BoPriapus™ (Bocox™) & P-Shot 100™ For ED

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The BoPriapus™ (Bocox™) and P-Shot 100™ procedures

Scientific research regarding BoPriapus™ and P-Shot 100™

Frequently Asked Questions

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The BoPriapus™ (Bocox™) and P-Shot 100™ Procedures

Dr. Charles Runnel invented the P-Shot® procedure ten years ago with much success and with a significant body of medical research supporting the procedure.

The BoPriapus™ (Bocox™) Procedure is a specific method of using Botox® to improve penis health & function.


It has been shown in research to help erectile dysfunction (ED) for some men--even when Viagra & Cialis does not work.
Over the past 6 years, a growing body of research (in animals and people) also supports the effectiveness and safety of injecting the corpus cavernosi of the penis with BOTOX.  In the latest randomized, double-blind, placebo-controlled prospective comparative study, the most effective and longest-lasting dose for improvement of erection firmness was 100 units of BOTOX, in total (50 units into each corpus cavernosi). This dose showed effectiveness up to 6 months with maximal effect at 6 weeks.

The mechanism of action of BOTOX in the penis seems to be partly due to the relaxation of the smooth muscle of the arterioles, resulting in increased blood flow (and even in a small increase in length in one study). This increase in erection firmness by increasing arterial flow is exactly how Viagra and Tri-mix injections work. In two separate studies, the injection of BOTOX was helpful to some men (not all) for whom Viagra and Cialis had quit working.

BOTOX (at doses much higher than 100 units) has been used for 2 decades for various problems with an extremely safe history.



The P-Shot 100™ procedure is a specific method of injecting blood-derived growth factors, including platelet-rich plasma (or platelet-rich fibrin matrix) and botulinum neurotoxin, to improve the health of the penis and enhance the size or function of the penis. The procedure includes patient selection, method of preparation of materials, method of injection, aftercare, and more.

P-Shot for men for ED and Peyronie's Disease
Priapus Shot P-Shot for ED

I am now offering the P-Shot® (Priapus Shot®) procedure combined with 100 units of Botox–the combination of the two is called the P-Shot 100™ (Priapus Shot 100™) procedure.

Suppose someone wants Botox alone injected into the penis. In that case, we have the  Bocox™ (BoPriapus™) procedure: a specific method of injecting the corpus cavernosi of the penis with botulinum neurotoxin (BoNT)–BOTOX– to improve penile tissue health and to enhance erectile function or penis size. The procedure includes patient selection, the method of preparation of the BOTOX, the method of injection of the BOTOX, aftercare, and more.


As with all procedures, there can be no guarantee of the outcome, and there can be
complications (some unexpected and of unknown severity). Using Botox for ED is an off-label use for BOTOX not approved by the FDA--as are other common uses of BOTOX. Some experts do not think Botox should be used for ED. Thankfully, we have 2 decades of use of Botox, with millions of doses per year, for many indications with an extremely high safety profile. The toxic LD50 for injecting cosmetic Botox iv for a 180-pound man is estimated to be around 150 to 200 Bottles of Botox (or around 15,000 to 20,000 units); we only inject a total of 100 units of Botox (one bottle) into the corpus carvernosi when we do the procedure (a smaller dose than what is often used to treat children with muscle spasm).

WARNING: Treating erectile dysfunction is serious business; only providers trained
& licensed by the Cellular Medicine Association® (indicated by their listing on our directory) can legally use the name, Bocox™, to describe a procedure offered in their office.

Scientific Research

Abdelrahman, Islam Fathy Soliman, Amr Abdel Raheem, Yaser Elkhiat, Abdelrahman A. Aburahma, Tarek Abdel-Raheem, and Hussein Ghanem. “Safety and Efficacy of Botulinum Neurotoxin in the Treatment of Erectile Dysfunction Refractory to Phosphodiesterase Inhibitors: Results of a Randomized Controlled Trial.” Andrology 10, no. 2 (2022): 254–61.

El-Shaer, Waleed, Hussein Ghanem, Tamer Diab, Ahmed Abo-Taleb, and Wael Kandeel.
“Intra-Cavernous Injection of BOTOX® (50 and 100 Units) for Treatment of
Vasculogenic Erectile Dysfunction: Randomized Controlled Trial.” Andrology 9, no. 4
(2021): 1166–75.

Giuliano, Francois, Charles Joussain, and Pierre Denys. “Safety and Efficacy of
Intracavernosal Injections of AbobotulinumtoxinA (Dysport®) as Add-on Therapy to
Phosphosdiesterase Type 5 Inhibitors or Prostaglandin E1 for Erectile
Dysfunction—Case Studies.” Toxins 11, no. 5 (May 21, 2019):

Habashy, Engy, and Tobias S. Köhler. “Botox for Erectile Dysfunction.” The Journal of Sexual Medicine 19, no. 7 (July 2022): 1061-63.

Naumann, Markus, and Joseph Jankovic. “Safety of Botulinum Toxin Type A: A Systematic Review and Meta-Analysis.” Current Medical Research and Opinion 20, no. 7 (July 2004): 981–90.


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    How does Bocox™ procedure improve erections? 

    Botox® has been used for years as a way to relax the smooth muscle of the bladder with bladder spasm. Botox is also thought to relax the smooth muscle that controls blood flow through the arteries of the penis; when the smooth muscle relaxes, the arteries increase in diameter, and more blood flows into the penis---causing improved erection and, perhaps, penile health.
    Botox also is known to migrate along the axon that innervates tissue (this is known to happen when Botox is used to treat migraines). It could be that this migration of Botox along the ganglion to the controlling axon could increases parasympathetic tone--also contributing to increased firmness of the erection.

    You can read more of the science here

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    Is the Bocox™ procedure safe?

    No serious sequelae have been seen with Bocox™. But, since Bocox uses Botox, and since Botox for ED works by the same mechanism as does Viagra (relaxing the smooth muscle of the arteries in the penis), in theory, any side effect seen with either Botox or with Viagra could happen with the Bocox procedure. For that reason, the consent form includes the same warnings included with consent for those two drugs.

    The amount of Botox used when doing Bocox is less than what is used for the treatment of migraines, and less than 1% of the LD50 (the toxic dose) for a 130 pound man.

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    Will the Bocox™ procedure increase the size of the penis?

    The Bocox™ procedure alone is unlikely to improve the erect size of the penis
    (though is may help when combined with other procedures). 
    The Bocox procedure does improve the size of the flaccid penis by maintaining
    more blood flow in the flaccid state; this effect, in theory, could help in the
    recover of the penis post prostate surgery, as well as in overall penis health.

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    How much does it cost & how long will it last?

    P-Shot 100™ (Priapus Shot 100™)
    The P-Shot® procedure combined with the Bocox™ procedure (PRP combined with 100 Units of BOTOX).

    P-Shot® (Priapus Shot®) Procedure: The first procedure.

    Repeat P-Shot® (Priapus Shot®) Procedure: Repeat injection (recommended to wait 8-12 weeks for the full benefit of the first injection before determining if a second injection is needed).

    The procedure improved erection for three months in one study in which the men
    received 50 units of Botox. The men who were helped by 100 units of Botox saw
    improvement for up to six months

  • larger penis
  • firmer penis with erection
  • straighten penis
  • increase blood flow to your penis for better function
  • enhance the benefits of other therapies (Cialis, Viagra, bimix/trimix shot etc.)
  • no downtime
  • minimal pain
  • no allergic reactions
  • no lumpiness or necrosis
  • Minimal bruising may occur


  • know platelet dysfunction
  • critical low platelet count
  • hemodynamic instability
  • active systemic or local infection- wait until resolved


  • NSAIDs use within 48 hours
  • corticosteroid injection within the last 4 weeks
  • systemic use of corticosteroid within 2 weeks
  • cancers (blood related or bone)
  • severe anemia- hemoglobin less than 10 g/dl

How much growth to expect?

About 10-20% in length and girth. The increase in girth occurs first, then about an inch or a little more in length. Results may vary

Where is the injection put?

Using a very small needle, the PRP is injected into the shaft, at the corpus cavernosum at very specific locations, and into the head of the penis. The same way as the injection for ED.

Does it hurt?

Since the injection is done after applying a very strong numbing cream, and the needle is very small, pain is minimal – same or less as an injection to the face or buttock.