| Category Name | Content |
| Name | P-Shot (Priapus Shot) |
| Uses | Injection of Platelet-Rich Plasma (PRP) into the penile tissue to enhance erectile function, improve circulation, increase sensitivity, and assist with Peyronie's disease. |
| Route Of Administration | Intracavernosal and peripenile PRP injection using PRP derived from the patient’s own blood. |
| Frequency Of Use | Typically performed once, with follow-up treatments every 6-12 months as needed. |
| Concentration(s) | PRP concentration varies based on patient’s platelet count and centrifugation process: - **4-6x baseline platelet concentration preferred** |
| Maximum Dosage (Day, Wk) | One treatment per session; PRP volume per injection site varies based on patient anatomy and treatment plan. |
| Contraindications | Active penile infections, history of priapism, uncontrolled diabetes, active sexually transmitted infections (STIs), clotting disorders, low platelet count, use of anticoagulant therapy, or hypersensitivity to local anesthetics. |
| Possible Side Effects | Mild discomfort, swelling, bruising, minor bleeding at the injection site, temporary sensitivity, rare risk of infection or allergic reaction. |
| Compatibility With Other Treatments/Drugs | Safe to combine with ED medications like sildenafil or tadalafil. Avoid recent filler or neurotoxin injections in the treatment area within 2 weeks. |
| Allergies | Assess for hypersensitivity to lidocaine or other anesthetic agents used during the procedure. |
| Administration Time | 30-45 minutes per session, including PRP preparation and numbing time. |
| Dosing/Settings | Standard dosing protocol: - **Total PRP Volume**: 6-10 mL - **Injection Sites**: - **Corpus cavernosum (shaft of the penis)**: 3-6 mL - **Glans penis (head of the penis, if treating sensitivity issues)**: 1-2 mL - **Plaque areas (if treating Peyronie’s disease)**: 1-2 mL |
| Test Spot Requirement | Not required; however, first-time patients should start with a conservative injection volume to assess response. |
| Pre-Treatment Guidelines | - Ensure patient is well-hydrated before blood draw for optimal PRP yield. - Avoid NSAIDs or anticoagulants for 5-7 days before treatment. - Perform a penile exam to assess vascular health and exclude active infections. - Discuss realistic expectations and obtain informed consent. |
| Provider Clearance Guidelines | - Ensure the patient meets all clearance criteria before treatment. - If the patient has a history of erectile dysfunction (ED), Peyronie’s disease, or cardiovascular conditions, consider referral to a urologist prior to treatment. - Document all clearance decisions in the patient’s medical record. |
| Pre-Treatment Screening Workflow | - Does the patient have active STIs or penile infections? (If YES, delay treatment until resolved) - Is the patient on blood thinners? (If YES, consult before proceeding) - Does the patient have a history of priapism? (If YES, proceed with caution) - Has the patient had recent penile surgery or implants? (If YES, obtain clearance from a urologist) |
| What To Do If Adverse Reaction Occurs | - **Pain or prolonged swelling**: Apply cool compress and recommend topical lidocaine. - **Persistent bleeding at injection site**: Apply firm pressure for 5-10 minutes. - **Infection (rare)**: If suspected, swab for culture and start empirical antibiotic therapy. - **Allergic reaction (to anesthetic or PRP preparation, rare)**: Discontinue treatment and provide appropriate medical intervention. |
| Clinic Implementation Guidelines | - Confirm all consents are signed before treatment. - Ensure aseptic technique during PRP preparation and injection. - Use proper blood draw and centrifugation technique to maximize PRP quality. - Conduct post-treatment follow-up within 4-6 weeks. |
| Photographic Documentation Protocol | - Not required but may be included if baseline assessments are part of the treatment protocol. - Store patient-reported outcome measures securely in the medical record. |
| Post-Treatment Care | - Avoid sexual activity and vigorous exercise for 24-48 hours post-treatment. - Hydrate well to support tissue healing. - Mild swelling and sensitivity may persist for up to 48 hours. - Follow-up treatments should be scheduled based on patient response and provider recommendations. |
| Additional Documentation Requirements | - Signed informed consent detailing risks, benefits, and post-care instructions. - Treatment log including PRP preparation details, injection sites, and patient response. - Post-treatment care instructions provided and documented. |