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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

 

Straighter, Harder, Bigger. Step 3. Priapus Shot®

Priapus Shot® Procedure

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.

The Science

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).

Find Certified Priapus Shot® Provider (click)<==

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.

What Goes with the Shot?

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.

Apply for Certification as Priapus Shot® Provider (click)<==

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.

Hard & Easy Cases

Hard Cases

  • Penis Growth-Only 60% of men achieve 1/2 inches or more in growth (circumference and length). But, men in that 60% sometimes see up to 1.5 inches in circumference & length (often after 2 to 3 procedures).
  • Men with long-standing vascular disease see less response. If the blood flow going to the penis (ileac arteries) is blocked, then the Priapus Shot® injection into the penis will not help much. The man needs a vascular surgeon. One way to get an idea here….if the man sees absolutely no response when taking Viagra or Cialis for more than 2 years, then he may have blockages or other problems that the Priapus Shot will not help.

Easy Cases

  • Post op for prostate surgery as part of a penile rehabilitation program. If the man could achieve erection before the surgery, the following the Priapus Shot® protocol could be very beneficial (even if it’s been 2 or 3 years since surgery).
  • Improved firmness of erection in the man who can already achieve erection. Typical results are that he may be able to cut the dose of Viagra or Trimix in half (but still need the drug) or if he needs only a low dose of the drugs he may be able to stop using them.
  • Improvement in lichen sclerosus. This is HUGE since lichen sclerosus appears on the foreskin with severe discomfort and often recurs even if the man has a circumcision.
  • Peyronie’s Disease. This possibility is another HUGE benefit of the procedure—with the Priapus Shot® probably safer and more effective than collagenase injections (research to be published soon). If a man undergoes surgery for Peyronie’s disease, the curvature often recurs later since the autoimmune process continues. Also, with surgery, there can be infection and shortening of the penis. None of those side effects have been seen with the Priapus Shot® procedure (side effects include INCREASE in size in most men with Peyronie’s).

Summary

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

Apply for Certification as Priapus Shot® Provider (click)<==

Find Certified Priapus Shot® Provider (click)<==

References

1. Siroky M. Vasculogenic erectile dysfunction: newere therapeutic strategies. J Urol. 2003;170(2 Pt 2):S24-9.

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.

7. Nikolai S. Erection rehabilitation following prostatectomy--current strategies and future directions. Nature Reviews Urology. 2016;13(.):216-225.

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.

9. Sellers T, Dineen M, Wilson SK. Vacuum protocol and cylinders that lengthen allow implantation of longer, inflatable prosthesis. Toronto, ON: (Abst) Society of Sexual Medicine; 2008.

10. Raheem A. The role of vacuum pump therapy to mechanically straighten the penis in Peyronie's disease. BJU Int.. 2016;117(4):E7.

11. Levine L. Peyronie’s disease: contemporary review of non-surgical treatment. Transl. Androl. Urol. 2013;2(1):39-44.

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.

13. Paulis G. Efficacy of vitamin E in the conservative treatment of Peyronie's disease: legend or reality? A controlled study of 70 cases. Andrology. 2013;1(1):120-128.

14. Lue T. The Challenges of Peyronie's disease. Translational Andrology & Urology. 2012;1(S1):PS 9.

15. Raynor M. Dorsal Penile Nerve Block Prior to Inflatable Penile Prosthesis Placement: A Randomized, Placebo‐Controlled Trial. The Journal of Sexual Medicine. 2012;9(11):2975-2979.

16. Sanchez-Gonzales J. Platelet-Rich Plasma Peptides: Key for Regeneration. International Journal of Peptides. 2012;10:1-10.

17. Taylor D. A systematic review of the use of platelet-rich plasma in sports medicine as a new treatment for tendon and ligament injuries.. Clin J Sport Med. 2011;21(4):344-52.

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.

19. Sell S. A case report on the use of sustained release platelet-rich plasma for the treatment of chronic pressure ulcers. The Journal of Spinal Cord Medicine. 2011;34(1):122-7.

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

21. Ding X. The effect of platelet-rich plasma on cavernous nerve regeneration in a rat model.. Asian J Androl. 2009;11(2):215-21.

22. Ding X. Platelet-rich plasma on the Cavernous Nerve Regeneration. Chinese Medical journal. 2008;88(36):2578-2580.

23. Rene' Y. Safety of Intracavernous Bone Marrow-Mononuclear Cells for Postradical Prostatectomy Erectile Dysfunction: An Open Dose-Escalation Pilot Study. European Urology. 2016;69(6):988-991.

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.

25. Singh S. Role of platelet-rich plasma in chronic alopecia areata: Our centre experience.. Indian Journal of Plastic Surgery. 2015;48(1):57-9.

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.

27. Goldstein A., Runels C. Intradermal Injection of autologous platelet-rich plasma for the treatment of vulvar Lichen sclerosus. Journal of the American Academy of Dermatology. 2017;76(1):158-160

27. Zaman H. Association of psychological factors, patients’ knowledge, and management among patients with erectile dysfunction. Patient Preference and Adherence. 2016;10:807.

Save

Save

Peyronie’s & ED Treatment: The Priapus Shot® Procedure

Priapus Shot® Procedure

The Priapus Shot® procedure indicates a specific protocol for treating the penis with blood-derived growth factors: specifically platelet-rich plasma or PRP. 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 warrant protection as intellectual property and so would not indicate any particular quality of care.

The trademark gives a method of teaching a specific protocol that providers agree to follow and develop; this agreement offers a measure of quality control and is being followed and developed by around 500 urologists and interventional radiologists, family practitioners, and internists in multiple countries and by faculty in several medical schools where further studies are being done.

The Priapus Shot® procedure defines a protocol that 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. Other post injection steps can include: stopping smoking, CoQ10 (12), vitamin E (13), Trimix, and aerobic exercise. Protocol steps can vary depending on the problems presented by the patient.

It is the policy of most of our providers of the procedure to offer any patient that is not happy with the Priapus Shot® procedure a complete refund.

Find Priapus Shot® Provider <--

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.

Consulting the patient includes informing him that unexpected side effects could occur and the results can vary with some patients seeing no benefit.

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. Multiple kits have gained FDA approval. Some of the approved kits include Regen, Magellan, TruPRP, Eclipse, Pure Spin, & Emcyte. There are over 8,000 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.

The first indication that PRP may be useful in the penis is in a paper published in Urology in 2003 indicating that, in animal models, using growth factors was successful to treat erectile dysfunction and indicated that such a strategy may be feasible in men— actually providing a way to correct underlying pathology (1). Viagra and Trimix do not correct underlying pathology of penile circulation.

Another animal model study in 2010 showed that transferring adipocyte derived stem cells (ADSCs) into the penis caused endothelia cell growth as well as increased nitric oxide activity in the dorsal nerve. Interestingly, the ADSCs were tagged and perished - so the improvement seen was not from maturation of the ADSCs but rather from recruitment and activation by growth factors of stem cells from within the body. Also, indicating the PRP may demonstrate a similar effect (2).

Dr. Virag (also a pioneer of Trimix injections) published a paper 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 the corpus cavernosum of the human penis (3).

One of the growth factors (over 20 known) found in PRP includes vascular endothelial growth factor (VEGF). In one animal model study, the animals were castrated to create a penis that demonstrated, on microscopy, atrophy of smooth muscle and nerves as well as endothelial cell pathology. Injecting VEGF directly into the corpus cavernosum 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.

In regards to improvement in erection firmness, the Priapus Shot® protocol also includes a recommendation of aerobic exercise which by metaanalysis of 5 randomized controlled studies using the IIEF 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 later this year. It should be noted that 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 the physicians currently utilizing the Priapus Shot® protocol demonstrate improved blood flow and an increase in endothelium (improved health) as well as such results being indicated animal model studies, only some of which have been cited.

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) though the growth was not as significant as in the other studies previously cited. The PRP alone, in Dr Virag’s study, out-performed the pump with demonstration of remodeling of the plaque.

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. Further, other modalities are also used in the Priapus Shot® procedure that have been demonstrated to be synergistic: 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 Priapus Shot® protocol does not intend to make any particular therapy obsolete but rather offer a protocol for enhancing an overall, synergistic approach to pathology of the penis. The surgical treatment of Peyronie’s disease can be unsatisfying and lead to serious complications (14); we are seeing the safety profile of PRP and the Priapus Shot® protocol offer an appealing conservative step to take before proceeding to surgery.

For, example 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.

Most men find the procedure very comfortable if a topical lidocaine cream is used since a 1/2 inch 30 gauge needle is used for injection (similar to a Trimix injection). However, some men do ask for a dorsal nerve block which can easily be done using 1% lidocaine without epinephrine for a near painless procedure (since this same block can be used for prosthesis placement, it makes a 30 gauge needle completely painless for most men) (15).

Considering the duration of effectiveness and risks involved it’s useful to consider the nature of the cell biology employed. A review article considering the basic science 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 offered 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 article speaks of the 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, that of 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.

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).

References

1. Siroky M. Vasculogenic erectile dysfunction: newere therapeutic strategies. J Urol. 2003;170(2 Pt 2):S24-9.

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.

7. Nikolai S. Erection rehabilitation following prostatectomy--current strategies and future directions. Nature Reviews Urology. 2016;13(.):216-225.

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.

9. Sellers T, Dineen M, Wilson SK. Vacuum protocol and cylinders that lengthen allow implantation of longer, inflatable prosthesis. Toronto, ON: (Abst) Society of Sexual Medicine; 2008.

10. Raheem A. The role of vacuum pump therapy to mechanically straighten the penis in Peyronie's disease. BJU Int.. 2016;117(4):E7.

11. Levine L. Peyronie’s disease: contemporary review of non-surgical treatment. Transl. Androl. Urol. 2013;2(1):39-44.

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.

13. Paulis G. Efficacy of vitamin E in the conservative treatment of Peyronie's disease: legend or reality? A controlled study of 70 cases. Andrology. 2013;1(1):120-128.

14. Lue T. The Challenges of Peyronie's disease. Translational Andrology & Urology. 2012;1(S1):PS 9.

15. Raynor M. Dorsal Penile Nerve Block Prior to Inflatable Penile Prosthesis Placement: A Randomized, Placebo‐Controlled Trial. The Journal of Sexual Medicine. 2012;9(11):2975-2979.

16. Sanchez-Gonzales J. Platelet-Rich Plasma Peptides: Key for Regeneration. International Journal of Peptides. 2012;10:1-10.

17. Taylor D. A systematic review of the use of platelet-rich plasma in sports medicine as a new treatment for tendon and ligament injuries.. Clin J Sport Med. 2011;21(4):344-52.

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.

19. Sell S. A case report on the use of sustained release platelet-rich plasma for the treatment of chronic pressure ulcers. The Journal of Spinal Cord Medicine. 2011;34(1):122-7.

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

21. Ding X. The effect of platelet-rich plasma on cavernous nerve regeneration in a rat model.. Asian J Androl. 2009;11(2):215-21.

22. Ding X. Platelet-rich plasma on the Cavernous Nerve Regeneration. Chinese Medical journal. 2008;88(36):2578-2580.

23. Rene' Y. Safety of Intracavernous Bone Marrow-Mononuclear Cells for Postradical Prostatectomy Erectile Dysfunction: An Open Dose-Escalation Pilot Study. European Urology. 2016;69(6):988-991.

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.

25. Singh S. Role of platelet-rich plasma in chronic alopecia areata: Our centre experience.. Indian Journal of Plastic Surgery. 2015;48(1):57-9.

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.

27. Goldstein A., Runels C. Intradermal Injection of autologous platelet-rich plasma for the treatment of vulvar Lichen sclerosus. Journal of the American Academy of Dermatology. 2017;76(1):158-160

27. Zaman H. Association of psychological factors, patients’ knowledge, and management among patients with erectile dysfunction. Patient Preference and Adherence. 2016;10:807.

Size

3 Questions about the Priapus Shot® Procedure

  1. P-Shot® increase size much? With or without the pump?
  2. Other methods for size- pump work alone? If so how to use and for how long etc?
  3.  Physical techniques using the hands or traction?

Podcast Answer.
Consult your doctor before doing anything & before stopping anything your doctor told you to do...

Related Links...

Transcription of Podcast

Question 1: Does the P-Shot® increase the size much and with or without the penis pump?

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.

Starting Point

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.

Nutrition & Growth

In addition to starting cell mass, other factors affecting growth include nutrition.

Poisons to Growth

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.

Method of Preparing & Injecting

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.

You can find a certified provider here (click)<—

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?

What’s Possible with the Priapus Shot® Procedure?

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).

Does it “work” every time? Can you guarantee results?

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.

Some simple things to ask include the following:

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?

Absolutely not.

Would he look like Arnold if he never used anabolic steroids?

Absolutely not!

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.

Back to penis growth and a second question.

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.

Physical techniques using the hands or traction, do they work?

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).

Pump Ideas

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.

Follow the guidelines here (click)<—.

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.

Summary

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,

Charles Runels, MD
888-920-5311

 

 

 

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