P-Shot & Penile Rejuvenation in Southlake, TX.

Two procedures, two mechanisms.

The P-Shot delivers concentrated growth factors directly into penile tissue via PRP injection, supporting regeneration of microvasculature and connective tissue over 8 to 12 weeks. Softwave shockwave therapy delivers low-intensity focused acoustic waves that stimulate neoangiogenesis (new microvessel growth) and tissue remodeling across multiple sessions. They work on different mechanisms, which is why the combination tends to outperform either alone.³

Most men come to penile rejuvenation after a partial PDE-5 response, after noticing reduced sensitivity, or after a vascular workup that flagged early atherosclerosis. The P-Shot and Softwave protocol provides a regenerative path before more invasive interventions are considered.

How the P-Shot actually works at the tissue level.

The P-Shot — short for Priapus Shot — is a regenerative medicine procedure derived from the broader category of platelet-rich plasma (PRP) injection therapy. The mechanism is autologous: we draw 30–60 mL of your blood, spin it in a calibrated centrifuge to concentrate the platelet fraction, and inject the resulting growth-factor-rich plasma into specific anatomic targets within the penis under local anesthetic. The growth factors carried by the platelets — PDGF, VEGF, TGF-β, EGF, IGF-1 — trigger angiogenesis (formation of new microvessels), recruit local stem cells, modulate inflammation, and over the following weeks drive a tissue remodeling response.

The clinical effects develop on a predictable timeline. Most patients begin to notice improvement at 3–4 weeks post-procedure: stronger morning erections, more reliable spontaneous erections, improved sensitivity. Peak effect is typically at 3 months, with durable improvement extending to 12–18 months in most cases. Some men do an annual maintenance shot; others do a single shot and never need another. Combining with a Softwave shockwave series during the same window — which we frequently recommend — tends to extend the durability and amplify the magnitude of the response.

What the procedure looks like, step by step

A typical P-Shot appointment runs 60–90 minutes start to finish. We confirm the indication, draw blood from the antecubital vein, and start the centrifuge. While the centrifuge runs (15–20 minutes), we apply a topical anesthetic cream to the injection sites and prepare the local anesthetic injections. Once the PRP is ready, we administer two to three local anesthetic injections at the base and along the shaft to fully numb the area — this is the part patients describe as "pressure" rather than pain. The PRP is then injected at five sites along the shaft and into the glans using a small-gauge needle. Total injection time is under 5 minutes. Most patients drive themselves home immediately afterward.

Recovery is straightforward. Mild soreness or bruising at the injection sites for 24–48 hours is normal — it's the inflammatory response that drives the healing cascade. We ask you to avoid NSAIDs (ibuprofen, naproxen, aspirin) for 7 days before and 14 days after the procedure since anti-inflammatories blunt the cascade that makes PRP work. Acetaminophen is fine. You can have intercourse the same evening if you choose, though most patients wait 24 hours.

What the evidence supports

Strongest evidence: mild-to-moderate vasculogenic erectile dysfunction. Multiple peer-reviewed studies show meaningful improvement in International Index of Erectile Function (IIEF-5) scores, EHS (Erection Hardness Score), and patient-reported satisfaction at 3, 6, and 12 months post-procedure.

Solid evidence: Peyronie's disease (penile curvature and palpable plaques). PRP appears to soften plaques and reduce curvature in a meaningful subset of patients, particularly when combined with traction therapy and shockwave. Best results are in early-stage disease before plaques have fully calcified.

Promising evidence: reduced sensitivity post-prostatectomy, post-radiation ED, and erectile dysfunction in the context of well-controlled diabetes (less effective in advanced or poorly-controlled diabetes due to underlying microvascular disease).

Less suitable: severe end-stage ED with completely fibrotic erectile tissue, severe untreated diabetes, severe peripheral vascular disease — the regenerative substrate has to be present for the growth factors to work on. We will tell you honestly during the consultation if your case falls into this category.

Low-intensity acoustic energy that triggers angiogenesis without injection.

Softwave (low-intensity extracorporeal shockwave therapy, or LiESWT) is the non-invasive cousin of the P-Shot. Instead of an injection, we use a handheld applicator that delivers focused low-intensity acoustic pulses to penile tissue. The mechanical energy of the pulses triggers angiogenesis — new microvessel formation — and disrupts small areas of fibrosis. There are no injections, no needles, no anesthetic required, and no downtime. A typical session takes 15–20 minutes and patients drive themselves immediately afterward.

Standard protocol is 6 sessions over 3 weeks (twice weekly), delivered within the ED and Peyronie's programs. The clinical evidence base for low-intensity shockwave in vasculogenic ED is genuinely strong — published in journals like European Urology, Sexual Medicine Reviews, and the Journal of Sexual Medicine — with multiple meta-analyses supporting its use as a first-line or adjunctive therapy for mild-to-moderate vasculogenic ED.

P-Shot or shockwave — or both?

Patients commonly ask which procedure is better, and the honest answer is that they work through different mechanisms and stack well. Shockwave delivers acoustic energy that mechanically stimulates the existing vascular network. The P-Shot delivers concentrated growth factors that recruit cells to build new tissue. Many of our patients run a 6-session shockwave series over 3 weeks and time a single P-Shot at the midpoint or end of the series. The combined cost is meaningfully less than the sum of the standalone prices, and the outcome data we track in-clinic supports the layered approach.

Who's a good candidate, and what it actually costs.

Best candidates: men with mild-to-moderate vasculogenic ED, men with Peyronie's disease (curvature, palpable plaques), men with reduced sensitivity post-prostatectomy, men with ED in the context of well-controlled cardiovascular risk factors, and men seeking optimization beyond reliance on PDE-5 medication. Many of our patients want to reduce or eliminate daily Cialis or as-needed Viagra; for the right candidate, a P-Shot plus shockwave series can do exactly that.

Less ideal: men on therapeutic anticoagulation (relative contraindication for the P-Shot specifically due to bleeding risk; shockwave is fine), active genital infection, severe end-stage ED with fully fibrotic erectile tissue, men with active malignancy in the pelvic region, and men whose primary issue is purely psychogenic.

Pricing. Penile rejuvenation is offered as three programs: the Erectile Dysfunction program is $1,850 ($1,999 with the Kaplan electric pump), the Peyronie's protocol is $3,999 (P-Shot, 12 SoftWave treatments, and pump), and P-Long enhancement is $1,600 a month for six months ($9,600 total, pump included). Insurance does not cover regenerative procedures of this category; these are elective. HSA and FSA cards are accepted because the procedures qualify as medical expenses under physician treatment plans.

What we won't sell you

A few things commonly marketed in this category that we will not offer or recommend: stem-cell injections for ED (the FDA has issued warning letters; the human evidence base in the consumer-clinic context is weak), penile lengthening procedures by injection (no good evidence and meaningful risk of disfigurement), or "GAINSWave" branded shockwave at premium pricing (it's the same low-intensity shockwave technology as Softwave; brand markup does not improve outcomes). If another clinic has quoted you any of these, we are happy to give you a second opinion before you commit.