E-Shot (platelet-rich plasma, PRP) Clinical Evidence

Clinical governance statement

All treatments undertaken by MansMatters (Shockwave Clinics Ltd) are subject to clinical review before they are introduced into practice and at regular intervals thereafter. This review considers the safety profile of each intervention, including contraindications and adverse effects as specified in the manufacturer's instructions for use or the Summary of Product Characteristics; the regulatory status of each medical device and medicinal product; the position of current UK and European clinical guidance, including the European Association of Urology (EAU), the National Institute for Health and Care Excellence (NICE) and the British Association of Urological Surgeons (BAUS); the qualifications and scope of practice of the treating clinicians; the stage and severity of the condition being treated; and the requirements for informed consent. Each patient is assessed individually, and treatment is offered only where it is clinically appropriate.

The basis of clinical evidence

Clinical evidence is derived from several sources, which carry different weight. Systematic reviews and meta-analyses pool the results of multiple studies and provide the highest level of evidence. Randomised controlled trials, including sham-controlled trials, compare a treatment against a control group under defined conditions. Prospective and retrospective cohort studies, published in peer-reviewed journals, describe outcomes in defined groups of patients over time, and the replication of results by independent research groups in different countries strengthens confidence in a finding. Laboratory and mechanistic studies explain how a treatment is thought to act. In-clinic observational studies and structured outcome audits record the results achieved in routine practice and contribute to the developing evidence base, particularly for newer and combined treatments. Long-term follow-up establishes the durability of results and the safety of a treatment over time.

The evidence relevant to this treatment is summarised below. All citations are hyperlinked to the original source.

Is it safe?

The E-Shot uses your own blood, which is prepared into platelet-rich plasma (PRP) in a sealed, CE-marked kit, so the risk of an allergic reaction is very low. A 2024 review of 17 studies (1,099 men) (Asmundo et al. 2024) found that side effects were minor and short-lived, mainly bruising and mild discomfort where the injection was given. In our own study of 20 men, whose treatment included PRP injections, there were no serious side effects. It isn't suitable if you have a blood or platelet disorder, an active infection or cancer; men taking blood-thinning medication are assessed individually. Injections are given by our registered clinicians.

What the evidence shows

PRP has been studied for both Peyronie's disease and erectile dysfunction. A 2024 review of 17 studies (1,099 men) (Asmundo et al. 2024) found that in Peyronie's disease, PRP reduced curvature by an average of around 16 to 17 degrees (about 40%), reduced pain during intercourse by a third or more, and improved erectile function. In erectile dysfunction, randomised trials found PRP performed better than placebo for up to six months. A second 2024 review (Costantini Mesquita et al. 2024) reported reduced curvature and plaque size and improved quality of life, with a favourable safety profile. In our own study of 20 men, PRP was part of our PD360 combined programme, which reduced curvature by 50% on average. Results vary between studies and between men, and researchers continue to refine how PRP is prepared and given.

Guidelines and regulation

European and international guidance recognises PRP as a promising, developing treatment for Peyronie's disease and erectile dysfunction, and recommends further high-quality research (EAU guidelines; ICSM 2024). Your PRP is prepared from your own blood, at the time of treatment, in a sealed CE-marked kit, and is given by registered clinicians in a clinic registered with the Care Quality Commission. We record outcomes for every patient so that we can add to the evidence.

Independent research

PRP for Peyronie's disease and erectile dysfunction has been studied by independent university teams in several countries. These include a placebo-controlled trial at the University of Miami in the United States (Ledesma et al. 2024), a systematic review by researchers in Italy and Denmark (Asmundo et al. 2024), and a review from Brazil (Costantini Mesquita et al. 2024). Our own study of PD360, which includes PRP, was carried out at our clinic with input from a researcher at King's College London. It was awarded first place at [conference name, year] and is currently under peer review.

How PRP compares

In published studies of Peyronie's disease, intralesional PRP reduced curvature by a mean of approximately 16 to 17 degrees (Asmundo et al. 2024). This compares with an average of 11.7 degrees (17.2 degrees among men who improved) reported with penile traction therapy in a randomised trial (Ziegelmann et al. 2019). In line with international recommendations favouring combined treatment (ICSM 2024), PRP is used alongside other treatments, including within our PD360 programme.

How PRP is thought to work

PRP is an autologous concentrate of platelets, prepared from the patient's own blood. At MansMatters, the PRP undergoes an enhanced two-stage preparation process: high-speed centrifugation to concentrate the platelets, followed by photoactivation designed to increase the release of growth factors. When injected into the plaque, the platelets release growth factors and other signalling proteins. These are thought to stimulate local tissue repair, improve blood supply and modulate the inflammatory and fibrotic processes involved in Peyronie's disease, supporting remodelling of the affected tunica albuginea (Asmundo et al. 2024; Costantini Mesquita et al. 2024).

Long-term results and our experience

Published studies of PRP in Peyronie's disease have reported outcomes over follow-up periods of up to 12 months (Asmundo et al. 2024). PRP has been part of our clinical practice since 2021. It forms part of our PD360 programme, offered since early 2025, in which patients are being followed up at 12 months so that longer-term outcomes can be reported.

Who is most likely to benefit

PRP may be considered for men with Peyronie's disease in either the active or stable phase, usually as part of a combined treatment programme rather than on its own. In our PD360 study, men aged 33 to 65 with curvature of 40 to 70 degrees improved in both phases, with 19 of the 20 men seeing a reduction in curvature. Suitability is assessed individually at consultation, taking into account the phase and severity of the condition, plaque characteristics and erectile function. PRP is not suitable for men with the conditions listed under "Is it safe?". Men with severe deformity, or whose erectile function makes intercourse difficult, may be referred to a specialist urologist for further assessment.

Before your treatment

Before treatment, your clinician will assess your suitability, explain what the E-Shot involves and the current evidence, and answer any questions. This information is given verbally at consultation, and you will be asked to give your consent before treatment begins. You should be well hydrated on the day of treatment, as this helps with the blood draw. A blood sample is taken at the start of each appointment, and the PRP is prepared and given during the same visit.