what was seen by these authors. So, we are grateful for their contribution–showing that a different protocol works less well. Further studies are needed to look at the variables regarding the preparation of the PRP, activation, and injection technique to understand further why their protocol was less effective and how current protocols can be improved.

    Some of the supporting data for PRP for the treatment of ED.

    11. Also, further studies are needed regarding combination therapies. For example, one prospective, randomized, controlled study showed that PRP greatly improved the results seen with shock waves for erectile dysfunction.


    In conclusion, Masterson et al demonstrated (in this underpowered study using a placebo that is not a placebo) that injecting 1/2 the volume of the P-Shot® procedure using their alternative technique of injecting and not activating the PRP with CaCl is possibly less effective than what has been shown in other studies. That is valuable to know, and we are grateful for their study.


    To find the nearest P-Shot® (Priapus Shot® provider)<–

    To apply for training for the P-Shot® procedure<–

    Charles Runels, MD

    Charles Runels, MD
    Cellular Medicine Association
    1-888-920-5311
    DrRunels@Runels.com

    References

    References Regarding the Benefits of the P-Shot® Procedure for ED

    Bosma-Den Boer, Margarethe M., Marie Louise Van Wetten, and Leo Pruimboom. “Chronic Inflammatory Diseases Are Stimulated by Current Lifestyle: How Diet, Stress Levels and Medication Prevent Our Body from Recovering.” Nutrition and Metabolism 9 (2012). https://doi.org/10.1186/1743-7075-9-32.

     

    Casabona, Francesco, Ilaria Gambelli, Federica Casabona, Pierluigi Santi, Gregorio Santori, and Ilaria Baldelli. “Autologous Platelet-Rich Plasma (PRP) in Chronic Penile Lichen Sclerosus: The Impact on Tissue Repair and Patient Quality of Life.” International Urology and Nephrology 49, no. 4 (April 2017): 573–80. https://doi.org/10.1007/s11255-017-1523-0.

     

    Chung. “A Review of Current and Emerging Therapeutic Options for Erectile Dysfunction.” Medical Sciences 7, no. 9 (August 29, 2019): 91. https://doi.org/10.3390/medsci7090091.

     

    Chung, Eric. “Medical Sciences A Review of Current and Emerging Therapeutic Options for Erectile Dysfunction,” 2019, 1–11.

     

    Everts, Peter, Kentaro Onishi, Prathap Jayaram, José Fábio Lana, and Kenneth Mautner. “Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020.” International Journal of Molecular Sciences 21, no. 20 (October 21, 2020): 7794. https://doi.org/10.3390/ijms21207794.

     

    Garcia, MM, TM Fandel, G Lin, AW Shindel, L Banie, CS Lin, and TF Lue. “Treatment of Erectile Dysfunction in the Obese Type 2 Diabetic ZDF Rat with Adipose Tissue-Derived Stem Cells,” 2010, 14.

     

    Israeli, Joseph M., Soum D. Lokeshwar, Iakov V. Efimenko, Thomas A. Masterson, and Ranjith Ramasamy. “The Potential of Platelet-Rich Plasma Injections and Stem Cell Therapy for Penile Rejuvenation.” International Journal of Impotence Research, November 6, 2021, 1–8. https://doi.org/10.1038/s41443-021-00482-z.

     

    Kumar, C.S. “265 Combined Treatment of Injecting Platelet Rich Plasma With Vacuum Pump for Penile Enlargement.” The Journal of Sexual Medicine 14, no. 1 (January 2017): S78. https://doi.org/10.1016/j.jsxm.2016.11.174.

     

    Lee, Ping-Jui, Yuan-Hong Jiang, and Hann-Chorng Kuo. “A Novel Management for Postprostatectomy Urinary Incontinence: Platelet-Rich Plasma Urethral Sphincter Injection.” Scientific Reports | 11 (123AD): 5371. https://doi.org/10.1038/s41598-021-84923-1.

     

    Liu, Ming-Che, Meng-Lin Chang, Ya-Chun Wang, Wei-Hung Chen, Chien-Chih Wu, and Shauh-Der Yeh. “Revisiting the Regenerative Therapeutic Advances Towards Erectile Dysfunction.” Cells 9, no. 5 (May 19, 2020): 1250. https://doi.org/10.3390/cells9051250.

     

    Matz, Ethan L, Amy M Pearlman, and Ryan P Terlecki. “Safety and Feasibility of Platelet Rich Fibrin Matrix Injections for Treatment of Common Urologic Conditions.” Investigative and Clinical Urology 59, no. 1 (January 2018): 61–65. https://doi.org/10.4111/icu.2018.59.1.61.

     

    Matz, Ethan L., Kyle Scarberry, and Ryan Terlecki. “Platelet-Rich Plasma and Cellular Therapies for Sexual Medicine and Beyond.” Sexual Medicine Reviews 10, no. 1 (January 2022): 174–79. https://doi.org/10.1016/j.sxmr.2020.07.001.

     

    Poulios, Evangelos, Ioannis Mykoniatis, Nikolaos Pyrgidis, Filimon Zilotis, Paraskevi Kapoteli, Dimitrios Kotsiris, Dimitrios Kalyvianakis, and Dimitrios Hatzichristou. “Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial.” Journal of Sexual Medicine 18, no. 5 (May 1, 2021): 926–35. https://doi.org/10.1016/j.jsxm.2021.03.008.

     

    Raheem, Amr Abdel, Giulio Garaffa, Tarek Abdel Raheem, Michelle Dixon, Amanda Kayes, Nim Christopher, and David Ralph. “The Role of Vacuum Pump Therapy to Mechanically Straighten the Penis in Peyronie’s Disease.” BJU International 106, no. 8 (2010): 1178–80. https://doi.org/10.1111/j.1464-410X.2010.09365.x.

     

    Ruffo, A., M. Franco, E. Illiano, and N. Stanojevic. “Effectiveness and Safety of Platelet Rich Plasma (PrP) Cavernosal Injections plus External Shock Wave Treatment for Penile Erectile Dysfunction: First Results from a Prospective, Randomized, Controlled, Interventional Study.” European Urology Supplements 18, no. 1 (March 2019): e1622–23. https://doi.org/10.1016/S1569-9056(19)31175-3.

     

    Schirmann, A., E. Boutin, A. Faix, and R. Yiou. “Pilot Study of Intra-Cavernous Injections of Platelet-Rich Plasma (P-Shot®) in the Treatment of Vascular Erectile Dysfunction.” Progrès En Urologie, June 2022, S1166708722001300. https://doi.org/10.1016/j.purol.2022.05.002.

     

    Shaher, Hussein, Abdallah Fathi, Salah Elbashir, Shabieb A. Abdelbaki, and Tarek Soliman. “Is Platelet Rich Plasma Safe And Effective In Treatment Of Erectile Dysfunction? Randomized Controlled Study.” Urology, February 2023, S0090429523000742. https://doi.org/10.1016/j.urology.2023.01.028.

     

    Siroky, Mike B., and Kazem M. Azadzoi. “Vasculogenic Erectile Dysfunction: Newer Therapeutic Strategies.” Journal of Urology 170, no. 2S (August 2003). https://doi.org/10.1097/01.ju.0000075361.35942.17.

     

    Towe, Maxwell, Akhil Peta, Russell G. Saltzman, Navin Balaji, Kevin Chu, and Ranjith Ramasamy. “The Use of Combination Regenerative Therapies for Erectile Dysfunction: Rationale and Current Status.” International Journal of Impotence Research, July 12, 2021, 1–4. https://doi.org/10.1038/s41443-021-00456-1.
    Masterson, Thomas A., Manuel Molina, Braian Ledesma, Isaac Zucker, Russell Saltzman, Emad Ibrahim, Sunwoo Han, Isildinha M. Reis, and Ranjith Ramasamy. “Platelet-Rich Plasma for the Treatment of Erectile Dysfunction: A Prospective, Randomized, Double-Blind, Placebo-Controlled Clinical Trial.” Journal of Urology, April 30, 2023, 10.1097/JU.0000000000003481. https://doi.org/10.1097/JU.0000000000003481.

    References Regarding P-Shot® Procedure for Peyronie’s Disease

    Culha, Mehmet Gokhan, Erkan Erkan, Tugce Cay, and Uğur Yücetaş. “The Effect of Platelet-Rich Plasma on Peyronie’s Disease in Rat Model.” Urologia Internationalis 102, no. 2 (2019): 218–23. https://doi.org/10.1159/000492755.

     

    Levine, Laurence A. “Peyronie’s Disease: Contemporary Review of Non-Surgical Treatment.” Translational Andrology and Urology 2, no. 1 (2013): 39–44. https://doi.org/10.3978/j.issn.2223-4683.2013.01.01.

     

    Raheem, Amr Abdel, Giulio Garaffa, Tarek Abdel Raheem, Michelle Dixon, Amanda Kayes, Nim Christopher, and David Ralph. “The Role of Vacuum Pump Therapy to Mechanically Straighten the Penis in Peyronie’s Disease.” BJU International 106, no. 8 (2010): 1178–80. https://doi.org/10.1111/j.1464-410X.2010.09365.x.

     

    Virag, Ronald, Hélène Sussman, Sandrine Lambion, and Valérie de Fourmestraux. “Evaluation of the Benefit of Using a Combination of Autologous Platelet Rich-Plasma and Hyaluronic Acid for the Treatment of Peyronie’s Disease.” Sexual Health Issues 1, no. 1 (2017). https://doi.org/10.15761/SHI.1000102.

     

    References Regarding Saline is Not a Placebo

    Asghar, Aneela, Zahid Tahir, Aisha Ghias, Usma Iftikhar, and Tahir Jameel Ahmad. “Efficacy and Safety of Intralesional Normal Saline in Atrophic Acne Scars.” Annals of King Edward Medical University 25, no. 2 (June 24, 2019). https://doi.org/10.21649/akemu.v25i2.2867.

     

    Bagherani, Nooshin, and Bruce R Smoller. “Introduction of a Novel Therapeutic Option for Atrophic Acne Scars: Saline Injection Therapy.” Global Dermatology 2, no. 6 (2016). https://doi.org/10.15761/GOD.1000159.

     

    Bokey, E. L., J. P. Keating, and P. Zelas. “HYDRODISSECTION: AN EASY WAY TO DISSECT ANATOMICAL PLANES AND COMPLEX ADHESIONS.” ANZ Journal of Surgery 67, no. 9 (September 1997): 643–44. https://doi.org/10.1111/j.1445-2197.1997.tb04616.x.

     

    Cass, Shane P. “Ultrasound-Guided Nerve Hydrodissection: What Is It? A Review of the Literature” 15, no. 1 (2016): 3.

     

    “Clinical Benefit of Intra-Articular Saline as a Comparator in Clinical Trials of Knee Osteoarthritis Treatments_ A Systematic Review and Meta-Analysis of Randomized Trials | Elsevier Enhanced Reader.” Accessed April 6, 2022. https://doi.org/10.1016/j.semarthrit.2016.04.003.

     

    El-Amawy, Heba Saed, and Sameh Magdy Sarsik. “Saline in Dermatology: A Literature Review.” Journal of Cosmetic Dermatology 20, no. 7 (2021): 2040–51. https://doi.org/10.1111/jocd.13813.

     

    Popp, Lothar W. “Improvement in Endoscopic Hernioplasty: Transcutaneous Aquadissection of the Musculofascial Defect and Preperitoneal Endoscopic Patch Repair.” Journal of Laparoendoscopic Surgery 1, no. 2 (January 1991): 83–90. https://doi.org/10.1089/lps.1991.1.83.

     

    Saltzman, Bryan M., Timothy Leroux, Maximilian A. Meyer, Bryce A. Basques, Jaskarndip Chahal, Bernard R. Bach, Adam B. Yanke, and Brian J. Cole. “The Therapeutic Effect of Intra-Articular Normal Saline Injections for Knee Osteoarthritis: A Meta-Analysis of Evidence Level 1 Studies.” The American Journal of Sports Medicine 45, no. 11 (September 1, 2017): 2647–53. https://doi.org/10.1177/0363546516680607.

     

    Searle, Tamara, Firas Al-Niaimi, and Faisal R. Ali. “Saline in Dermatologic Surgery.” Journal of Cosmetic Dermatology 20, no. 4 (2021): 1346–47. https://doi.org/10.1111/jocd.13996.

     

    Sharma, ReenaK, Mudita Gupta, and Ritu Rani. “Delineating Injectable Triamcinolone-Induced Cutaneous Atrophy and Therapeutic Options in 24 Patients—A Retrospective Study.” Indian Dermatology Online Journal 13, no. 2 (2022): 199. https://doi.org/10.4103/idoj.idoj_483_21.

     

    References Regarding the Activation of PRP

    Hamilton, Bruce, Johannes L. Tol, Wade Knez, and Hakim Chalabi. “Exercise and the Platelet Activator Calcium Chloride Both Influence the Growth Factor Content of Platelet-Rich Plasma (PRP): Overlooked Biochemical Factors That Could Influence PRP Treatment.” British Journal of Sports Medicine 49, no. 14 (July 1, 2015): 957–60. https://doi.org/10.1136/bjsports-2012-091916.

     

    Kao, David S., Stephanie W. Zhang, and Alexander R. Vap. “A Systematic Review on the Effect of Common Medications on Platelet Count and Function: Which Medications Should Be Stopped Before Getting a Platelet-Rich Plasma Injection?” Orthopaedic Journal of Sports Medicine 10, no. 4 (April 1, 2022): 232596712210888. https://doi.org/10.1177/23259671221088820.

     

    Sheean, Andrew J., Adam W. Anz, and James P. Bradley. “Platelet-Rich Plasma: Fundamentals and Clinical Applications.” Arthroscopy: The Journal of Arthroscopic & Related Surgery 37, no. 9 (September 2021): 2732–34. https://doi.org/10.1016/j.arthro.2021.07.003.

     

    Smith, Oliver J., Selim Talaat, Taj Tomouk, Gavin Jell, and Ash Mosahebi. “An Evaluation of the Effect of Activation Methods on the Release of Growth Factors from Platelet-Rich Plasma.” Plastic and Reconstructive Surgery 149, no. 2 (February 2022): 404–11. https://doi.org/10.1097/PRS.0000000000008772.

     

    Smith, Stephanie A., Richard J. Travers, and James H. Morrissey. “How It All Starts: Initiation of the Clotting Cascade.” Critical Reviews in Biochemistry and Molecular Biology 50, no. 4 (July 4, 2015): 326–36. https://doi.org/10.3109/10409238.2015.1050550.

     

    Toyoda, Toshihisa, Kazushige Isobe, Tetsuhiro Tsujino, Yasuo Koyata, Fumitaka Ohyagi, Taisuke Watanabe, Masayuki Nakamura, et al. “Direct Activation of Platelets by Addition of CaCl2 Leads Coagulation of Platelet-Rich Plasma.” International Journal of Implant Dentistry 4 (August 1, 2018): 23. https://doi.org/10.1186/s40729-018-0134-6.

     

    Ulasli, Alper Murat, Gokhan Tuna Ozturk, Bagdagul Cakir, Gulsemin Erturk Celik, and Fatih Bakir. “The Effect of the Anticoagulant on the Cellular Composition and Growth Factor Content of Platelet-Rich Plasma.” Cell and Tissue Banking, August 28, 2021. https://doi.org/10.1007/s10561-021-09952-6.
  • “P-Long” New Research Underway

    Explanation and Application for Participation in the P-Long Study

    Important good news…
    Even if you cannot participate in the following study, we can still inform you of future studies, if we receive your contact info in the form below…

    Transcript

    Hello, this is Dr. Judson Brandeis board certified urologist.

    Have you ever wished you had a longer penis? Most men do, but some men actually take action and sometimes with disastrous results. At BrandeisMD®, we’re pioneering a new technique for natural and safe penile elongation and girth enhancement. With an IRB-approved, clinical study listed by the National Institutes of Health.

    At other offices, doctors offer subcutaneous injection of fat and other expensive fillers that have to be re-injected every year. Some surgeons cut the suspensory ligament of the penis, right here, but this doesn’t make the penis any longer, it just hangs lower in the locker room and it’s unstable when it’s erect. There’s now even a silicone implant surgically inserted below the skin that makes the penis wider, but not longer and changes the proportion of the head of the penis to the shaft.

    Now I’ve seen many unfortunate complications of all of these procedures and wondered, is there a better way?

    The P-Long Study Uses Four Different Strategies Combined…

    The P-Long study utilizes (1) platelet rich plasma using the protocol of the Priapus Shot® (or P-Shot®) to stimulate the growth of the penis and penile stretching with traction devices to accelerate the process.

    P-Long also uses the (2) Affirm™ nitric oxide booster from AFFIRM Science to help improve penile circulation [as well as instructions and use of both a (3) penile vacuum pump and (4) traction device].

    Is the Study Safe?

    P-Long has institutional review board approval and is listed by the NIH at clinicaltrials.gov. There’s a discounted cost for participating in this study.

    How Do You Apply for Participation in the Study?

    If you wish to be contacted about this or future studies [to improve sexual performance & health] or to learn more about the results [of this study], when we publish them, please provide the information requested below; the application is privacy protected.


    I’m Dr. Judson Brandeis board certified urologist and expert in sexual medicine in San Ramon, California. For more information about me and my office, please visit our website, Brandeismd.com, to learn more about my other four groundbreaking studies and all of the other new developments in the field of sexual medicine.

    Check out and subscribe to my YouTube channel, Instagram and Facebook page [all to be found at] BrandeisMD.

    I hope that I can be of service to you.

    Thank you.

    More details about the study at ClinicalTrials.gov (US National Library of Medicine) click<–

    If you are interested in participating in this or future studies regarding improving male sexual function,
    you may supply your information in the following form.
    You will then be redirected to a page where you can apply for this study and receive information about future studies.
    Since the subject matter regards the penis (which the spam filters often catch), finding the email that will be sent to you and opting in will assure future delivery of our coming opportunities and valuable information about male sexual function.

     

     

    More research regarding the Priapus Shot® (P-Shot®) procedure
    Apply to become a P-Shot® provider
    Find the nearest P-Shot® provider

  • Peryronie’s Disease Personal Video Story from Brave Man

    Brave Man Tells His Story about Treatment of Peyronie’s Disease with the Priapus Shot® [P-Shot®] Procedure
    *Results May Vary*

    Transcript

    Meet Dr. Shanthala<–

    Dr. Shanthala Shivananjappa

     

     

     

     

     

     

     

     

    Doug Brown: Hi, I’m Doug Brown. I’m here at Dr. Shanthala, MD’s office, and I’m here to have a procedure for something that most men or most people don’t even understand, which is called Peyronie’s disease.

    Peyronie’s is a condition that happens over time for most men, and quite frankly it’s a little embarrassing. But it’s where the penis actually starts to have a curvature to it, and it happens gradually over time. And many men are embarrassed by it and many men don’t understand what it’s all about because it’s happening and they’re trying to figure out, well, why is this happening to me? That’s what was happening, as well, to myself.

    And so I was seeking out multiple treatments, and, frankly, there wasn’t a lot that I could find online, at the time. And then I would find things of, you know, magic potions and magic pills, and those wouldn’t work, and different types of contraptions that people wanted to sell.

    I eventually decided that I was going to just take the medical route, and so I went and had a couple of injections of what they call Xiaflex, and Xiaflex is kind of an enzyme that eats away. What happens is plaque gets underneath the skin. It’s due to either an injury or sometimes an allergic reaction, it’s really kind of what the medical community calls idiopathic. It’s really not a cause that somebody really understands why this happens.

    And it’s been interesting to me because, you know, now that I’ve had the issue and I’ve talked to other people, and they now know they have the issue, but they didn’t even know what it was, so as I was progressing through this process with the Xiaflex, I actually got some results.

    The Xiaflex are a series of injections. However, they’re very, very costly. Too little vials of medication are actually $9,000 from the pharmacy, and so I had a couple of those, but then the insurance wouldn’t support it any longer. So I was looking for other alternatives, because even though I got some results from it, I wanted more of a natural type of process. Because while I went through those, I had things called hematoma, which is where the blood vessels sort of burst with inside the skin, or it felt like that anyways, and things would swell. And it was very painful.

    Anyways, I’m here because I went through what is called the P-shot. And the P-shot is a process where they use your own natural blood and what they call PRP, I believe it’s called, and what that does is it goes in and it actually does a similar thing that the Xiaflex does. However, it’s not a series of multiple injections that you have to go through, and there’s no adverse reaction to it.

    So I had one done already, and immediately I started noticing a vast change, and for the positive. So, where the curve was still a good sized curve, it started straightening out immediately on all angles. And so it’s been very successful for me, and so I’m back to have another one, because I got better results this time, the first time, and I want to have better results the second time.

    So the good thing about the PRP and the P-shot versus the Xiaflex, for myself, was not only do you not have to have insurance get involved, but number two, it’s very quick. So the time recovery on the P-shot versus the Xiaflex shot, the recovery time was instantaneous. Really, that day. It wasn’t painful after that. It was very straightforward.

    But with the Xiaflex, you do it in one day and then you got to wait a couple of days and you go back again, and they’re constantly … I’ll just, for the lack of better terms, using an invasive type of process, and so there is a week to four week recovery time. And what I noticed with the P-shot was the recovery time was instantaneous. I was recovered that day, and back to normal function.

    And so, you know, I’m here to talk about this because most men, frankly, they don’t want to talk about it. It’s kind of embarrassing to them. And, you know, this happens to a lot more men than people know.

    So I’m here to answer a series of questions as well, so there may be some questions thrown to me at this point.

    Speaker 2: Well, Doug, thank you very much for talking. I appreciate it. Very well said. I was just wondering, does this hurt? Do you have any pain when you’re having the procedure done?

    Doug Brown: No, I mean, because they’re numbing up the area, you do feel a slight pinch when the needle is inserted, but it’s not painful. At least it wasn’t for me. And I don’t think it’s anything worse than what I would consider maybe a mosquito bite or a bite like that.

    And then once the pinch is gone, I didn’t feel a thing, honestly.

    Speaker 2: How many shots do you think would be optimal to get the results that you desire?

    Doug Brown: Well, I think it depends on the person’s condition. You know, I’ve talked to men who have slight curvature, and unfortunately, the more curvature that one has, then it’s a challenge with all kinds of function, whether it’s sexual function or also urinary function as well. I was running into that in the beginning. And that’s one of the reasons I just said … you know, I didn’t know about the P-shot before, so I just went to the Xiaflex ’cause that was the only thing that medical doctors who are traditionalists would recommend.

    So, you know, I got results in my first P-shot, so for me, I’m back because I want more results, but I noticed an immediate straightening and I noticed an immediate … I used to have an indenture on both sides where the curvature was happening, and they both went away within an hour. You know, I was like, wow, what happened. And now, the reason I’m back is because over time the indenture on the left is completely gone and the one on the right is slightly back, so I want to get rid of that as well.

    The other thing that I noticed immediately, I noticed a size increase immediately. So length and girth, width, as well. So, you know, for me, it was pretty immediate. But I think most men probably should look, you know, between one and four treatments, probably on average, to make it work out right.

    And the reality is, when you compare it against the other, even with co-pays on insurance, what I have found is this is much more economical, and the recovery time … I mean, the second Xiaflex shot I had, I mean, it took me about four weeks to recover. So, and you know, it was painful for about two weeks.

    Speaker 2: Did you feel that you had your privacy respected when you came into the office?

    Doug Brown: Here?

    Speaker 2: Yes, yes.

    Doug Brown: Oh, yeah, absolutely. Yeah, they’re … you know, I’m kind of a, like, you know, I’m not really that modest anyways. Probably one of the reasons I’d be willing to do this and that. But I do understand that many men, you know, in different professions, and I sort of have a public persona profession so to do this is actually a stretch for me, but I think it’s so important that, you know, a lot of men, or a lot of guys out there, they’re suffering with this condition and, you know, it’s affecting their whole life. It was affecting my whole life. And I think that the privacy here was respected as well as anywhere I’ve ever been. In fact, better so.

    What I got here is, you know, in the other medical community, because they’re dealing with insurance companies and they’re running people through the mill and they’ve got such a high overhead on a lot of things, there wasn’t, I would say, that personalization that I got here, by any means.

    You know, sometimes I would have to wait an hour to get in for the procedure on the other place, or, you know, a couple of times the doctor was so busy because they were out on call all night long, they were sleeping, they couldn’t even get back to the office, so I had to go back a couple of times. And it was and hour drive for me, because there’s not a lot of people who actually do this type of treatment, and so, you know, certainly, it’s more far and few between.

    So when I found this, and I found it in my local area, I was like, you know what, I’m going to give it a shot, and I’m very grateful I did.

    Research supporting the use of the P-Shot® for Peyronie’s disease (and how it works better then Xiapex)<–

    More research supporting the above man’s  brave story<–

    The full P-Shot® protocol for the treatment of Peyronie’s Disease<–

    Find nearest P-Shot® provider<–

    Apply to become provider of the Priapus Shot® [P-Shot®] procedure<–

  • Priapus Shot® for Improved Sexual Function. Vegas 2018

    International Society for Cosmetogynecology<–

    Cellular Medicine Association<–

    Transcript

    Dr. Marco Pelosi III: Our next speaker is probably best described as the Michael Jordan of platelet rich plasma, Dr. Charles Runels from Alabama, that pioneered the O-Shot® [Orgasm Shot®], the Vampire [Face]lift®, the P-Shot® [Priapus Shot®], and he’s taken all the abuse and he’s given the world some very, very useful procedures for everyone. He’s going to talk about the studies he did and the studies done in platelet rich plasma in regards to sexual function. Dr. Runels, it’s a pleasure to have you here.

    Dr. Runels: Thank you for having me.

    I’m going to go through a whirlwind look at research that’s been done where people have used PRP to help with sex. Much of the research has been done by the people in our group, and I’ve described many of them in this room who have done this research. It’s a for-profit organization, but we pay for research, we pay for education, we pay for marketing for our providers. Just to echo what you just heard, sex is much more than about just having fun. Rainer Maria Rilke said it’s just so correlated to the creative experience that it’s affecting how we do our work, how you do your presentation, and how – of course – relationships and families.

    I want to echo that sentiment, and remind us that back in 1980, if you look in ‘Urology’ – this was ‘Urology’ 1980 – the most common cause for erectile dysfunction was thought to be 85% psychogenic. Here’s a quote from ‘Urology’ where urologists were encouraged to become counselors, because most of erectile dysfunction was thought to be psychogenic. Of course, I’m echoing the penis stuff because if you take a penis and shrink it and unzip it, that becomes a clitoris. I’m thinking most of the research will eventually apply to that. Certainly, our attitude is applying because we’re back in the … We’re not, I’m preaching to the choir, but many of our colleagues are back in the 1980’s and saying the main thing we have for sexuality for women is counseling.

    My thinking that perhaps, as you guys do, some of the pathology that applies to the penis may apply to the clitoris, and maybe some of these women are suffering from actual genital histopathology, not just psychogenic problems. We have this one FDA approved drug now for female sexual dysfunction that’s a psych drug, flibanserin. It’s a useful drug, but obviously, we need much more and maybe we should think in terms of systems, like we do for the rest of the body.

    Platelet Rich Plasma.

    Obviously, this is not a new idea. This is from, this month, over 9,000 papers indexed in PubMed about platelet rich plasma. Our orthopedic colleagues, our dentist, our facial plastic surgeons have worked with this, and all we have to do is take their ideas and then hopefully people in this room will extend what I’m about to show you and just take those ideas and adapt them to the genital space. Here’s some of the growth factors we know about. There are many more. They have these effects. These are good things for the genitalia. Down-regulating autoimmune response, proliferation of fibroblasts, new angiogenesis, the adipocytes enlarge and multiply – think labia majora, collagen production, neurogenesis and maybe some glandular function.

    Find Nearest P-Shot® Provider<–

    There’s never, in all those 9,000 papers, I still cannot find one serious side effect. No granulomas, no serious infection. PRP is what your body makes to heal when you do your surgeries and help prevent infection. Obviously, there are always certain things that can happen, bruising and such, but if you have a serious life-threatening complication from PRP, you will have the first recorded in all of that 9,000 plus papers. That’s a nice thing.

    Next Workshops With Live Models<--

    We have commercially available methods for preparing it, within 5 or 10 minutes of the bedside, and the devices are FDA approved. So you guys don’t get confused, obviously the FDA does not approve your procedures. That’s a doctor business. They don’t approve blood that belongs to you, just like your spit and your saliva and your skin. They tried, at one time, to control eggs and the gynecologists said, “Hell no.” So they don’t control eggs and they don’t control blood, but you should use an FDA approved device if you do this [approved for preparation of PRP to go back into the body].

    Autoimmune Disease

    Here’s some of the ideas about down-regulating autoimmune response. We have split-scalp studies showing that PRP helps alopecia areata better than triamcinolone. More hair growth that comes in thicker. Here’s rat studies looking at rheumatoid arthritis. What do we have in the genital space? We have lichens sclerosus. We did some before and after pictures where you use stem cells mixed with PRP, and before and after pictures show improvement. Of course, that’s two variables because you have stem cells and you have the PRP.

    We took the same idea and just used PRP. Andrew Goldstein worked with me on this, and we had two blinded dermatopathologists. The protocol was biopsy, PRP, wait six weeks later, another PRP injection, and then six weeks after that, another biopsy. Two blinded dermatopathologists out of George Washington University did not know the before or the after. We showed statistical improvement in both the histology and symptomatology. Here’s our histology. You can see obviously, that’s the same magnification and we’re showing decreased hyperkeratosis. That’s obviously healthier tissue. A layperson could tell that’s better. Of course if you look at the gross pictures, lady on the left as you guys know, she has pain wearing her blue jeans. The lady on the right is back to making love to her husband. They’ve invited me into their close Facebook groups and I saw a post a few months ago. Quote says, “I was sitting next to my husband, whom I love, last night. I was afraid to hold his hand because I was afraid he would become aroused and I’m bleeding and hurting today.” That’s what you guys are helping.

    We published that in ‘Lower Genital Tract Disease’. We extended it because it worked. We published this past January in the journal of the American Academy of Dermatology. You have some science to go do this now.

    One of our providers, Kathleen Posey, who’s a gynecologist out of New Orleans, took this idea and then she said, “Let’s do some dissection in the office”, and she presented this in Argentina, published it in the same journal ‘Lower Genital Tract Disease’. Here’s one of her patients, where you can introduce [inaudible 00:06:44]. It had been 12 years since she had had sexual intercourse, penis and vagina intercourse, with her loving husband … 12 years. She was being followed by a dermatologist on high dose clobetasol. Kathleen dissected it out in the office and then injected PRP … 8 weeks later, she’s having comfortable sex with her husband. She’s now 3 years out. She’s had to be treated with PRP, not repeat surgery … PRP now, 2 other times a year apart to maintain that result. She now has a series of 60 or so patients that she’s now going to publish with similar results, where she’s dissecting out – as you guys know how to do – treating the [inaudible 00:07:27], but then following that with PRP injections to help the healing and decease the autoimmune response.

    Find Nearest Priapus Shot® Provider<–

    That same doctor, Casabona, repeated his study with lichen sclerosus in men [BXO], and showed with just PRP alone … This study of 45 men with repeat treatments … It is cumulative, 2 to 10 treatments, the same thing. All of them stopped their steroids. None of them started back. Only one went on to have circumcision.

    Peyronie’s

    Peyronie’s disease, another autoimmune disease … This came out this month out of Wake Forest, where they took men and they followed their results with Peyronie’s disease. Not only did their Peyronie’s improve statistically, but they also improved their erectile dysfunction by 5 on that scale of 5 to 25 that the urologists use. For some reason, thankfully, they threw in one woman just for good measure, and showed that it helped her incontinence. They just tucked that in as an aftermath.

    Ronald Virag, as you guys know as the legendary vascular surgeon who was first to present the idea of intracavernosal injections for erectile dysfunction, out of Paris. His big thing now is PRP for Peyronie’s. He just published a study where he showed that this is comparing PRP with Xiapex, which is a $50,000 series of injections, FDA approved version of collagenase. He showed that PRP works better with few side effects. There’s a risk of about 1 in 30, that actually go from a bent pencil to a fractured pencil and a limp noodle. You don’t see that with PRP. You see the side effect is the erectile function improves. He showed the same thing, actually, in his studies that erectile dysfunction improves by an average of about 7 on that 5 to 25 point scale.

    Wound Healing/Scar Resolution

    Let’s think about the [inaudible 00:09:29] literature. Look at this, there’s so much of this out there. This is looking at post-operative adhesions, lots of studies looking at scarring with microneedling and PRP. This is a split-face study comparing PRP with microneedling verus PRP … Excuse me, microneedling with saline or Vitamin C serum and split-faced studies in PRP wins. Dr. Sclafani did some studies in the cosmetic space looking at increased collagen production and fibroblast activity, and never a neoplasia documented. People worry about that. This is not indiscriminate blindness blind growth. You don’t worry about carcinogenesis when you do surgery and it’s the same PRP that’s causing healing. There’s actually some helpful immune processes that go on, that you could argue actually might help prevent cancer. I’m not going to make that argument but it might need to be made one day.

    If you look further, here’s a wound healing study looking at reepithelialized exposed bone and tendon of the foot and ankle. When I took that and applied, this is a hypertrophic scar that was a year old from cortisone, and then using PRP and Juvederm or HA filler, this is a few days later, a month later, and that’s a year later. Now, take that and think, “How could I use that in the genitourinary space?” Doing that anecdotally, we have many of the members of our group are seeing help with episiotomy scars or dyspareunia, pelvic foreplay instead of injecting that pelvic floor tenderness with triamcinolone. Physiatrist for the past ten years has been using PRP, your sports medicine doctors. Now, when you palpate it, consider injecting with PRP instead. Dyspareunia from mesh and that unknown dyspareunia, we’re seeing this is where we need you guys to help extend the research. The science is there that it should help and it seems to be helping. Not 100%, but about 80% in people with dyspareunia.

    Mesh Pain

    Here is a look at a gentleman who did … He took the mesh out and then he patched the hole with a gel form of PRP and showed benefit. We’re finding anecdotally – no one’s done this study yet, here’s another one for you to pick up … I’m giving you low hanging fruit. We’re seeing anecdotally that if you inject in the distribution of the pudendal nerve, which seems to be inflamed in some women with mesh pain, that their pain will frequently go from 9 out of 10 down to 1 or 2 out of 10, without even taking the mesh out. Just another place where we need some research done.

    Interstitial Cystitis

    Here, we have rat studies looking at inflammation. Let’s think about this one. Here’s a rat study where they modeled cystitis and we are seeing in chronic interstitial cystitis without even infiltrating the bladder, just infiltrating in the periurethral space, some of our women are getting better. I’ve had two separate urologists call me and say, “Charles, I can’t believe it. I was doing this and expecting not this to happen. I have these patients now who have had chronic interstitial cystitis pain for years, and it’s gone.” Not 1005 but finding out who’s going to respond and who’s not and why, there’s a lot of variables that need to be thought about that you guys will hopefully do the research.

    Penis Growth

    Here’s a study that came out in the ‘Journal of Sexual Medicine’, where a guy took … the [inaudible 00:12:51] men who have an erection of 3 inches or less and then he treated them with PRP, combined with a pump, and showed that if you repeated it every time you did it, it grew by about 7 millimeters. I’ve always thought if I could give you a guarantee half an inch to an inch with anything, I’d get my picture on a postage stamp. I don’t have that yet, but I can tell you that we’re seeing about 60% of the time we do this procedure, men will see some sort of growth.

    If you look at the neovascular space, there was a study out of Southern California that was published in the ‘Journal of Sexual Medicine’ where they transferred adipocyte stem cells to the penis of diabetic rats. They showed new endothelial cell growth and increased nitric oxide activity in the dorsal nerve. Would that be helpful in the clitoris? Probably, but the interesting thing is the adipocyte-derived stem cells were attacked and they died. The postulate was the improvement was from the growth factors.

    Penile Rehabilitation and Erectile Dysfunction

    I have seen what [inaudible 00:13:52] have seen in that when you inject this in the penis, erectile function goes up on the average of about 5 to 7 per injection. Think about nerve repair. We have rat studies modeling prostrate surgery, showing that the nerves improved with PRP and so we have, again, another clear place where we need studies if you add this now to the usual protocol for rehabilitating the penis post-prostate surgery … would you see benefit? We have seen that in some of our patients who are a year or two out who failed the rehabilitation part of that. Would that help your patients who have, say, numbness and decreased function from riding their bikes too much, or trauma? I don’t know, but it’s worth thinking about and publishing research about.

    Next Workshops With Live Models<–

    In thinking about where to put this, where we do our O-Shot, when we do PRP to the anterior vaginal wall, we’re putting it as distal from the bladder as possible. We found that it works better. We’re essentially making a liquid sling. Think infiltrating and getting ready to put in the mesh. That’s what we’re doing. Very simple, only we’re using a material that has never caused a granuloma ever. Doing that, frequently our patients will have their incontinence go away that day from the actual liquid and as it’s replaced with new tissue, it never recurs. Usually, you’ll have to repeat the procedure at a year or two out depending on the etiology. Sometimes it lasts longer.

    The interesting idea is what might be happening with those [inaudible 00:15:21]. They become more active, and does that help with sexual function? The other place we put it is in the actual corpus cavernosum of the clitoris. We use [inaudible 00:15:29] ultrasound visualization and see it flow down into the body of the clitoris by the pubic ramus and the wave form goes to what you see in a flaccid penis to what you see in an erect penis.

    Improved Orgasm & Libido in Women

    That’s my time, almost done. Just 30 more seconds. Here’s a pilot study we did where we showed that in women with female sexual distress, that it dropped by an average of 10 and female sexual function went up by 5 when you do what I just showed you. Here’s a study that Dr. Neto, who may be here, published where he looked at incontinence and sexual function down in Brazil and showed that 94% of the people loved it. The question here is how would you combine it with your energy source? It works great in the face if you do laser and follow it with PRP … better results, faster healing. Is it going to … We need people to help us work out the algorithms. Not everybody has laxity, but when you have something, when do you use which treatment and when do you combine it with PRP? We need those answers, because I don’t have them yet. This is possible helps.

    I am done. Thank you very much for having me. I put all these references at that website, if you want to go download them. Thank you. You guys have a wonderful conference.

    Dr. Marco Pelosi III: Thank you Charles. Beautiful

    More about the Cellular Medicine Association

    O-Shot® Research<–
    P-Shot® Research<–

    Upcoming Workshops With Live Models<–

  • When Should You Treat Peyronie’s with the P-Shot® Procedure…Early After Onset, or Later?

    Question (name changed)…

    Dr. Runels:

    I’m an ENT doctor but in this case a urology pt with recent-onset (noticed 2-3 weeks ago) Peyronie’s. My urologist ______ in ______ gave me your flier about the Priapus Shot® treatment.

    (1) Does your Rx address the plaques?

    (2) Does it stop or reverse the Peyronie’s process?

    (3) Is it better to treat early (now) or wait 8-10 months when the plaques stabilize?

    Thank you.

    Answer:

    (1) Yes! Research shows a decrease in plaque size.
    (see research listing below)

    (2) If you mean, does the Priapus Shot® procedure help the curvature? Yes, in most men.  If you mean, does it permanently reverse the underlying process so the curvature never recurs…then probably in some. To further elaborate with some data, we did the following research (click to read) with lichen sclerosus (also thought to be an autoimmune process, like Peyronie’s), showing that our process with the O-Shot® procedure decreased inflammation according to 2 blinded dermatopothologists–indicating that somehow the procedure down-regulates the autoimmune response.  There are other papers showing this downregulation of the autoimmune process by PRP.

    Further as to permanence, our provider group has seen women who see a recurrence of their lichen at 1 year out, a few who are not helped at all, and many who are still well at 3-4 years post procedure. How these data will relate to Peyronie’s disease remains to be seen but we expect a similar spectrum.
    (see research listing below)

    (3) DEFINITELY  better to treat early  before the scar tissue matures. I saw Dr. Virag lecture in Venice this past summer when we shared the podium and he will soon publish data showing that using PRP is more effective and safer than Xiaflex. Depending on how you look at the data, Xiaflex has a 1 in 50 to 1 in 100 risk of fracture/impotence post procedure. The Priapus Shot® procedure has associated with it the probable side effect of an improvement in erection quality by around 5 – 7 on the 25 point scale commonly used.
    (see research listing below)

    IMPORTANT! If your provider is not on the following list of physicians who have studied the accepted methods of the Priapus Shot® procedure (click) and agreed to follow them, then your physician may be a wonderful provider, but I have no way of knowing who or how he/she was trained and what method he learned. So, I have NO way to make any comments about the quality of the procedure he/she may provide. What I can say, is that your physician (if she/he says he’s providing the P-Shot® but is not listed on that directory) is either knowingly or unknowingly breaking the law and pretending to be part of a group that he/she is NOT a part of. The certified providers of the Priapus Shot® procedure share notes with each other, finance research, and support the advancement of the effectiveness of the procedure. THOSE WHO USE THE NAME “PRIAPUS SHOT” BUT WHO ARE NOT LISTED AS ONE OF OUR MEMBERS ARE USING THE FRUITS OF OUR LABORS ILLEGALLY and possibly providing and inferior service by deceiving patients.

    Certified Members of the Priapus Shot® Provider Group (click)<–
    Research Listings for the Priapus Shot® Protocol for Treating Peyronie’s Disease (click to read)<–

    Best regards,

    Charles Runels, MD

     

    Inventor of the Priapus Shot® Procedure

     

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