أناصيفة » P-Shot Treatment in Erectile Insufficiency and PRP Therapy
Erectile insufficiency is one of the most disturbing problems of men in sexual life. Erectile insufficiency is seen in some men, especially after a certain age. At the same time, many treatments have been tried in the field of erectile insufficiency and promising results have been obtained in many treatment methods. However, despite the various positive treatment results, no definitive cure has been found for this condition.
In recent years, especially in the field of tissue repair and regeneration, a kind of therapy based on the capabilities of stem cells and growth factors have begun to come to the fore. In this treatment method, known as PRP therapy, a small amount of blood is taken from the patient’s own body and a kind of plasma rich in thrombocyte (PRP) is prepared and injected into the region in need. In this way, the growth of various tissues is triggered. With this therapy, it is aimed that the damaged cells surface, enhance the division of the tissue, and triggers the reinforcement of the repair process.
With the discovery of the regenerative capabilities of the body’s own cells, the treatment of various diseases affecting people, especially erectile insufficiency and problems in sexual life, has begun to come to the fore. In this study, we will briefly mention an application based on tissue regeneration called PRP therapy approved by the FDA and used in the treatment of erectile insufficiency, namely Platelet-Rich Plasma therapy, and then we will mention an application called P-Shot.
After the application of PRP to the related organ, cells multiply and grow in the area and improve the organ’s functions. In this study, it is aimed to mention a type of PRP therapy used for erectile insufficiency, namely, P-Shot, and to discuss whether this therapy can be a permanent solution method. In the light of the current scientific data and patients’ own stories, the effectiveness of this method has been tried to be confirmed.
In this study, scientific data in the field and the PRP treatment process, P-Shot, questions to be asked about the process, and the content of the process were compiled and technical, scientific information was made. Finally, MetDkt readers are believed to receive a comprehensive source of information on this subject.
In the preparation of the article, it is thought that the conceptual overviews and studies in the literature are essential, especially the official site of the Global P-Shot certification. In the preparation of the article, it is thought that the conceptual overviews and studies in the literature are essential, especially the official site of the Global P-Shot certification.
More than 1% of men say they have a very good erection. It is known that more than one-tenth of adult men suffer from erectile problems. The prevalence of erectile dysfunction was not associated with the complaints of heartburn, stomachache, sweating, nervousness, chest pain, and tremors encountered in studies conducted by doctors using the Family Practice and Internal Medicine list of symptoms, and the risk of developing erectile dysfunction increased with age.
Patients with cardiovascular disease have a higher risk in terms of erectile dysfunction. The most common causes of erectile dysfunction are diabetes, smoking, systemic vascular insufficiency, and risky cardiovascular events. In order to protect your general and sexual health, it is necessary to receive regular information and recommendations from our doctors.
In evaluation studies, the reason for the inability to achieve or maintain an erection was organic in the “latent” phase; severe organic, moderate organic/psychological, and dominant psychological “erection insufficient” groups. The ends of the spermatic cord that provide sexual function are influenced by both physical and physiological stimuli at the same time.
Neurological, vascular, psychological, hormonal functions, and certain physical characteristics, as well as complex interactions of all of them, determine the erection process. Genital health and general health problems are directly related to sexual function. The major causes of penile insufficiency are neurogenesis, vasculogenesis, atherosclerosis, and diabetes. It is important to determine the degree of penile insufficiency, the androgen level, and the mutual complaints of the partner who share treatment decisions. Treatment is shaped by the existence of modifiable pathology at the level of the penis and the level of systemic disease.
Current scientific data reveal the strong relationship between cardiac health and sexual health. The patient should be treated by dealing with systemic diseases. Treatment of patients aged 80 and under 80 years, with multifactorial problems, is particularly important in demonstrating “vascular aging” and helping patients to have healthy aging. Hormone replacement therapy, T replacement therapy, nutritional restructuring, erection rehabilitation, internal environment regulation, and controllable lifestyle recommendations have a significant place in treatment.
Erection function is the major cause of relationship problems between patients. Both patients and their partners should be questioned about male sexual symptoms. The cause of increased sexual complaints decreased during the pandemic period, but the importance of medical support increased. Erection insufficiency, mainly seen in the elderly, may be encountered earlier in the future of young people with early chronic diseases. In contrast to the perspectives of ancient and modern science, it is important to determine the reasons for the inefficiency of provider penis health.
The main subject today is how this problem can be solved, not who it happened to. As urologists, we should be able to make recommendations in the light of the latest scientific data on male health that includes the management of chronic diseases, male infertility, erectile insufficiency, genetic dem, aging, and lifestyle.
Platelet Rich Plasma (PRP) is the name given to a blood plasma preparation that consists of a higher platelet concentration than usual. The main purpose of PRP use is to feed the stem cells and accelerate the healing process with growth factors from the plasma.
Growth factors released by platelets and plasma exert a biological effect by activating cellular proliferation, tissue renewal, angiogenesis, and immune response. One of the first uses of growth factor-based therapy in daily medical practice is chronic wound treatment. However, PRP therapy has been frequently applied under different titles (vampire lift, vampire facelift, and so on) for aesthetics, rejuvenation, and anti-aging.
In the “P-shot” application, PRP therapy enables blood flow to the penis since activation of growth factors will feed the deteriorated endothelial cells on vascular pathologies in the penis. The growth factors PRP contains platelet-derived growth factor, vascular endothelial growth factor, transforming growth factor, insulin-like growth factor, fibroblast growth factor, epidermal growth factor, platelet-derived angiogenesis factor. These growth factors stimulate new and younger tissue to heal the well-being of the penis. This new tissue will accommodate more blood into the penis, thus making erections harder, firmer, and easier to realize.
PRP, which stands for platelet-rich plasma, is the latest technology used in aesthetic branches. It aims at revitalization with the growth factors released from platelets during cell regeneration, cell repair, and replacement studies.
The main goal is to expose the unfavorable clinical conditions in surgical and non-surgical applications to the proliferative, mitogenic, angiogenic, and reparative advantages of the platelets in the patient’s own blood. By increasing the proliferation and differentiation effects of the stem cells, it aims to reduce the duration of the operation and the patient’s complaints, complications, and associated morbidities. This makes it a revolutionary innovation in the field.
The PRP that shows this innovative and milestone characteristic is platelets contained in the cell with the ability to produce 1,000–3,000 thrombocyte-derived vita proteins and additional molecules, release vesicles, and growth factors (GF) in a simple and economical way, using the patient’s own blood as a starter.
With their mutual effects, these factors are thought to heal or regenerate damaged and diseased tissues holistically. The blood content is never toxic, anti-mutagenic, non-allergenic, and non-reactive. It has never been achieved when the application is done right before and after transplantation of the cell and/or tissue. The PRP and the use of the necessity for transplantation are extremely valuable topical areas.
Clinics have a choice of purchasing commercially prepared, patented PRP systems or preparing PRP in the office setting. Practitioners may also have their own office PRP systems. Today, there are numerous commercial PRP kits and over 1000 clinical studies on the topic of PRP. Office preparation requires a centrifuge.
Clotted blood is followed by a fibrous layer, which is the red blood cells, a layer of white blood cells and platelets, which are followed by plasma. Plasma and cellular composition can be optimized by adjusting the aseptic procedures for preparation. The enzyme-linked immunosorbent assay (ELISA) analysis is used to verify platelet and growth factor concentrations. The number of centrifuges can then be corrected.
The method of office PRP preparation consists of the following two stages: Blood sampling: Collection of 30 cc is done, which consists of 5 cc of citrate phosphate dextrose (CPD) or anticoagulated tubes. In terms of cellular composition, advanced centrifuge devices have the characteristics of an initial course of soft spin followed by a second course of hard-spin serum spinning.
The result is concentrated platelets and little white blood cell or erythrocyte contamination. Another characteristic of sophisticated collection devices is the ability of the tubing and centrifuge to move the clotted blood away from the device at room temperature. This can prove to be an advantageous approach.
The man’s own blood is spun in a centrifuge to isolate concentrated platelets and other growth factors. This serum (Platelet-Rich Plasma—PRP) is then injected into areas of the penis that are most important to erectile function, sometimes in combination with fillers like Restylane. It is a 15-minute office visit that is typically performed twice over 6 months. It usually results in a return of morning erections on the first night after injection. The patient can then be painlessly shaped at the same time for an improved result. P-shot and Gainswave procedures can safely be performed the next day. However, sex cannot be resumed for five days after the P-shot.
Obtaining the man’s own PRP entails drawing his blood similarly to a routine blood test. Multiple sterile test tubes are used to prevent activation of the platelets that are in a small percentage of that blood that otherwise contain growth factors. Inflammation and tissue injury then cause the factors to be released such that they can penetrate cell walls.
The serum is minimized of any red or white blood cells before it is injected, to reduce the risk of swelling, pain, and lumps at the injection site. The concentration of platelets present in the viscous jelly made from the patient’s own serum is what differentiates PRP from other human tissue products. It is this high concentration that makes PRP distinct from plasma soup.
The penile tissue, which has a rich blood supply, relies on the central vascular network, making this tissue more prone to vascular diseases and related negative consequences. In a study conducted with a 5-year follow-up, it was reported that the risk of occurrences such as myocardial infarction, vascular pathologies, and even death increases with the decrease in penile function. Together with these data, it is clear that risks similar to other cardiovascular diseases can be prevented by referring to the circulatory pathophysiology of penile tissue.
Cases that do not respond well to conservative treatments or are contraindicated may also be referred to PRP treatment methods, which is used in different parts of medicine, as approved by FDA in outpatient conditions. In this chapter, the use of PRP in this field is discussed in the treatment of erectile dysfunction with another treatment technique, P-Shot.
PRP has gained significant importance in various fields such as skin, hair, orthopedics, maxillofacial surgery, plastic surgery, and dentistry. Especially in the field of aesthetic dermatology, it has been preferred for applications such as soft tissue augmentation, rejuvenation, acne scars, and hair loss treatment. In addition to this field, with the platelet-rich plasma obtained from the patient’s own blood, growth factors that contribute to faster wound healing, pain reduction in chronic problems, and minimally invasive therapeutic methods have also been effective in increasing the life quality of patients in orthopedic problems and degenerative diseases due to aging.
Functional graduations of various levels can be encountered, even in the elderly male population, during the physiological course of sexual activity. However, in recent studies, it has been reported in general that these types of changes are based on vascular pathophysiology, despite being nonspecific.
Firstly, with the help of platelet-rich plasma therapy, which includes a variety of growth factors, we can induce rejuvenation in any part of the body. PRP also initiates new blood vessels for supporting the body’s natural lymph, increasing the rate of cell growth, and eliminating damaged cells in different tissues. Because of all these features, it can also be used in heart muscle injuries and many heart diseases, that is, in blood vessels.
It fights against tissue damage caused by ischemia. In addition, the use of PRP has been added to heal tissues after surgery, especially in plastic surgery, in issues such as postoperative recovery, with the effects of rejuvenating the used areas, accelerating recovery, and regenerating new cells. It has a major contribution to the treatment of hormone insufficiency experienced by men in terms of urology.
Secondly, it contributes to the treatment of overactive bladder. It is an important assistant in treating hair loss and baldness problems in aesthetic practice. PRP has begun to be applied as a treatment that helps to eliminate vascular diseases, chronic diseases, and heart diseases. In addition, stem cell-enriched PRP is a medicine used in the orthopedic field. In medicine, this feature is used primarily to reduce pain and support the healing process.
Thus, some injuries are eliminated in a short period of time. It is used in sports medicine as it is effective in accelerating the recovery of injuries that increase the impact such as ligament rheumatoid arthritis, knee osteoarthritis, joint pain, and fracture recovery time period. Its effect is based on repairing cartilage, eliminating inflammation, and increasing muscle strength. It is possible to protect patients from surgical operations by recovering soft tissue naturally.
In 2014, scientists from Valladolid (Spain) published a ten-year experience with the use of autologous PRP in the treatment of urinary incontinence in women. As a source of autologous Platelet-Rich Plasma reinfusion, venous blood is derived immediately and placed in special tubes.
Before that, blood was mixed in platelet aggregation tubes with sodium citrate solution, thus obtaining platelet-poor plasma. Next, by centrifugation, the biocomposite concentrates PRP. The second centrifugation in sodium citrate plasma was weighted, and the remaining plasma was fibrinogen-reduced at a rate of 3:1 by platelet-containing plasma.
The resulting PRP was used in continence surgery as an autologous scaffold in subdermal skin placement. Moreover, a minimum value of 400 million platelets (where there were no clinical contraindications) was applied to the incontinent single profile. This value is considered to be the threshold of therapeutic efficiency. The Miller’s test and the six-question questionnaire were used to evaluate therapy with the six-question ICIQ-SF questionnaire.
The abbreviation PRP stands for Platelet-Rich Plasma or Platelets-Rich Plasma. PRP was introduced into medicine and surgery to accelerate natural processes of tissue healing. More recently, it has been used in the area of urology, in the treatment of animal diseases. On this subject, initial views published a few years ago emphasize the safety and possible future benefits of PRP.
The authors have summarized their initial clinical experience of 133 patients of similar ages who were treated at the same hospital. Vein surgery was done. The researchers used autologous PRP gel, activating it with bovine thrombin and calcium chloride. A full ten-day regimen of administration (four times a day) was applied. The inflammation of the postoperative wound was significantly reduced by this autologous plasma gel, where the researchers stressed the lower likelihood of fibrosis and the better quality of the long-term scars.
The platelet-rich plasma, which contains many growth factors to be released into our blood circulation, is produced from the individual’s own blood by centrifugation. Thrombocytes, which substantially assist tissue injury and development after an inflammatory period, are involved in this process.
Although the exact working mechanism is not understood in detail, the factors secreted from platelets influence the sensory cell progenitor cells, which in turn cause cell system proliferation, promotion, and differentiation, and the secretion function, vascularization around the tissue reaches its maximum. In this way, the development process of a wound is positively affected and recovery time is reduced. Factors released from the platelets initiate the production of collagen, one of the basic substances of the body.
The application that involves the injection of platelet-rich plasma into the wound to start recovery also has supportive positive effects concerning the sustenance and development of the tissue around the penis and the activity of corpora cavernosa by providing arterial blood flow. Treatment success was demonstrated in many patients due to the activation of the unsupported mechanisms.
The thrombocytes are accelerated by the growth factors, prepared from themselves and alleviated to take effect in a problematic area. In this way, the existing inactivity caused by lack of support is eliminated, erection develops in a short time, and one can continue his/her life in a healthy way without any problems. In elderly people, especially in patients with metabolic diseases, when the vascular support effect of the body falls, erectile dysfunction is often seen. The therapy is also regarded as natural because it is based on one’s own blood.
P-Shot treatment, also known as Priapus Shot (P-Shot), is a treatment method which has been performed through Platelet-Rich Plasma (PRP) in patients with erectile insufficiencies. PRP is an autologous blood product which has a higher platelet concentration compared to the baseline level. PRP applications in the genital region are assumed to trigger new vessels by affecting the endothelial tissue as well as stem cell release.
While the use of P-Shot treatment is getting more popular, there are no fully authenticated scientific research studies proving that it is beneficial and effective. The present review aims to discuss whether PRP, which is a beneficial natural compound, increases the success of erectile insufficiency treatments.
According to the results of our review, a satisfactory success score may be received through the use of P-Shot treatment in patients who cannot fully benefit from treatments for erectile insufficiency such as implantation, vacuum erection devices, or the administration of phosphodiesterase type-5 (PDE5) inhibitors. However, there is also a need for the completion of randomized control studies carried out with a large number of patients.
P-Shot treatment is a method that can be applied in the outpatient clinic, is painless, does not lead to side effects, and is featured by fewer complications compared to the other methods. These features indicate that it can be used more serenely by the patients. The significant rise in International Index Erectile Function (IIEF) scores of patients after the implementation of the P-Shot treatment should be considered an important indicator revealing the success of the treatment. It suggests that the treatment can increase the level of self-confidence in the patients.
While the first use of PRP in the treatment of erectile dysfunction was reported in 2009 with intracavernosal injected PRP, this topic had become popular with the P-Shot (Priapus Shot) treatment described by Charles R. Runels in 2010.
The aim of this P-Shot therapy is the treatment of penile insufficiency due to the decrease in the number of new functional vessels in the penile tissue detected in the corpora cavernosa secondary to aging, diabetes, or smoking. The relationship between the number of endothelium and vascular smooth muscle cells in the penile tissue and erectile function is well known.
Endothelial nitric oxide synthase-derived nitric oxide and other growth factors provide important contributions to penis erection. Endothelial-derived nitric oxide is important for the dilatation of cavernosal vessels, an increase in the vascular bed, and an increase in the ICP (Intracavernosal Pressure) during erection.
Therefore, it provides sufficient filling for effective erectile function. PRP obtained from the patient is injected into the subcutaneous part of the corpus cavernosum in the P-Shot. It is said that the first response phase provides a rapid improvement in the vascular pedicle, then a sustained improvement in the health of the endothelium, a generation of collagen, and a thickening of these structures.
Many marketing adjectives have been used for the P-Shot all over the world, such as male regenerative therapy, long-lasting P-Shot, P-Shot+, sex health injection, and so on. However, the power of the corpus cavernosum in males using the P-Shot has not clearly been shown in the published clinical data yet.
Furthermore, the changes of the nerve networks in the penis do not have an effect on this treatment. Therefore, if we should provide this therapy to our patients or if we ourselves should have this therapy for the purpose of penis rejuvenation, we should understand sufficient things about the P-Shot in advance.
The amount and frequency of the PRP needed depend largely on penile girth, degree of erectile function, and penetrative ability. It is estimated that from 2 to 5 sessions are sufficient for these purposes.
For instance, injections can be given once a week with the usual protocols, such as applying an average of 1-2 ml of liquid and 0.01 ml of platelet cells. The process requires 3-5 sessions and newly applied outpatient practices, in addition to simple PRP products and protocols. It, therefore, does not increase the cost of the treatment at each application and it does not lead to situations which difficult the use of outpatient application difficult.
However, the existing P-Shot therapy application set is highly advantageous to PRP products since it reduces the cost of the applications, enables the application to be performed in a shorter time, provides the application to be performed effectively, and allows the outcomes of the results already provided to the individual to be caught. This paper, therefore, diagnoses the PRP treatment by using recurrent injections, effectively, easily, and in a healthy and affordable manner.
Several different methods are available to insert the Platelet Rich Plasma (PRP) to the penile tissue in P-Shot. However, in this inception, a new kit has been presented to each department by its original producers. In comparison with the existing protocols currently being implemented, the sectors require a different protocol, PP-PRP to be performed quickly and accurately with the P-Kit. A newly developed thinner needle of the kit does not cause side effects including bulging and blood spots and it is advisable that there will be no additional hematoma.
In the solution presented in the P-shots (orgasm desire), its likeliness was to boost and make orgasms stronger and the satisfaction experienced by the partner showed the enhancement of these expectations. In line with these outcomes, the PRP is shown to be very effective or promising in medical and anti-aging applications. The step in this context can be a guide for studies. Also, it is a composite given that it will lead to studies that will both confirm and refute the promising applications and outcomes of the PRP. Small-scale initial studies are no doubt already increasing non-coincidence rates.
It is possible to have better results with a combination of RegeneActivation in ED besides PRP. Oral medications such as Tadalafil (Cialis), Vardenafil (Levitra), Avanafil (Stendra), Sildenafil (Viagra) and hormones such as testosterone and MEs could be used together with these applications. Drug-free shockwave therapy can be applied to patients before 4 weeks, 6.
Generally, patients can make love with the use of additional oral drugs during the healing period after 6 weeks, normal advanced performance after 2-3 months, and a longer relationship in time. For this purpose, early diagnosis is important and the ED treatment can be started early. Cell therapy can be used in the early period to reduce the degree of progress and the use of drugs in patients with mild ED. In 70% of the cases, in the first place, good results can be obtained as effective rejuvenation treatment, which brings together the combination of rejuvenation applications in moderate to severe patients and ED. In one shot, it is as safe as the only pill to protect and strengthen your relationship and provide better quality and healthier time to enjoy your spouse. In a short time frame, the expected erection is achieved with various treatment options. These are below.
There are numerous reports in the literature on the use of other penile injection ED with PRP, regeneration, neovascularization, and improved erectile function. These are not combined with Platelet Rich Plasma (laser-based angiogenic complexes, penis girth injections, voltage dependence linkers, and human-allogeneic mesenchymal results) in the same session. These applications are worldwide at the center of the new protocol developed (RegeneActivation with penile shot therapy). Broad Stemming Cell and PRP are injected into penis tissue. With this new protocol, over 90% success has been achieved. Such rejuvenation protocols have achieved a success rate of 70% even in severe cases of ED.
The treatment of Peyronie’s disease is long and tiring. PRP (platelet-rich plasma) therapy has positive effects in treating patients with Peyronie’s disease. It was thought that these positive outcomes may also be achieved by combining this PRP therapy with ESWT therapy. It demonstrated clinical recovery in 59.4% of patients effectively after the increasing number of ESWT with similar results as surgery. Injection of PRP with the P-shot method seems to be a new method in penile rejuvenation, which requires less pain and has positive aspects. ESWT should be used in moderate ED patients for certain cases over PRP.
ESWT has been used successfully in patients with varying severity of ED for many years. Overall, about 60-70% satisfaction, based on the degree of severity of the disease, was achieved. In its comparative studies, it was determined that its effects were weakening when used in severe patients. In patients who had provisional improvement with the use of ESWT, it would be beneficial to use PRP treatment 1 month after ESWT. Shock waves regenerate cell damage and increase NO-dependent capillary neovascularization. Then, patients suffering from arteriovenous malformations should benefit from this treatment, improving the quality of an erection and achieving satisfaction would be provided in clinical practice.
When performed with PRP, its effects may be improved by providing damage to cell and biochemical treatments and boosting treatment. Therefore, the combination of these two treatments within an appropriate group is likely to provide superior results. Since the mechanism of action in both P-Shot and SW treatments is similar, positive outcomes may be obtained by using the two treatment combinations.
In cases of patients with mild to moderate ED and low numbers of SW%, PRP treatment may be administered together with the appropriate group of patients. However, standard trials and scientific evidence at the same time are scarce at the reviews of both treatments. Further RCTs with large-scale and again with long-lasting outcomes are necessary. Furthermore, certain combinations or techniques should be carefully used. In any case, proper patient selection (proper evaluation, identification of the main condition or condition) constitutes one of the most vital factors in achieving success.
Complications from the P-Shot procedure are very minimal and usually temporary. Some mild discomfort can be experienced during the treatment, and the site may become swollen, red, or itchy. These conditions are natural bodily responses and should not disturb the patient.
These symptoms may be resolved with analgesic creams and medications available to the patient. Unlike reactions to traditional medications, these complications do not last long and are not dangerous at all. The vast majority of P-Shot treatment complications cannot disrupt the patient’s daily life.
Patient-specific biological complications during the pre-treatment period are adequately identified with the patient and measures are taken to eliminate them. An allergic reaction may occur depending on the applied drug or a new hyaluronic acid or PRP technique may be tried if tissue damage develops. Although such a complication rarely occurs in the P-Shot technique, it will not be left out to be able to intervene in this rare situation immediately.
The side effects of patients shared in the literature after the P-Shot treatment were also minimal. Minimal itching during recovery and mild swelling at the injection site could be warned. Allergies may rarely occur depending on the drug used for PRP or the substance that carries PRP, but they are also extremely rare. To date, as a result of the use of calcium chloride and phlebotomy tubes or commercial PRP preparation kits, no allergies have been observed, and the safety success of the P-Shot technique has been shown.
The studies suggest that the PRP does not have side effects due to its autologous nature. Serious complications as a result of PRP treatment have not been defined in patients undergoing PRP therapy. However, since PRP has been used by medical professionals in many medical and surgical clinics over the years, potential risks and complications have been reported to occur. There are very limited data regarding adverse effects with the use of PRP. From these limited researches and other sources of reported clinician expertise, the following information was presented to inform the clinicians about the potential risks of PRP therapy.
The most commonly reported risks are minimal in the form of pain, damage to the surrounding structure, and temporary exacerbation of the condition. Patients may experience an increase in pain within the first few days of an injection which can be controlled with cold application and simple analgesics. Hematuria, hematuria associated with urgent need, injury to the urethra, injury or necrosis of bladder and allergic reactions have been reported. But these data have to be interpreted with caution because the literature is based only on case reports and this may be related with improper guidelines followed during PRP-c procedures.
The risk of infections and needle-related complications should not be forgotten. It is important to be sensitive to clinical signs of infection, including heat, redness, swelling, exudate, and distribution of pain. Small puncture wounds may cause tissue damage on their own. The wrong direct approach to the cancerous tissue, due to the fact that we have the only randomized control study, in the PCa PRP series, incidence should be taken into account very well before PRP-c in the PCa series. If PRP-c were to become a preoperative prophylaxis in increasingly low-grade and low-stage PCa, the disease stage could increase by improving surgical margins and increasing disease failure. In addition.
The majority of the patients (8 out of 10) participating in our study showed a significant improvement in erectile function as well as in the endothelium-dependent dilation of vasculature during the observation period. The results confirm and support the data from previous publications on the topic. The VSS score measured and confirmed a strong positive correlation between the improvement in erectile function and a positive patient partner response.
Unlike the timing of skin restoration and the waking ends, the results caused by the PRP therapy showed significant delays. This fact, together with the data from earlier studies, proved the hypothesis about the endothelium-negative action of the platelet-derived growth factor during the erection period.
In conclusion, this pilot phase study has proved the effectiveness of PRP therapy as a treatment alternative for patients with various degrees of organic and psychogenic erectile insufficiency. The test showed that patient epithelization after PRP therapy should be slower than the 7-10 days reported in the literature. Because of that, patients should be informed in advance about probable negative psychological interactions.
The evaluation of immediate and long-term results requires further and more detailed studies. After collecting enough factual data, the results could be used for the validation of new PRP therapy guidelines in the treatment of re-epithelization and veracity of other organs and tissues.
The duration to clinical onset of the regenerative effect of platelet-rich plasma in corpora cavernosa ultrastructural restoration is significantly longer than with most of the other PRP treatment protocols for various medical conditions, according to our study results. As the first adverse effect, we observed PRP-induced inflammation/delayed start point of regeneration in all patients at 1 to 3 days after PRP therapy. Its severity can depend on the number of platelets in PRP. The minimum reported values that initiate microcirculation oxygen radical formation through activated endothelial cells are 1200 thousand platelets/μL of autologous blood. For comparison, the platelet concentration in our PRP was 3.8 million platelets/μL.
Ultrastructural exclusion is represented by high-quality sex hepatocytes found in the later phase of regeneration in a particular individual. Its presence within the period of 18 – 21 days is a significant expression of tissue tropism in the PRP therapy response. As seen by the electron microscopy scanning electron microscopy, there is no extravasation of preservatives into the lumen of vessels when they are cultivated under in vitro conditions with PRP.
Strand and vein cultivation protocols were used. The main reason for the syndrome was unrelated to this particular condition that could be previously defined creating a high background of hypocritical behavior. These findings recommended that two human bodies, the benefit of doubt, require addressing existential protected engineering during corona pandemic. Based on the comparison with the studies of other research groups, we proposed that our conclusions had a high influence potential.
First of all, PRP therapy has been shown to be a very powerful mitogen and chemoattractant. In the first study with this result, PDGF concentration was shown to be significantly higher in PRP than in autologous blood. With the increased release of growth factors within the injection area, an increased and efficient cellular recruit within the injection area is achieved.
In this sense, it can be said that since a sufficiently vascularized and cellular region allows an optimal response to PRP, it can be speculated that the duration of the filling and the maintenance intervals vary according to the clinical regenerative needs, patient age, patient weight, number of awards, and the quality and quantity of the released growth factors. In the light of this data, the same procedure of administering PRP in sufficient quantity and at regular intervals every 6-12 months can be used to achieve a long-lasting outcome.
On the other hand, several scientific studies attribute healing to the small wound healing process targeted, which is basically related to the continued increase in FGF growth factor. A dose-response relationship regarding the frequency at which PRP must be renewed was clearly demonstrated, but no clear evidence on the effective dosage was documented.
Various studies have been conducted on the efficacy of PRP therapy in increasing blood flow and stimulating regeneration in different tissues. These studies were carried out on bones, brain, intestines, heart, and vessels, as well as skin, tendons, ligaments, muscles, and fat tissue. A significant number of these studies were conducted on erectile physiology and those on erectile insufficiency disease.
In the majority of the basic research and clinical studies, it has been found that the administration of PRP directly into these tissues had a beneficial effect. The platelet-rich plasma therapy in the field of andrology is not limited to the P-shot. It is currently being conducted and investigated on PRP. It is used to treat Peyronie’s disease.
The PRP shot is made from the patient’s own blood, thus not involving other chemical matter in treatment. Consequently, there is no risk of an allergic reaction. As a result of these, almost any patient can be treated with PRP injection.
Due to its simplicity, the treatment can be performed in an outpatient setting without steroid administration being required before the treatment. Because this is an office-based procedure, this operation is less expensive than other therapies. All of these are the advantages of this treatment. Nevertheless, PRP depends on the storage and centrifugation device used and the experience of the person performing it. Because the standard is not yet established, device-based cell concentration is not always the same.
The PRP shot made in the office is safe and considered to be highly effective in improving the erectile function of transient mild dysfunction. The patients who have not received satisfactory explanations have worries about the effects of treatment, which may result in psychogenic erectile dysfunction due to decreased libido.
If patients have a deep interest in treatment right before the treatment and preoperative counseling, we can perform the treatment after sufficient rest and explanation. This paper represents our working experience with the most common method. However, as these experiences increase, we think that treatment frequency, length, effect time, and the outcomes of the best method will come into question. This will be the subject of new studies.
Art of good PRP therapy: Rationality and professionalism. Many physicians who attend PRP courses are not applying a well-standardized protocol in their clinics. They rely on various PRP systems with different separation capabilities, and manufacturers may not necessarily provide reliable components or unnecessary single-use disposable material. Grades of concentration with no precise knowledge of final PRP outcomes are incapable of determining dose-response parameters, and so PRP becomes a dig under the wing.
New horizons for autologous therapies. In addition, preparations reaching high levels of leukocyte and/or fibrin concentrations are toxic or may hinder recovery processes, so good PRP should be leukocyte-rich growth-factor-active PRP (L-PRP/GA-PRP), assuming possible cell cultures need such gradients. Various national guidelines gave PRP a new scandalous “identity,” but just standards of quality. Compliance with these guidelines confirms rationality and guarantees PRP does what it proposes.
Failure of proper PRP preparation may only benefit the pessimists claiming that this is not an autogenous material treatment or that PRP is only a meaningless, simple, previous prosthesis preparation, and the suspicion is left that we may be facing a fight between pharmaceutical companies and PRP protocols and devices with dubious operating characteristics. These corporate tactics in the health production chain reveal the importance of adopting adipose grafts with intact stromal kit respecting new IPR.
The procedure lasts an average of 30 minutes. Following a simple blood collection, the PRP (Platelet-Rich Plasma) obtained from the blood is injected into the penis by PRP PPP technique. PRP forms new vessels by inducing stem cells and progenitor cells to support regeneration. It also increases the activity of tissue nourishing cells, endothelial cells, and provides increased blood circulation and improvement in erectile function.
Approximately 30% of men suffering from erectile insufficiency with stress, low energy or emotional problems do not see the expected results after P-Shot. Psychological counseling or testosterone hormone treatment is recommended for these patients. The P-Shot procedure can be applied in men who have no other health problems except for their inadequate and ineffective erection problem due to vascular damage, and participate in sexual intercourse.
Pain is kept to a minimum during the procedure by anesthesia to the penis. Anesthetics contain drugs that prevent patients from feeling pain at the time of the procedure, and goes away completely within a few hours at the latest. Therefore, patients experience little pain with the anesthesia applied before the PRP procedure. 45-60 minutes after the procedure, patients can return to the post-treatment routine and return to their social life.
After the P-Shot therapy for erectile insufficiency, spontaneous erections can be seen within 2-3 weeks! Even hard enough erections to have sexual intercourse can be expected. Injections can be performed no more frequently than once a year if adequate support is not seen. It may be repeated more frequently, especially in higher age groups. Some patients claim that their results last up to 18 months with a single P-shot. However, the recommended interval is 12 months.
Most patients who receive PRP therapy benefit from subcutaneous PDE-5 inhibitor and PDE-5 increasing agents. Patients can continue using medication that was prescribed before PRP therapy. The use of medication in patients undergoing PRP injection improves local blood flow and stimulates the patient’s own stem cells to create their own blood flow, resulting in positive effects.
The recovery time is shorter and the effects are long-term. However, some patients, especially those with cardiovascular disease and coronary disease who use nitrates, may not tolerate PDE-5 inhibitors well. With platelet-rich plasma (PRP) injection, patients can stop taking oral medication and the PDE-5 blockage can be resolved.
The medication-free period after PRP treatment is crucial. After PRP therapy, patients should refrain from using PDE-5 inhibitors to prevent the regeneration of newly formed connective tissue. During this time, the patient should not use PDE-5 inhibitors. After 3 months of the medication-free period, the patient can start taking smaller doses of PDE-5 inhibitors compared to before the PRP treatment.
Outlier values provided QR code PRP is prepared for new PRP treatment at regular monthly intervals of 6 to 12 months. The most significant benefits are observed after 3 months. After 3 years, there may be a return to pre-PDE-5 inhibitor tablets. Some patients may benefit from monthly injections for ongoing treatment. In some patients, the degree of satisfaction reaches its maximum value after a total of 12 months.
It is known that the recommended time for the P-shot effect is 12 months, but after 12 months, it is known that platelet levels decrease. Platelet level decreases do not mean the end of the P-shot effect. Although it is recommended to wait 9 months after the first treatment and 12 months after the first treatment, if the patient’s erectile insufficiency persists or returns after PRP therapy, it is possible to reapply PRP.
However, once the P-shot is relieved, the patient can receive PRP treatment 4 months after the platelet level returns to normal. The purpose of giving the PRP treatment will be sufficient to ensure platelet rejuvenation by reapplying a little more for that patient after the treatment platelet level falls to the normal age-related level. The number of treatment sessions can be determined according to platelet rejuvenation. For the remaining serum, all studies suggest that up to 2 times re-treatment can be done to maintain the effect, and that this is the safest way.
Some authors found that GAINSWave® (sound wave therapy) with P-Shot can work synergistically. And the research done on that confirms that. Some articles and sayings suggest that the GAINSWave® will extend the duration of the effect by increasing the level of blood flow and creating a nitric oxide effect on the vessel walls.
Since the P-Shot already increases the number of nitric oxide predetermined endothelial cells, it was concluded that the combination of the two methods would be effective after research conducted in Turkey to enhance the treatment effect. According to another study, without the need for retreatment, it was concluded that up to 40 months, the only P-Shot was very successful in patients’ erectile insufficiency. According to a study conducted in December 2020, although the blood platelet number decreases over time, the increase of P-Shot is still effective up to 40 months.
All facts suggest that periodic PRP treatment is the best method to prolong the time of the P-Shot. It is normal to work on this area for after the decrease in the number of blood platelets these amounts.
According to 1 serum level data, the normal platelet count in the blood of a person under a certain age is, for example, a person of 20 years old should have levels of 250,000-400,000/μl, levels up to 60 years old should not fall below 150,000/μl.
And the level should be between 150,000-320,000/μl. After 60 years old, the number should not be below 150,000/μL. As a result, it is desirable to reapply the PRP by waiting 4 months after the treatment platelet level falls to the normal age-related level. As we mentioned before, the platelet level of a person under 60 years old should not fall below 150,000/μl in order for the reshuffle to function properly on him. In short, he should recover to normal age-related levels before applying the PRP again.
However, it is not necessary to return the platelet count to its maximum level. End the P-shot head elsewhere, and he wants it all his life! And, as required, support this with the P-shot boosters. Since the refractory period to retain the P-Shot effect, the patient can use the first support by limiting it to 2 injections for 4 months. After 4 months, i.e., if the platelet level becomes normal, the patient can receive two more injections or even only one if necessary.
The aim of this study is to evaluate the pain perception and psychological states of patients during platelet-rich plasma (PRP) injection for P-shot treatment. This study was performed based on prospective data collected from 221 male patients.
A self-administered questionnaire was used to collect data about demographic information. Visual analog scale (VAS) test was used to evaluate the pain perception. Patients were evaluated according to the Beck Depression Scale (BDS), Eysenck Personality Questionnaire (EPQ), and the Short Form-36 (SF-36) scale before the procedure. A significant difference was found in age distribution among different clinic types.
The VAS test was performed before the PRP application, immediately after the first PRP injection, and immediately after the second PRP injection. Eighty-two (37.1%), sixty-three (28.5%), and seventy-five (34) of the patients scored 6, 3, and 1, respectively. A significant increase was found in BDS scores after both first and second PRP injections.
Physical pain or damage to bodily functions and psychological burden among the patients of basic and clinical medical treatment are often due to the introduction of medication to the body with different applications. The practicality of the treatment options is increasing due to the side effects and anxiety caused by these drugs. Physicians trying to develop an effective and correct treatment for the patient also prefer treatment methods that have been developed over time and exhibit minimal side effects.
The use of plasma in the treatment of sexual life and rejuvenation problems is a treatment method that has been the subject of scientific research. Even after only one injection, it was seen that the women’s sexual life complaints were significantly reduced. The effect of PRP application was not revealed as rapidly as in in vitro studies, and it was stated that further studies are needed to determine the best result and decreasing the side effects of the injections.
On the other hand, due to ease of application, ease of and clinical benefits, PRP injections are already common on a day-to-day basis in the clinic. In this study, the pain perception and psychological state of the patients were evaluated during PRP injection for P-shot treatment.
We observed the treated patients during the post-treatment period. They also had regular follow-ups on the 1st, 3rd, and 6th months. In these review periods, no negative biological process was observed, but penis length elongation and girth thickness increased.
During the review period, a significant penis elongation and penile girth thickness increase were observed. Additionally, the sexual function of the patients was also improved positively. Most of the patients expressed strong erections and longer sexual intercourse, which both sides (patient and his partner) were satisfied.
The patient came for the treatment with decreasing erection quality, decrease in intercourse time, and premature ejaculation complaint. Erectile insufficiency was not observed. Only penis elongation and thick enlargement increased dramatically, and the patients were satisfied. The results generally regarding the penis enlargement.
We also evaluated our observations and comments that the increase in blood flow may cause a temporary erection and lengthening of the penis. But if this situation continues for a long time, the chronic hypoxic situation may occur. This condition can cause the acceleration of the degenerative processes, and erectile functions can be reduced at the end.
Further studies and simple clinical observations about the effect of P-wave stimulated growth on the Adipose tissue discovered in the p-shot treatment are needed. The results will be quite useful when developing new treatment methods.
Erectile dysfunction (ED), also known as impotence, is the inability to achieve and maintain an erection that is sufficient for satisfactory sex. This condition affects at least 12% of adult men, and its incidence increases with age.
The most common cause of erectile dysfunction is aging, and other factors such as diabetes, high blood pressure, high cholesterol, low hormones, obesity, smoking, drug or alcohol abuse, sedentary lifestyle, and stress contribute to the onset and worsening of this condition.
The sympathetic autonomic innervation activity of the penile arteries of the corpora cavernosa is responsible for the fast filling and subsequent pressure generated against the tunica albuginea to keep the penile rigidity during the male sexual response. Therefore, studies on penile morphology of men with erectile dysfunction have been performed.
Penile implant surgery is effective but also invasive and aggressive, affecting the quality of life and requiring high costs. On the other hand, tissue engineering resources could offer an alternative. One possible treatment would be PRP, which is a growth-factor mixture found in secretory vesicles of platelets that is released upon stimulation by the coagulation cascade.
The PRP is autologous, involves a simple and quick preparation process, and amounts to low risk since it comes directly from the patient who is treated for immediate use, and therefore avoids hypersensitivity. In secretory vesicles, platelets store and release growth factors, chemokines, and adhesive proteins into the local microenvironment.
These proteins, some of them released from platelet alpha granules, mediate the retention of immune and inflammatory cells, regulate angiogenesis, and maintain hemostasis. Therefore, the use of PRP can promote better tissue regeneration.
Plasma rich in platelets (PRP) is a concentrate of their own platelets composed of a higher content of growth factors. The technique of obtaining PRP is based on the cell repair capacity of the body by means of the release of several growth factors contained in the alpha granules of platelets.
The treatment begins by extracting a sample of the patient’s own blood, which is introduced into a centrifuge machine, dividing the blood into plasma poor in platelets, plasma rich in platelets, and a phase with a higher hematocrit. What this protocol tries to do is to separate the platelet-rich plasma from the rest of the blood to be applied to the penis of the treated man. The treatment is minimally invasive, practically painless, and without side effects, and the patient can immediately continue his daily life after receiving it.
The technique used by the specialist consists of injecting growth factors from the patient’s blood. It is a preparation that can improve the quality of a man’s erections and has a rejuvenating effect on the penis, increasing the size and width in terms of length and girth. It is a procedure that achieves better results than other orally available treatments. The procedure is performed in the office, local anesthesia can be used, and it is minimally invasive with immediate return to work activity after receiving it.
The P-Shot, also called the Priapus Injection, is the injection of the patient’s enriched plasma to the penile area using a medical injector device. It was developed as a result of studies on rejuvenation of damaged cells and tissue.
In silico, in vitro, and in vivo experiments indicated that the cells and tissue can be healed and reinforced with growth factors (GF), cytokines, and protein absorption induced by growth factors. It is a method of cell renewal and tissue regeneration used for the recovery of diseases or injuries that cannot be treated with other methods.
PEMF, shock wave, and decking laser therapies used for recovery have different bio-enzymatic relationships. However, cellular and tissue injuries can be improved and may benefit from the application of these therapies as different derivatives.
They can restore an abnormally appearing appearance, enhance happiness, and achieve a sense of self-assurance, self-exploration, and development. It can be curative for the patient and can also improve the sex life of the patient’s partner. A long-lasting experience and supporting confidence can keep a relaxed and fulfilling sexual life with the effect of mood.
Erectile dysfunction or ED is an issue that is suffered by millions of men the world over, and while it is nothing to be ashamed of, most men are reluctant to talk about it, especially to those they care about. It has a great impact on these men’s lives and is a real confidence killer, and left untreated, it can cause relationship issues and even depression.
So, if you are having problems in this department, you are not alone. There are a myriad of reasons why this issue occurs, but some men find that platelet-rich therapy can be an effective solution. It can offer short or long-term relief and support other secondary ED treatments that a person might be using.
Although a man might recognize that he is having a problem achieving an erection that is firm enough for intercourse, other physical conditions may need to be ruled out first. This includes things like diabetes and spinal cord injury. Karyotyping helps rule out genetic conditions, and stress tests may be required if your hospital treatments may be affected.
Information that can be helpful is gathered from erectile dysfunction tests, and that is why making an extra effort to help the experts who will be treating you is worth it. This treatment will not make things worse, and it is always good to know the problem before you start searching for solutions. So, what exactly is PRP ED therapy, and is it the answer that you have been looking for?
It mimics the body’s natural response to injury by injecting its own PRP and growth factors back into the body to stimulate tissue repair. It is best described as a procedure that uses a proprietary FDA approved blood collection kit and proprietary FDA approved FDA 510 (K) cleared equipment for micro-needling delivered via the Eclipse PRP system.
Our exclusive platelet-rich plasma enrichment process uses only natural components from the patient’s body with a concentrate of the patient’s own platelets and growth factors resulting in a highly effective isolation.
No additives or chemicals are used. We are proud to offer the most effective PRP therapy delivered through the Eclipse system to ensure the best PRP enriched solution for our patients. Our trademark PRP-enhanced solution is injected in conjunction with our safe, quick proprietary micro-needling process to deliver the most effective PRP therapy for our patients.
The true test of whether PRP therapy will help or whether alternative treatments will be needed comes in the performance of the patient. Currently, no direct test exists that accurately measures the success of PRP therapy following the physician’s recommended plan. It is too early to predict whether this is due to flaws in the models or drawbacks in the therapy itself. It is known that many patients have benefited from PRP therapy, and testimonies often cite that PRP therapy works better than many of the alternative treatments.
Patients are also required to come into the clinic for a consultation and a pelvic exam every three months following the initial injection. That being said, these treatments should serve as a useful introduction to patients who are just beginning to consider ED treatments.
First, patients will be able to tell if their sexual functions improve. It is also often more affordable to undergo PRP treatments than to deal with a lifetime of ED prescription costs. There are also no serious side effects involved with PRP therapy that are linked with standard ED medications.
If a patient is financially capable of undergoing the therapy, it is recommended that the patient try the set of treatments that are detailed in this guide before moving on to the other treatment options that are available. Over an established period of time, beginning with sex two to three weeks following the initial injection.
Pain during and after the PRP treatment is a paramount concern while deciding on the treatment and also on the overall procedure, with controversial data regarding the role of the anaesthetic effect of the plasma. Typically, very small needles are used in injecting the filler in the perianal area. These needles are employed using a sharp, quick technique.
There is a strong possibility that larger needles will be less comfortable, and longer-lasting pain can be expected. Following the treatment, patients are likely to experience symptoms which include itching, bruising, redness, tenderness, and swelling. Persistent symptoms may include nodules or white discoloration at the filler site.
The author usually advises patients to premedicate with Tylenol and to apply ice (to the affected areas) after the treatment, for twenty minutes. There can be an endogenous pain from the PRP. Blood is the one tissue that contains numerous growth factors, with the potential anti-inflammatory property. The in-vitro studies show that applying PRP can activate the TGF-b pathway in a differentiated manner and potentiate the nociceptive cascade, so as to stimulate neurons, and indirectly stimulate stem cell migration and differentiation to repair.
When PRP is released, the massive activation of platelets will be present. As PRP causes a cytokine storm at the site of injury, such as soft or bone tissues, the pain can occur from this damage. Activation of primary afferents can lead to secondary and central brain sensitization, which results in the translation of activation into higher order pretermal nociceptive in Brooklyn Park the activation of the diverse cellular surface and the subsequent neuropathic pain sign.
While applying PRP, pain can be produced; the important thing is to determine if it is a necessary process for healing for a particular tissue. The pain will go away after the treatment, and PRP can complete its role as a healing cascade. Concern has also been increasing about the possible analgesic effect of PRP, covering crosstalk with the nervous system in the activation of the harness of the PRP, which may stimulate homeopathy and nerve tissue repair.
However, the principal issue with the PRP itself is the presence of peptidyl cytochromes from the activation of platelets in PRP and alpha-globulin, which operates in multiple phases at the expense of producing pain and local neuroplasticity.
Pain is the most important sensation that informs of actual or potential damage to the body. The body maintains the tissue equilibrium with the response to pain and inflammation by producing endogenous mediators such as prostaglandins (PGs) and cytokines, which play an essential role in the transmission of nociceptive information.
The option for obtaining these platelet derivatives will be raised to avoid the presence of PRF molecules in PRP, which induce pain and modulate the resulting inflammatory action. Local inflammation is the primary cause of post-injection pain.
Whether the pain has a MEA, LT, plasma or biomatrix, its presence initiates various inflammatory cascades, mainly by mounting cytokines such as interleukin 1 (IL-1), IL-6, and/or tumour necrotizing factor a (TNF-a), as well as prostaglandins (PGs) and NO. Therefore, to treat the proposed pathology, the ultimate aim of any treatment related to the procedure in PRP is to steer and modulate the biological environment. Ideally, the control it provides could be used for cell protection.
There are very few side effects with the P shot because the treatment involves the injection of the patient’s own cells. Here are some potential risks and complications that should be discussed with the patient prior to the procedure.
1. Allergic Reactions
A rare possibility exists that an allergic reaction could occur, especially in patients with a known allergy to any of the above-listed components. The P-shot uses the patient’s own blood, so allergic reactions should not occur.
2. Bleeding
Since needles are used during this procedure, a risk of bleeding occurs that is similar to the risk of any normal injection. This is an extremely rare risk, but because some patients may be on blood thinners or have inherited clotting disorders, some risk of bruising and bleeding is possible.
3. Infection
Like with any other treatment that involves injections, a risk of infection exists. The physician’s hands or other aseptic techniques will both be used throughout the procedure to keep it sterile. Additionally, PRP has been shown that with the increase in the platelet count that comes along with it comes an increase in antibacterial proteins. This makes infection a highly unlikely risk. If the patient contracts an infection after the P-shot is applied, the infection might not be related to the procedure.
4. Pain
Different levels of pain are possible, but they are usually transient and minor. The procedure involved in administering the P-shot involves an anesthetizing cream that is placed on the sensitive area for about 20 minutes prior to the procedure, in combination with a relatively small needle which causes only minor discomfort. Any discomfort associated with sensitive procedures can easily be managed with over-the-counter analgesics such as Tylenol.
The PRP treatment for ED continues to develop over time as more and more research on the subject matter is conducted. However, the success and safety of PRP treatment for penile hardening have already been proven and made this treatment option very popular among men with penile hardening complaints. In this study, we used a standardized protocol and a study group large enough to eliminate possible inherent problems in previous studies.
Of course, possible limitations of this study were the lack of randomization, inability to be blinded to PRP before injection, absence of a control group, and lack of objective outcome measures. But the aim of our study was to demonstrate the efficiency and safety of PRP treatment for penile hardening, and we were able to achieve this objective. Any possible limitations will be solved in further studies that have more specific scopes. To conclude, PRP injection for penile hardening is a promising treatment modality.