P-Shocks vs P-Shot: Evidence, Differences and Risks
Updated: Aug 19
The P-Shot and P-Shocks are not the same treatment. A P-Shot usually means platelet-rich plasma (PRP) injected into penile tissue. P-Shocks is the clinic’s name for a broader, individually planned pathway that may combine assessment, low-intensity shockwave therapy, PRP, a vacuum erection device and established ED treatments.
The key evidence point: shockwave therapy may offer a mild benefit for selected men with vasculogenic ED, while evidence for PRP remains insufficient for routine use. There is no reliable proof that combining them produces an extra synergistic effect.
P-Shocks vs P-Shot at a glance
P-Shot: penile PRP injection prepared from the patient’s own blood.
P-Shocks: a clinic-defined care pathway; the exact components should be stated before consent.
Best-supported use of shockwave: selected men with mild vasculogenic erectile dysfunction, with variable results.
Evidence for PRP in ED: limited; European guidance restricts it to clinical-trial settings.
Evidence in Peyronie’s disease: shockwave may help pain but not curvature or plaque; PRP is not established.
Neither option replaces diagnosis, cardiovascular risk assessment or discussion of proven treatments.
What is the P-Shot?
The P-Shot is a commercial name commonly used for an intracavernosal PRP procedure. A blood sample is centrifuged to concentrate platelets, and the prepared product is injected after local anaesthetic. PRP preparations, platelet concentrations, injection sites and treatment schedules vary between clinics, which makes results difficult to compare.
Because the product comes from the patient’s own blood, allergy risk may be lower than with some manufactured substances, but this does not remove the possibility of pain, bruising, bleeding, infection or a disappointing result.
Read more about the P-Shot procedure, evidence and risks in London.
What does P-Shocks mean?
P-Shocks is not a universally standardised medical procedure. At this clinic, it describes a personalised pathway that can include low-intensity shockwave therapy, PRP, a vacuum erection device, lifestyle and cardiovascular risk management, medicines or other established options when appropriate.
Personalisation should mean selecting only clinically relevant components—not automatically selling every component as a package. The patient should know which elements are established, which are supported only for selected cases and which remain investigational.
What does the evidence show for erectile dysfunction?
Low-intensity shockwave therapy
Research has focused mainly on men with vasculogenic ED. Meta-analyses and guidelines suggest a mild average improvement in erectile-function scores for some selected patients, but protocols vary and the recommendation is weak. Results are less predictable in severe ED, after major nerve injury or when vascular disease is advanced.
See the full evidence summary for shockwave therapy and erectile dysfunction.
PRP injections
Small trials have reported changes in erectile-function scores, but studies differ in PRP preparation, dose, injection technique and follow-up. Current evidence does not establish routine effectiveness, the ideal protocol or durable benefit. European guidance therefore advises PRP only in a clinical-trial setting.
See the evidence review on PRP for erectile dysfunction.
Combining PRP with shockwave therapy
Using two biological or device-based interventions together does not automatically create a greater benefit. Direct evidence for the specific combination is limited, so any proposed advantage should be described as a hypothesis rather than a proven result.
What about Peyronie’s disease?
Peyronie’s disease causes penile plaque and deformity and may also cause pain or ED. Low-intensity shockwave therapy can be considered for pain in selected patients, but studies do not show reliable improvement in curvature or plaque size. Evidence for PRP is too limited to support routine use.
Treatment depends on disease phase, curvature, indentation or hourglass deformity, penile length, erectile function, pain and the effect on intercourse. Options may include observation, traction in selected cases, intralesional treatment, ED therapy or surgery.
Review the patient guide to non-surgical Peyronie’s disease treatment.
Risks and practical differences
PRP injection: pain despite anaesthetic, bruising, bleeding, swelling, infection and uncertain benefit.
Shockwave therapy: discomfort, temporary redness or bruising and lack of meaningful response.
Vacuum device: bruising, discomfort, numbness or injury if pressure and timing are incorrect.
Medicines and supplements: interactions, contraindications and variable evidence; a medication review is essential.
Combined plans: higher total cost and complexity do not necessarily mean greater effectiveness.
Who might consider a consultation?
A consultation may be useful for men with persistent ED, incomplete response to tablets, cardiovascular risk factors, symptoms after prostate or pelvic treatment, or ED alongside Peyronie’s disease. Suitability for any procedure can only be decided after diagnosis and discussion of established alternatives.
Questions to ask before paying for P-Shot or P-Shocks
What diagnosis is being treated, and what evidence supports each proposed component?
Which parts are established care and which are investigational?
What outcome is realistic for someone with my cause and severity of ED?
What are the risks, alternatives, total cost and follow-up arrangements?
Who performs the procedure, and what is their professional registration?
How will lack of improvement or an adverse effect be managed?
Frequently asked questions
Is P-Shocks better than the P-Shot?
That has not been proven. P-Shocks can include a wider assessment and more treatment components, but evidence does not establish that the combination outperforms appropriate standard care or PRP alone.
Can either treatment increase penis size?
Reliable permanent enlargement has not been established. Changes in erection firmness can alter perceived size, but clinics should not promise length or girth gains from PRP or shockwave therapy.
Can P-Shocks straighten Peyronie’s curvature?
Shockwave therapy may help pain but is not recommended to correct curvature or reduce plaque. PRP is also not established for straightening. A deformity-focused assessment is needed.
How many sessions are needed?
There is no universally validated P-Shocks or PRP protocol. The number of sessions should not be fixed before diagnosis, and a longer package does not guarantee a better outcome.
Are these treatments risk-free?
No. PRP is autologous but still requires an injection, and shockwave therapy is a device-based intervention. Risks, uncertainty and aftercare should be discussed before consent.
Assessment before regenerative ED treatment in London
At Holistic Andrology, Dr Fabio Castiglione assesses erectile dysfunction and Peyronie’s disease at 9 Harley Street, London. The purpose is to identify the likely diagnosis, discuss established care first and explain clearly where shockwave therapy or PRP sits within current evidence.
For clinic information or to request an assessment, visit P-Shocks London.
Medical review and evidence
Medically reviewed by Dr Fabio Castiglione, Consultant Urologist and Andrologist. Last reviewed: 19 August 2026.
For erectile dysfunction, low-intensity shockwave therapy has a weak guideline recommendation for selected vasculogenic cases, while PRP remains investigational. For Peyronie’s disease, shockwave may be used for pain but not to improve curvature or plaque.
This article is for general education and is not a diagnosis or individual medical recommendation. A consultation should review medical and sexual history, current medicines, examination findings and tests when clinically indicated.
Clinical sources
European Association of Urology: Management of Erectile Dysfunction
European Association of Urology: Penile Curvature and Peyronie’s Disease
About the author
Dr Fabio Castiglione
Consultant Urologist and Andrologist in London. Holistic Andrology, 9 Harley Street, London W1G 9QY.
GMC reference number: 7541824
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