The P Shot® and Bocox®

It is almost impossible to turn on the TV and not see advertising for Erectile Dysfunction (ED). ED is now practically a house-hold word. This is not necessarily a bad thing because healthy sexual functioning affects many aspects of our lives: it leads to more joy, creativity, increased confidence, decreased depression and improved overall health. It is not uncommon to occasionally experience difficulty with erections due to fatigue or excess alcohol consumption. However, for some men (about 5% of men in their forties and 15% – 25% of men age 65 or older) the cause of their difficulty is more complex and results in frequent episodes of ED. This can be devastating as it erodes self confidence and sense of virility. It can even contribute to depression and a feeling of hopelessness and loss of manhood. A strong erection is dependent on four factors: brain stimulation (libido), healthy nerve function, good penile circulation and the ability of the veins to ‘trap’ the blood in the penis. All this is taken for granted – until something stops working.

Common causes of ED are:

  • Atherosclerosis (hardening of the arteries)
  • Chronic Illness (such as Diabetes)
  • Peyronies Disease (scar tissue in the penis)
  • Medications (especially cardiac meds)

Current medical treatments include:

  • Oral Medications (Viagra, Cialis or Levitra)
  • Penile Injections of Alprostadil (Caverject)
  • Penile Implant

The P Shot (Priapus Procedure)®.

Priapus is a word of Latin derivation and refers to the Greek god of fertility. The name penis is also based on this word (hence, the term P Shot). This procedure is the brain-child of Dr. Charles Runels and consists of injecting Platelet Rich Plasma into the cavernosum of the penis. Click here for more about PRP Therapy. This simple, safe, painless procedure (the penis is numbed beforehand with a powerful anesthetic cream) only takes about 30 minutes. Following treatment, a Kaplan Penis Pump is used for 10 minutes with twice daily use for a 6 week period thereafter. There is no downtime and sexual relations can be resumed immediately.  Results begin to manifest around 3 weeks.  Full results are appreciated at 3 months and are maintained for about a year. If a second injection is desired, it is done 8 – 10 weeks after the first.

Benefits of the Priapus Procedure:

  • Improved firmness and strength of erection
  • Improved effectiveness of other therapies (such as Viagra)
  • Increased penile sensitivity
  • Increased libido and intensity of orgasm
  • Enlargement (1/2 – 1 inch) of penile girth (first) and length (later) in over 60% of males.


In his continuous pursuit of improving sexual health and function in males, Dr. Runels has developed an additional treatment for ED: Bocox™ or BoPriapus™.  As the name would suggest, this is the unique application of Botox to the penis.  The mechanism of action is twofold:  Botox relaxes the smooth muscle that controls arterial blood flow in the penis. This in turn results in dilation of these vessels and more blood flow equates to stronger erections (similar to the way Cialis and Viagra works).  Secondly, it is thought that Botox causes an increase in parasympathetic nerve tone thusly contributing to increase firmness of the erection.

Bocox™ injections are similar to those used for the P Shot.  A topical numbing cream is applied and when numb, four injections are given. Results of Bocox are seen within a week (although most men say sooner) and are maintained for 3 – 6 months.

Benefits of Bocox™:

  • Increased size of flaccid penis
  • Decreased penile retraction
  • Decreased premature ejaculation

 What one man had to say – 

“Good Morning Dr. Cohen,
It’s been nearly two weeks since I was in for a “Bocox” injection. In my case, veery positive results were seen within the first 24 hours. After the first two days of dramatic improvement, I have seen additional improvements leveling out at the first week. My ability to get and keep an erection, significantly increased sensitivity, increased quality of erections, in nearly any parameter you would want to improve or measure I have seen…nearly miraculous gains! If you would like, I would be happy to provide more detail, but suffice it to say I am extremely pleased and happy with the results. I will be getting another Bocox injection with your approval, when the results begin to fade. This is seriously rolling the clock back for me! I feel like 25 again! Thank you!”   


Bocox™ can be a stand-alone treatment or it can be combined with a P Shot to further potentiate the benefits of each. 

If ED is something you’ve been suffering from or if you’re frustrated with your sex life and would like to increase sexual satisfaction, it may be time to explore the possibilities of a P Shot or Bocox™.