What Happens If the P-Shot Doesn't Work? Next Steps to Consider
✅Medically reviewed | Updated September 2026
Interest in the P shot has grown steadily across London and the wider UK. Many men research the procedure carefully before booking. Far fewer research what follows a disappointing result. A weak response to P shot treatment does not close the door on effective care. It opens a structured review instead.
Evidence explains why this matters. Research on platelet-rich plasma (PRP) for erectile dysfunction (ED) remains limited. Trials reach mixed conclusions. Some men report clear gains, while others notice no change. Sensible planning therefore covers both outcomes before the first injection.
This article explains what happens if the P-Shot doesn’t work. A realistic timeline for judging results comes first. Common reasons for a limited response follow, together with the checks worth repeating. The article then compares alternatives recognised by the NHS and NICE. Every section draws on UK guidance and peer-reviewed research.
The purpose is practical. Readers gain a framework for judging outcomes, a clear list of next steps, and a way to avoid repeat spending without a medical reason.
What the P-Shot Involves and What the Evidence Shows
How the Treatment Works
Clinicians also call the P shot the priapus shot or penis shot. The treatment uses platelet-rich plasma. A clinician draws a small blood sample. A centrifuge then concentrates the platelets. After local anaesthetic, the clinician injects the concentrate into penile tissue. Platelets release growth factors. Laboratory studies suggest these factors may support blood vessel formation and tissue repair. Human evidence for this mechanism remains incomplete.
What the Research Shows
A 2021 randomised trial in the Journal of Sexual Medicine reported better erectile function scores after PRP than after placebo. A 2023 randomised trial in European Urology found no clear difference between PRP and placebo. European Association of Urology (EAU) guidelines describe the evidence as limited and classify PRP as investigational. The NHS and NICE Clinical Knowledge Summaries (CKS) list other treatments first.
Mixed trial results explain why individual outcomes vary so widely.
Placebo response adds further complexity. Erectile function scores often improve in placebo groups, because expectation and attention influence sexual performance. Careful measurement therefore matters more than first impressions.
How Long to Wait Before Judging the Result
The Usual Assessment Window
Biological repair takes time. Some patients report early changes within two to four weeks. Most clinicians judge response at around three months. Others allow up to six months. A verdict before eight weeks usually lacks a fair basis.
Measuring Progress Objectively
A conclusion that the P-Shot doesn’t work needs measured evidence, not impressions. Clinicians therefore use the International Index of Erectile Function (IIEF) questionnaire. The short IIEF-5 form scores five questions from 5 to 25. Higher scores indicate better function. Patients complete the form before treatment and again at three months.
A dated notebook adds useful detail. Entries can cover rigidity, morning erections, and successful intercourse attempts. Numbers and dated notes turn vague impressions into usable evidence.
Why Photographs Mislead
Clinic galleries often feature P shot before and after images. Photographs cannot measure blood flow, rigidity, or satisfaction. Lighting, arousal, and angle change appearance within minutes. P-shot before and after comparisons carry value only when supported by scores, dates, and consistent conditions.
Signs the P-Shot Doesn’t Work
Clinicians suspect limited benefit when several of these markers persist at three months:
- IIEF-5 score unchanged, or within a few points of baseline
- No change in rigidity or ability to sustain an erection
- Continued need for the same medication at the same dose
- No improvement in the ability to complete intercourse
- Unchanged frequency of morning erections
One missed marker does not confirm failure. The overall pattern matters more. Partial improvement also counts as a response, even when gains fall short of expectations.
Symptoms That Need Prompt Medical Attention
Some symptoms need review whatever the timeline. Pain, swelling, redness, warmth, fever, or discharge after injection may signal infection. New lumps or new curvature also need assessment. The NHS advises emergency care for an erection lasting four hours or more. Patients should call 111 or attend A&E in such cases.
Why the Response May Be Limited
Erectile function depends on blood vessels, nerves, hormones, and mood. A single injection addresses only part of that system. Several factors commonly reduce response.
Vascular and Metabolic Disease
ED often reflects blood vessel disease. Diabetes, hypertension, and high cholesterol damage vessels and nerves. NICE CKS advises cardiovascular risk assessment in men with ED. PRP alone cannot reverse advanced vascular damage. Untreated risk factors therefore limit any injection benefit.
Hormonal Factors
Low testosterone reduces libido and erectile quality. NICE CKS advises morning testosterone testing when symptoms suggest deficiency. Thyroid and prolactin disorders also affect sexual function. PRP does not correct these hormonal problems.
Psychological Factors
Performance anxiety, depression, and relationship stress often coexist with physical causes. The NHS lists psychological triggers alongside physical ones. Untreated anxiety can cancel out physical improvement. Talking therapy therefore deserves attention early.
Medicines and Lifestyle
Several medicines affect erections. Examples include thiazide diuretics, beta-blockers, some antidepressants, and finasteride. Patients should never stop prescribed medicines without medical advice. Smoking, heavy alcohol intake, obesity, and poor sleep add further harm. No injection can offset ongoing vascular and lifestyle damage.
Patient Selection and Technique
Severe or long-standing ED usually responds less well than mild disease. PRP preparation also varies. Clinics use different kits, platelet concentrations, injection volumes, and injection sites. No universal standard exists. This variation makes comparison between clinics difficult.
A Simple Framework for Reviewing Results at Three Months
Structured review turns uncertainty into action. Three broad outcomes emerge.
- Clear improvement: Scores rise and function improves. Clinicians usually monitor progress and address lifestyle factors.
- Partial improvement: Gains appear but remain inadequate. Adding an established therapy often makes sense.
- No improvement: Scores stay flat. Repeat assessment and alternative treatments take priority.
Adverse effects change the plan in every category. Prompt medical review comes first when complications appear.
Next Steps When the P-Shot Doesn’t Work
Book a Structured Review
A review at around three months lets the clinician compare scores and symptom notes. The clinician also checks for complications and confirms the injection record. A current medication list and recent blood results make the visit more productive.
Repeat the Medical Assessment
NICE CKS outlines a basic ED assessment. It covers blood pressure, body mass index, blood glucose or HbA1c, lipid profile, and morning testosterone when indicated. A GP can arrange most of these tests through the NHS. Results often reveal treatable causes that an injection alone cannot fix.
Strengthen the Lifestyle Foundations
Lifestyle change carries strong supporting evidence. The NHS recommends regular exercise, weight loss for men who carry excess weight, smoking cessation, and moderate alcohol intake. Aerobic activity improves vascular function. Pelvic floor exercises may also help some men. Better sleep and stress control support hormone balance. These steps cost little and benefit overall cardiovascular health.
Consider a Second Session Carefully
Some clinics offer repeat sessions. Evidence for repeat dosing remains thin. A second injection makes sense only when the clinician identifies a specific reason, such as partial response with measured gains. Repeating an identical protocol after no measurable response lacks supporting evidence. A repeat injection needs a clinical reason, not simple hope.
Compare Established Alternatives
Guidelines place proven therapies first. Each option carries distinct benefits and limits.
PDE5 Inhibitors
Sildenafil, tadalafil, vardenafil, and avanafil form first-line therapy in NHS and NICE CKS guidance. These tablets help many men. They need sexual stimulation to work. Nitrate medicines make them unsafe, so a GP or pharmacist review comes first.
Vacuum Erection Devices
A vacuum pump draws blood into the penis. A constriction ring then holds the erection. The NHS lists this device as a treatment option. Bruising and a cool penis occasionally occur.
Alprostadil Injections and Pellets
Alprostadil relaxes penile blood vessels. Men inject it into the side of the penis or insert a urethral pellet. Clinicians teach the technique before home use. Prolonged erection remains a rare risk. Some private clinics prescribe combination injections, often called Trimix. Evidence for these preparations comes mainly from smaller studies.
Low-Intensity Shockwave Therapy
EAU guidance discusses low-intensity shockwave therapy for selected men with mild vascular ED. Protocols differ between clinics. Evidence quality remains modest.
Penile Prosthesis Surgery
Urologists offer implants for severe ED that resists other treatments. Surgery carries infection and mechanical failure risks. Published series report high satisfaction among selected patients.
Address Psychological and Relationship Factors
NHS talking therapies and psychosexual counselling help men whose anxiety sustains ED. Counselling can run alongside any medical treatment. Partners often join sessions when appropriate.
Common Misunderstandings About a Poor Response
Poor Results Do Not Prove Poor Technique
Biology varies between men. A disappointing outcome does not automatically point to an error. Equally, skilled technique cannot guarantee benefit.
Early Verdicts Ignore Biology
Declaring that the P-Shot doesn’t work at six weeks ignores the timeline of tissue repair. Clinicians rarely expect new gains long after six months. Structured reassessment at three to six months balances both risks.
Realistic Expectations, Cost, and Size Claims
Priapus Shot Price in the UK
Priapus shot price commonly ranges from £900 to £1,500 per session in the UK. Fees vary by clinic, location, and protocol. Some clinics sell packages covering several sessions. Patients should confirm exactly what each fee includes. When the P-Shot doesn’t work, further spending needs a clear medical rationale. A higher fee does not guarantee a better result.
Penile Injection Growth Claims
Some marketing links the P shot to penis size gain. Evidence for penile injection growth remains weak. The P shot targets erectile function, not length or girth. Male enlargement injections cost UK figures vary widely, and results remain unproven. Penile fillers also carry risks of lumps, infection, and deformity. Any p injection offer promising size gain deserves close scrutiny.
Setting Honest Expectations
Realistic outcomes range from modest benefit to no benefit. Guarantees have no place in this field. Reputable clinicians explain the limits of the evidence before treatment starts.
Reviewing Results With a Qualified Clinician
Credentials deserve checking before any review, whether in London or elsewhere in the UK. The General Medical Council register confirms a doctor’s registration and specialist status. Care Quality Commission registration shows regulated status for English clinics. A sound clinic records baseline scores, explains evidence limits, and screens medical risks. Pshots clinic UK, a Harley Street practice led by Dr Syed Nadeem Abbas (MBBS, MRCS, MRCGP, MSc Aesthetic Plastic Surgery), offers one example of a doctor-led setting for such reviews. A GP remains the first contact for underlying health checks.
Frequently Asked Questions
How long should a patient wait before deciding the P-Shot doesn’t work?
Most clinicians assess response at three months. Some allow up to six months. Earlier judgement usually lacks a fair basis. Baseline and follow-up scores give the clearest comparison.
Can a second P shot treatment help?
Sometimes. A repeat session makes sense when the first injection produced partial, measured gains and the clinician sees a clear rationale. Evidence for repeat dosing remains limited.
Does a poor result mean ED cannot be treated?
No. NHS and NICE pathways offer several established options. Tablets, devices, injections, counselling, and surgery each suit different patients. Underlying causes also respond to treatment.
Are P-shot before and after photos reliable?
Photographs show appearance only. They cannot measure rigidity, blood flow, or satisfaction. Reliable comparisons need validated scores, dates, and consistent conditions.
Can a P shot combine with ED tablets?
Many clinicians continue tablets during and after PRP treatment. Evidence on combined use remains limited. A prescribing clinician should review any combination.
Does the P shot increase penis size?
Robust evidence does not support size gain. The treatment targets erectile function. Claims of penile injection growth need caution.
Does the NHS provide the P shot?
The NHS does not routinely offer PRP for ED. Patients usually pay privately. GPs still arrange assessment and first-line treatments.
Key Takeaways
Disappointment after an injection is understandable, yet it carries useful information. A structured response protects health, time, and money. Three months of measured data, a repeat medical assessment, and a clear review usually reveal the next step.
Evidence supports several established routes. Tablets, devices, injections, counselling, and surgery each help selected men. Lifestyle change and treatment of vascular or hormonal causes often matter most. When the P-Shot doesn’t work, the underlying cause of ED still deserves answers.
Informed decisions rest on honest evidence, not marketing claims. Which question deserves an answer first: whether the injection failed, or why erections changed in the first place?
Read more:
What Is the P-Shot Success Rate? What the Research Really Shows
P-Shot Success Rate by Age: Do Results Differ in Your 40s, 50s and 60s?
Dr Syed Nadeem Abbas, MBBS, MRCSEd, MSc Aesthetic Plastic Surgery (Distinction) Medical Director, Pshot Clinic | CQC Regulated | Monday to Saturday 10:00–18:00 +44 7955 836986