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...
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.
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.
IMPORTANT: The natural progression of Peyronie's Disease is that it gets worse with time. In other words, if you have Peyronie's disease and you do nothing, it often worsens with time.
If you look at the research, though most of the people treated with Priapus Shot® methods got better, some did not get better and some got worse. The fact that most got better and some got worse does NOT mean conclusively that the procedure made them worse since the disease usually gets worse when left untreated. Sometimes the Priapus Shot® just does not work and so the disease progresses. We wish it worked every time in every person --but it does not.
If your Peyronie's disease gets worse, after any treatment, most likely it got worse because you have Peyronie's and that's what Peyronie's disease does...the procedure did not work for you. But, your doctor didn't give you Peyronie's disease and most likely he/she did not make you worse--the disease did.
On the other hand, no procedure is without risk and it could be that there are risks to the Priapus Shot® that are unknown to us and/or that occur more frequently than we suspect. You always have the option to not be treated at all or to choose another treatment. However, surgery and Xiaflex have their own risks. Here's the possibilities with Xiaflex (click to read)<--
Dr. Ronald Virag showed that PRP works better and with fewer side effects that Xiaflex (and with less serious side effects), but in the end THERE IS NO PERFECT PROCEDURE.
Still, we think that the Priapus Shot® is worth trying before going to more other methods (one of the risks of the Priapus Shot® can be that you get a better/harder erection).
If you do choose to do the Priapus Shot®--after discussion with your physician--we recommend you use the following protocol to increase the chances of your success (click)<--
Cellular Medicine Association
Brave Man Tells His Story about Treatment of Peyronie's Disease with the Priapus Shot® [P-Shot®] Procedure
*Results May Vary*
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.
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.
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.
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].
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.
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 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.
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.
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.
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.
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
Read the research about treating men with lichen sclerosus<=-=
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Cellular Medicine Association