The question that more and more patients are asking me
“Doctor, I’ve taken Viagra, Cialis… it only half works. Can we really fix things properly?” This is a question I hear more and more in consultations.
For a long time, the options were limited: optimizing medications, offering intracavernosal injections, or, in the most advanced cases, considering a penile implant. Today, there is an additional approach: P-Shot (PRP) .
The P-Shot is an injection of platelet-rich plasma (PRP) into the corpora cavernosa of the penis. The principle is to inject platelet-rich plasma directly into the erectile tissue to stimulate its regeneration.
No chemical drugs. No implants. Your own biology, redirected towards repair . It’s a technique I practice regularly, with concrete results but also limitations that I always explain clearly.
In this article, I give you a complete overview: what PRP can really bring, and in what cases.
Understanding why erectile tissue degrades
What I call endothelial dysfunction
When we talk about erectile dysfunction, we often think of something psychological, or a simple problem with blood circulation. This is partly true, but there is an underestimated dimension: the quality of the cavernous tissue itself .
The cavernous tissue, or erectile tissue, of the penis is composed of smooth muscle cells capable of expanding to accommodate blood during an erection. These cells need two things to function: a sufficient blood supply via the cavernous arteries, and the ability to produce nitric oxide (NO) — a molecule essential for triggering and maintaining rigidity.
When this tissue deteriorates, it gradually loses both of these abilities. Erections become less firm, less long-lasting, and less responsive to stimulation. And PDE-5 inhibitors—such as Viagra and Cialis—which act on the nitric oxide (NO) mechanism, become less effective because the tissue they act on is itself damaged .
In what cases can PRP actually help?
Here are the most frequent situations where I recommend PRP:
| Underlying cause: | What is happening in the tissues? | Can PRP help? |
|---|---|---|
| Poorly controlled diabetes. | Progressive degradation of the cavernous endothelium. | Yes — regeneration of damaged tissue. |
| Chronic smoking: | Vasoconstriction, loss of NO production. | Yes — with associated smoking cessation |
| Prostate surgery (prostatectomy) | Injury to the erectile nerves, penile devascularization | Yes — as post-operative reinforcement |
| Pelvic radiotherapy. | Vascular fibrosis, reduced arterial flow. | Partial — depending on the extent of the damage. |
| Testosterone deficiency (long-term) | Progressive atrophy of the cavernous tissue | Yes — combined with hormonal therapy |
| Peyronie’s disease: | Fibrous plaques, painful curvature. | Yes — as a first-line treatment or adjunct. |
| Cardiovascular diseases | Generalized endothelial dysfunction | Yes — associated with background therapy |
The common thread among all these patients is that their medications are ineffective, or no longer work at all. This isn’t because the medication is unsuitable, but because the tissue it’s meant to act on is too damaged to respond . This is where regenerative medicine becomes truly meaningful.
PRP: How your own blood becomes a treatment
Principle of regenerative medicine
Platelet-rich plasma is not new to medicine. It has been used for years in dermatology to regenerate skin, in rheumatology to treat joints, and in plastic surgery to improve scar quality. What we do in urology is apply this same principle to a specific tissue: the cavernous tissue of the penis .
Blood platelets are not only used for clotting — they also carry growth factors and tissue repair signals. When they are concentrated and injected into a damaged area, a local biological environment conducive to regeneration is created.
The PRP preparation procedure
It all starts with a simple blood test — performed in the office, before the injection session. Here’s what happens next:
- Patient blood sample — a specially designed tube to isolate the different phases of blood
- Centrifuging the tube — red and white blood cells sink to the bottom, while plasma and platelets concentrate at the surface
- PRP extraction — the platelet-rich golden layer is collected, ready to be injected
- Targeted injection into the corpora cavernosa — preceded by local anesthesia, with application of a soft tourniquet at the base of the penis to keep the PRP in contact with the tissue for as long as possible
- Use of a post-injection penile pump — to maximize the diffusion of PRP throughout the cavernous tissue
Session duration: 30 to 45 minutes
Anesthesia: Topical cream + light local anesthetic
Hospitalization: None — procedure performed in the office
Number of sessions: 2 to 3 injections spaced approximately 1 month apart
Renewal frequency: Annual cycle or according to clinical progress
For which patients and in which situations?
Erectile dysfunction of tissue origin
This is the main indication for P-Shot in my practice. The patients who benefit the most are those whose erectile dysfunction is linked to a degradation of the cavernous tissue — diabetes, smoking, prostate surgery, radiotherapy, cardiovascular diseases.
The P-Shot does not cure severe erectile dysfunction overnight. However, over 2 to 3 sessions spaced one month apart, it can improve tissue quality to the point where medications regain their effectiveness—or spontaneous erections reappear at a level satisfactory to the patient.
Results observed after 2 to 3 injections:
- improvement of erectile function
- best response to IPDE-5
- improved sensitivity
Delivery time: 4 to 8 weeks .
Lapeyronie's disease
Peyronie’s disease is a condition in which fibrous plaques form in the erectile tissue, causing a curvature of the penis, sometimes painful during erection. It affects approximately 3 to 9% of men and is often underdiagnosed.
PRP is one of the options I offer for treating this condition, in particular:
- As a first-line treatment for mild to moderate forms, to reduce inflammation and slow the progression of fibrosis
- In addition to other treatments (collagenase injections, shock waves) to optimize results
- Post-surgical use to improve the quality of healing after surgery on the curvature
The growth factors in PRP work on fibrosis by stimulating repair cells that can gradually break down abnormal collagen deposits. It’s not a miracle cure —advanced plaques often require a combined approach. But it’s a natural, low-risk option that I regularly recommend as a first-line treatment.
Decreased sensitivity and libido
Beyond erections in the strict sense, some patients consult me for decreased penile sensitivity—often linked to tissue aging, post-surgical complications, or mild neuropathy. PRP can improve the quality of local nerve endings, and some patients report enhanced sensitivity and more intense pleasure after a course of injections.
Libido, on the other hand, is more often hormonal or psychological in origin—and PRP doesn’t directly affect these factors. If a decreased libido is present, I always check the hormonal levels (testosterone, TSH) before recommending appropriate treatment.
Post-operative strengthening after prostate surgery
This is a situation I’m dealing with more and more. After a radical prostatectomy, the erectile nerves are often damaged—even when the surgery was performed robotically with nerve preservation. PRP, used post-operatively in the months following the procedure, can accelerate erectile recovery by stimulating the regeneration of nerve fibers and cavernous tissue.
This is an indication where early treatment is crucial: the sooner treatment begins after surgery, the better the response . I systematically discuss this with my prostatectomized patients during their post-operative follow-up.
The truth about the level of evidence: neither miracle nor imposture
I have to be honest with you about this — because it’s a question every well-informed patient eventually asks me: “Doctor, is the P-Shot really validated?”
Level of evidence: progressing (not yet in official recommendations).
PRP shows positive clinical results, but the protocols are not yet standardized (dose, frequency, injection site).
This lack of standardization does not mean that PRP does not work . It means that we are at the beginning of an era — as we were with the early uses of Viagra before the doses were perfectly calibrated.
What I observe in my practice, what my urologist colleagues who use PRP observe in theirs, and what the literature published in journals like Translational Andrology and Urology and Sexual Medicine Reviews is beginning to document: PRP improves erectile function in selected patients . The results are real. They are simply not yet standardized enough to be included in official guidelines.
My position: I offer the P-Shot to patients for whom the indication is clear, after explaining to them exactly where the research stands. Nothing more, nothing less. I’m not selling a miracle. I’m offering a real option, with a growing level of evidence, to patients who have often exhausted conventional alternatives.
A treatment that isn’t yet recommended isn’t automatically a bad treatment. It’s often a treatment ahead of its time. PRP is in that position today. And studies are coming in.
P-Shot vs. conventional medications: two different approaches
The most common misconception I encounter among my patients is that P-Shot is a direct alternative to Viagra or Cialis. This isn’t entirely accurate—because they don’t work on the same level.
Two different logics: symptom vs regeneration .
| criteria | (PDE5 inhibitors / ICDs) | P-Shot (PRP) |
|---|---|---|
| Mode of action | : Facilitates the on-time erectile response | ; Regenerates deep cavernous tissue |
| Duration of effect | : Occasional (a few hours) | Gradual over 2–6 months after the cycle |
| Disease-modifying treatment? | No — symptomatic | treatment. Yes — targets the underlying tissue cause. |
| Does it require taking a pill? | Yes — before each sexual encounter. | No — cumulative effect on tissues. |
| Effectiveness if tissues are damaged: | Limited or nonexistent. | Targets the tissue problem directly. |
| Invasiveness | Tablet or self-injection | Office-based medical injection |
| Side effects: | Headache, flushing, hypotension. | Minimal (local puncture, rare hematoma). |
| Peyronie’s disease | No | Yes — recognized indication |
| Level of evidence: | Very high (official recommendations) | Improving — not yet in the recommendations |
* P-Shot can also be used in combination with PDE-5 inhibitors to improve their efficacy in resistant patients.
In practice, what I often suggest for patients with erectile dysfunction and degraded cavernous tissue is to start with a P-Shot cycle to improve tissue quality, then assess whether medication becomes sufficient again. For some patients, the two combine naturally.
Who is the P-Shot for? The right profiles
The indications I encounter during consultations
- Mild to moderate erectile dysfunction — medications are partially effective, the tissue is degraded but not fibrotic
- Resistance to PDE-5 inhibitors (Viagra, Cialis) — P-Shot can rehabilitate tissue and make the medications effective again
- Peyronie’s disease — fibrous plaques, painful curvature, as a first-line or adjunct treatment
- Post-prostatectomy — strengthening erectile recovery after prostate surgery
- Decreased sensitivity due to aging or minor surgical sequelae
- Desire for a natural approach — without exogenous chemicals, using one’s own blood
- Regular follow-up is desired — the patient is motivated and able to complete a cycle of 2 to 3 monthly injections.
Cases where I don't specify the P-Shot
- Severe erectile dysfunction with highly fibrosed tissue — PRP cannot regenerate irreparably damaged tissue. A penile implant would be more suitable.
- Unrealistic expectations — a patient expecting an immediate result or one equivalent to a PDE5 inhibitor after a single session
- Uncontrolled coagulation disorder — contraindication to blood collection and injection
- Active infection in the area or ongoing fever
- Taking certain anticoagulants — to be evaluated on a case-by-case basis with the cardiologist if necessary
The P-Shot is not for everyone. But for the right profiles — men with degraded erectile tissue, mild to moderate dysfunction, and a real motivation to follow the protocol — it is an option that I defend and will continue to offer.
FAQ: Your questions about the P-Shot (penile PRP)
How much does a P-Shot cycle cost?
A course of 2 to 3 injections typically costs between €700 and €1,500 in total, depending on the practitioner and the number of sessions. Each individual injection costs on average €300 to €600 . This procedure is not covered by French national health insurance (Assurance Maladie) — it is a regenerative medicine approach not yet included in official reimbursement schedules. A detailed quote will be provided during your consultation.
How many sessions are needed to see results?
I recommend a cycle of 2 to 3 injections spaced approximately one month apart . Results are not immediate—they appear gradually, generally 4 to 8 weeks after the start of the cycle. Some patients notice improvement as early as the second injection. The cycle can be repeated annually to maintain and consolidate the effects.
Is it painful?
The injection into the corpora cavernosa is performed after application of an anesthetic cream and light local anesthesia. Discomfort is generally well tolerated. Slight tenderness and sometimes a small hematoma at the injection site are possible—transient and resolving within 24 to 48 hours .
Can P-Shot replace Viagra or Cialis?
Not directly—the two don’t work in the same way. PDE5 inhibitors facilitate a temporary erectile response. PRP aims to regenerate deep, long-term corpora cavernosa tissue. In some patients, P-Shot can improve the tissue enough for medications to become effective again. In others, the two are used together. It’s not a direct replacement— it’s a different treatment approach .
Is the P-Shot effective for Peyronie's disease?
Yes—that’s one of my regular recommendations. PRP can reduce inflammation in the fibrous plaques and slow the progression of the curvature, particularly in mild to moderate cases or in the active phase. For significant curvatures, it’s often combined with other treatments such as collagenase injections or shockwave therapy. Each situation is assessed individually during a consultation.
Is the P-Shot truly scientifically validated?
That’s the honest question — and I’m answering it honestly. P-Shot is not yet in official recommendations for erectile dysfunction, because the protocols (doses, frequencies, injection site) are not yet sufficiently standardized. But that doesn’t mean it doesn’t work. The scientific literature published in specialized journals shows positive results. We are at the beginning of an era — the evidence is mounting. I offer it to selected patients, after informing them of this context, within the framework of rigorous medical practice.
Can P-Shot be combined with other treatments?
Absolutely. The P-Shot combines very well with low-intensity shockwave therapy—another regenerative technique I offer for vascular erectile dysfunction. It can also be combined with PDE5 inhibitors or intracavernosal injections of alprostadil to optimize the overall response. In post-prostatectomy patients, it is often integrated into a broader erectile rehabilitation protocol.
After the P-Shot, should one abstain from sexual relations?
I generally recommend avoiding sexual intercourse for 48 to 72 hours after each injection to allow the PRP to work locally without mechanical interference. The use of a penile pump may be recommended daily in the weeks following your cycle to optimize the diffusion of growth factors into the tissue. These specific instructions will be provided to you during your consultation.
Can the P-Shot improve performance in a man who does not have erectile problems?
In theory, growth factors act on any cavernous tissue—including healthy tissue. Some patients without documented erectile dysfunction request a P-Shot to improve the quality and duration of their erections, or their sensitivity. I receive these requests openly, but I approach the consultation with caution: if erectile function is already good, the marginal benefit of PRP is difficult to guarantee. I prefer to identify whether there is a real tissue component before proposing the treatment.
Key takeaways
The P-Shot is a treatment I recommend because I believe it’s beneficial—not because it’s in all the guidelines. Regenerative medicine is the future of treating erectile dysfunction of tissue origin. And we’re already there, even if the literature is taking time to catch up with clinical practice.
For patients who have exhausted conventional medications, who suffer from Peyronie’s disease, who are recovering from prostate surgery and want to regain a satisfactory erectile life — the P-Shot is a real, natural, low-risk option , and one that I gladly integrate into a comprehensive therapeutic strategy.
For those seeking an immediate and dramatic result after just one session — that is not what I offer, and honestly, that is not what this treatment promises.
The principle is simple: use your own biology to repair tissue .
Make an appointment with Dr. Beley — Urology Practice Paris Opéra
Tel. +33 1 42 68 83 30 | Address: 82 Boulevard de Courcelles, Paris 17th arrondissement | Email: contact@beleyurologie.fr
Medical sources and references
Matz EL et al. (2018) — Safety and feasibility of platelet rich fibrin matrix injections for treatment of common urologic conditions. Investig Clin Urol
https://www.icurology.org/
Epifanova MV et al. (2020) — Platelet-rich plasma therapy for male sexual dysfunction. World J Mens Health
https://wjmh.org/
Masterson TA et al. (2022) — PRP for Peyronie’s disease and erectile dysfunction — review. Translational Andrology and Urology
https://tau.amegroups.org/
Sexual Medicine Reviews — Review of available evidence on the P-Shot and erectile dysfunction
https://www.smr.jsexmed.org/
French Society of Urology (SFU) — Recommendations on the management of erectile dysfunction
https://www.urofrance.org/
European Association of Urology (EAU) — Guidelines on Sexual and Reproductive Health 2024
https://uroweb.org/