P-Shot® & Male Enhancement

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P-Shot® · LiSWT · Male Enhancement · CMA Licensed Provider

The Most Clinically Comprehensive Male Sexual Wellness Program in Ann Arbor.

The P-Shot® (Priapus Shot®) delivers concentrated platelet-rich plasma directly into erectile tissue, stimulating new blood vessel formation, nerve regeneration, and sustained tissue remodeling. Paired with Low-Intensity Shockwave Therapy, the combination produces IIEF improvement of 8.2 in published meta-analysis, more than double either treatment alone. Arbour Longevity is a CMA-licensed P-Shot® provider. Gandhi Bhattarai is the only triple-certified clinician in SE Michigan performing this program within a complete hormonal and functional medicine framework.

The Arbour Longevity Male Enhancement Sequence: Four Steps, One Program

Each step is clinically independent, you can begin at any point. The full sequence produces outcomes that no single treatment achieves alone.

01

Foundation

Hormone Optimization

Testosterone, estradiol, thyroid, metabolic panel. Hormonal optimization before PRP creates a tissue environment that responds maximally to growth factors. The most important step most patients skip.

02

Core Program

P-Shot® + LiSWT

PRP regenerates erectile tissue from within. LiSWT restores vascular function by stimulating neovascularization. Published combination IIEF improvement: 8.2, the highest reported for any non-surgical intervention.

03

Enhancement

Botox Application

Off-label penile Botox relaxes smooth muscle to improve arterial inflow and reduce venous leakage, addressing the hemodynamic component of ED that PRP and LiSWT don't target directly. Disclosed at consultation.

04

Augmentation

Filler Enhancement

Dermal filler for penile girth enhancement: a distinct aesthetic goal from ED treatment. Assessed separately. Requires specific anatomy, realistic expectations, and thorough consent. Not appropriate for all patients.

Regulatory disclosure: The use of Botox and dermal fillers for penile enhancement is off-label. PT-141 in men is off-label. These uses are assessed by a licensed, board-certified clinician and discussed in full at consultation. All clinical decisions are individualized.

P-Shot® · CMA Licensed Provider

Priapus Shot®: Complete Overview

"You’ve tried the medication. It works, technically. But you want to understand why this started in the first place, not just manage it on a schedule."

The P-Shot® delivers concentrated platelet-rich plasma, drawn from your own blood, processed to 5–8× normal platelet concentration, directly into the corpus cavernosum and the head of the penis. The growth factors released (VEGF, PDGF, TGF-β, EGF) initiate a cascade: new capillary formation, nerve fiber regeneration, smooth muscle remodeling, and collagen production within the tissue that drives erectile function.

The mechanism is regenerative, not symptomatic. A PDE5 inhibitor asks dysfunctional tissue to perform better temporarily. The P-Shot asks that tissue to rebuild. Results develop progressively over 8–12 weeks as the biological response completes. For optimal outcomes, Arbour Longevity uses a series of up to 3 treatments, spaced 4–6 weeks apart, as taught in CMA training. Annual or biannual maintenance treatments sustain and build on the initial series result.

Series of up to 3 sessions · Annual maintenance thereafter

Indicated for: ED (vasculogenic, diabetic-related, post-prostatectomy), Peyronie's disease, penile sensitivity loss, performance optimization in hormonally healthy men.

Published Clinical Evidence: P-Shot® / PRP for ED

2024 PLOS One meta-analysis (12 controlled trials, 991 patients): PRP group demonstrated significantly better IIEF scores vs. control (SMD = 0.59, 95% CI 0.34–0.84). RR = 1.94 for achieving minimal clinically important difference. Poulios et al. double-blind RCT (J Sex Med, 2021): PRP outperformed placebo at 6-month follow-up. 2024 systematic review (World J Urology, 1,099 patients): small to moderate benefits, mild and transient side effects, no major adverse events. P-Shot® for Peyronie's (2023 cohort): mean curvature reduction of 16–17°, pain decrease (VAS −34–39%), IIEF improvement +50–61%.

Supporting Clinical Research

What to Expect: P-Shot® Protocol

Preparation

Topical numbing cream applied. Local penile nerve block administered. Blood drawn from arm.

Processing

Blood centrifuged to 5–8× platelet concentration. FDA-approved separation system. 30 minutes.

Injection

PRP injected into corpus cavernosum and glans. Comfortable with nerve block. 5–10 minutes.

Recovery

Resume normal activity same day. Sexual activity after 48 hours. Full response at 8–12 weeks.

LiSWT · Low-Intensity Shockwave Therapy · Vasculogenic ED

Low-Intensity Shockwave Therapy

"If ED has a vascular component, and it does in most men over 40, LiSWT is the only non-surgical treatment that addresses the underlying mechanism rather than compensating for it."

LiSWT delivers focused low-energy acoustic waves to the penile tissue, mechanically stimulating angiogenic growth factors and initiating neovascularization within the corpus cavernosum. The result: new capillary formation, improved arterial inflow, and restored endothelial function. The mechanism is identical to how LiSWT is used to stimulate bone and tendon healing, applied to vascular tissue.

A 2024 long-term randomized sham-controlled trial demonstrated statistically significant IIEF improvement at both 1 and 2 years post-treatment, the most durable non-surgical ED data published to date. The combination with P-Shot® produces the highest published improvement in erectile function of any non-surgical protocol: IIEF mean difference of 8.2 vs. 3.4 for LiSWT alone and 3.2 for PRP alone.

6 Sessions · Twice Weekly · 3 Weeks · Re-treat annually

LiSWT + PRP Combination: The Highest-Evidence Protocol

SMSNA 2024 Systematic Review (16 studies, 907 patients): LiSWT alone IIEF mean difference 3.4 (p significant). PRP alone: 3.2. PRP + LiSWT combination: 8.2, more than double either treatment alone. Cochrane Review 2025 (21 RCTs, 1,357 participants): LiSWT showed statistically significant improvement in erectile function at short and long term. 2024 long-term RCT: significant IIEF improvement sustained at 2 years with peak effect at 12 months.

"I came in thinking I'd get a shot and that would be it. Gandhi sat with me for an hour. Looked at my labs, asked about my sleep, my stress, my medication. By the time we actually talked about the P-Shot, I understood exactly why everything else had stopped working. The program changed things in a way that nothing else had."
P-Shot® + LiSWT + Hormone Optimization · Arbour Longevity Male Sexual Wellness Program

Peyronie's Disease: A Specific P-Shot® Indication

Peyronie's Disease: Non-Surgical PRP Approach

Peyronie's disease, fibrotic scar tissue (plaque) in the tunica albuginea causing painful curvature and erectile impairment, has historically required surgical intervention or repeated collagenase injections for meaningful correction.

PRP offers a non-surgical alternative with meaningful published evidence. A 2023 prospective cohort study reported mean curvature reduction of 16–17 degrees, pain during intercourse decreased by 34–39% (VAS), and IIEF improvement of 50–61% following a PRP series. A 2025 large-cohort study (Dachille et al.) confirmed that PRP intra-plaque injections rapidly reduce penile curvature and improve sexual function.

Arbour Longevity's approach: PRP series (2–3 treatments spaced 4–6 weeks) combined with hormonal optimization and, where appropriate, LiSWT to support the tissue remodeling response. Most appropriate for stable Peyronie's, active-phase disease requires assessment before treatment.

Peyronie's Disease Evidence

2023 Prospective Cohort (Zugail et al.): n=54 patients, stable PD. PRP + percutaneous needle tunneling + vacuum device. Mean curvature reduction: 16.88°–17.27°. Pain (VAS): −34% to −39%. IIEF improvement: +50% to +61%.
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2025 Large-Cohort Study (Dachille et al., World J Urology): PRP intra-plaque injections rapidly reduced penile curvature and improved sexual function. Confirmed as viable non-surgical first-line intervention in stable Peyronie's.

Questions Patients Ask: Answered Honestly

Nothing Here is Embarrassing.

how long will the process take?

Estimated 40minutes to 1 hour

P-Shot® · LiSWT · Male Enhancement · Ann Arbor

The Consultation is Private. The Results Are long-term.

Your clinician will assess your hormonal status, vascular health, and sexual function history before recommending any program. Most male sexual dysfunction has multiple contributing factors, the consultation identifies which ones apply to you, and designs the sequence accordingly. No judgment. No pressure. Complete confidentiality.

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Thursday-Monday, 10am-7pm. Closed Tuesday and Wednesday. · By Appointment Only