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The Science · Clinical Evidence · Honest Assessment
What the Evidence Actually Shows.
Sexual wellness PRP treatments exist in a space where patient enthusiasm exceeds the rigor of the published evidence, and where some providers overstate efficacy while others dismiss the treatments entirely. Arbour Longevity presents the evidence accurately: what is known, what is promising, and where more research is needed. Clinical honesty is the foundation of patient trust.
Published Clinical Evidence: Complete Reference
Study / Source
Condition
Key Finding
Protocol
Evidence Level
Huang et al. (PLOS One, 2024)
Meta-analysis
Erectile Dysfunction
12 controlled trials (991 pts) + 11 single-arm (377 pts). PRP vs control: SMD = 0.59 (95% CI 0.34–0.84). RR = 1.94 for MCID achievement. 80% willing to continue treatment.
2 sessions · 1-month interval · intracavernosal
Meta-analysis · Level 1 · Evidence inconclusive per AUA but promising
Poulios et al. (J Sex Med, 2021)
Double-blind RCT
Mild–Moderate ED
n=60. PRP outperformed placebo at 6-month follow-up. First double-blind, randomized, placebo-controlled trial for PRP in ED. FDA-approved separation system used.
10mL PRP · 2 sessions · n=30 PRP / 30 placebo
Level 1 RCT · Moderate quality
SMSNA 2024 Network Meta-Analysis
16 studies · 907 patients
ED · Comparative
LiSWT alone: IIEF difference 3.4. PRP alone: 3.2. PRP + LiSWT combination: 8.2, more than double either treatment alone. Highest published improvement for any non-surgical ED protocol.
LiSWT 6 sessions + PRP combination
Network meta-analysis · SMSNA 2024 presentation
Lange et al. (Transl Androl Urol, 2024)
Long-term RCT
ED · LiSWT Durability
Statistically significant IIEF improvement at 1 and 2 years post-treatment. Peak effect at 12 months. Results sustained at 24 months. First long-term durability data for LiSWT.
LiSWT · Twice weekly · 3 weeks · n=30 RCT
Level 1 RCT · Long-term follow-up
Zugail et al. (2023 Prospective Cohort)
Peyronie's Disease
n=54. Mean curvature reduction: 16.88°–17.27°. Pain (VAS): −34% to −39%. IIEF improvement: +50% to +61%.
PRP + needle tunneling + vacuum device
Prospective cohort · Level 2
Dachille et al. (World J Urology, 2025)
Peyronie's Disease
Large-cohort study. PRP intra-plaque injections rapidly reduced penile curvature and improved sexual function. Confirmed as viable non-surgical intervention.
PRP intra-plaque · Multiple sessions
Large prospective cohort · 2025
O-Shot Pilot (Brazil, n=68, 2016–17)
Female Sexual Dysfunction
94% patient satisfaction. Improvements in lubrication, arousal, libido, dyspareunia, and anorgasmia. SUI improvement in 90%+ of cases with urinary complaints.
2 sessions · 2 months apart
Non-randomized pilot · Level 3 · Encouraging
Mahmoud et al. (2021)
Female Sexual Dysfunction
Orgasm scores more than doubled after O-Shot treatment. Improvements in FSFI domains.
O-Shot protocol · n=~50
Observational · Level 3
Systematic Review (PMC, 2023)
FSD + SUI
Promising results across included studies but no clear RCT evidence established. More rigorous trials needed. Safety profile favorable across all included studies.
Systematic review · PRISMA
Level 1 systematic review · Inconclusive
PT-141 Phase IIb Trial (Bremelanotide)
HSDD Women / ED Men
FDA approved for HSDD in premenopausal women 2019. Phase IIb in diabetic ED: significant IIEF improvement. Co-administration with sildenafil shows synergistic effect greater than either alone.
Subcutaneous · 45 min pre-activity · 1.75mg
FDA-approved indication (women) · Off-label (men)
Candidacy: Who These Treatments Are and Are Not Appropriate For
Clinical Honesty About Candidacy
Appropriate candidates for P-Shot® / LiSWT
✓
Men with mild to moderate vasculogenic erectile dysfunction
✓
Men with ED who want to reduce or eliminate dependence on PDE5 inhibitors
✓
Peyronie's disease, stable phase, curvature less than 60°
✓
Post-prostatectomy ED, with appropriate expectations regarding recovery timeline
✓
Men seeking performance optimization within hormonally healthy baseline
Appropriate candidates for O-Shot®
✓
Women with reduced arousal, orgasmic difficulty, or decreased sensitivity
✓
Women with stress urinary incontinence, mild to moderate
✓
Post-childbirth tissue changes affecting sexual function
✓
Perimenopausal or postmenopausal women (ideally with concurrent hormonal optimization)
✓
Women with lichen sclerosus, emerging evidence for PRP
Contraindications and clinical cautions
×
Active blood disorders, platelet dysfunction, or anticoagulation therapy, as PRP requires normal platelet function
×
Active infection at the injection site, defer until resolved
×
Platelet count below normal range, as PRP efficacy requires adequate platelet concentration
×
PT-141: uncontrolled hypertension or cardiovascular disease, due to transient BP increase of 6/3 mmHg; not appropriate in high-risk cardiac patients
×
Severe Peyronie's disease with curvature greater than 60° or active phase, where surgical or collagenase consultation may be more appropriate first
×
Severe ED with neurogenic etiology, as vascular treatments produce limited results and the underlying neurological cause should be addressed
×
Dyspareunia with structural etiology (vaginismus, anatomical), as O-Shot alone is insufficient and pelvic floor assessment is required
×
Active malignancy, as PRP stimulates growth factors and is not appropriate without oncology clearance
Clinical Evidence · Sexual Wellness · Ann Arbor
Personalized Care Grounded in Clinical Expertise.
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