Erectile dysfunction treatment in London: without surgery, without ongoing medication

Roughly half of men experience some form of erectile dysfunction by age 50, rising steeply with age, vascular disease, diabetes, and certain medications. It is not a rare condition and it is not a moral failing. In most cases, it is a treatable physiological problem.

What's changed in the last decade is the range of treatments. The default NHS pathway begins with PDE5 inhibitors (Viagra, Cialis) and may progress to vacuum devices, injection therapy, or surgical implants. Private regenerative-medicine approaches, including PRP and focused shockwave, add a different option. They do not manage the symptom on demand; they work to repair the underlying tissue.

ED has multiple possible causes, and the right treatment depends on which is driving yours. Most men have a mix.

Vascular (the most common cause). Atherosclerosis, hypertension, smoking history, sedentary lifestyle, age-related vascular decline. This is the cause that responds best to PRP and shockwave because both target tissue and blood vessel regeneration.

Diabetic. Diabetes drives both vascular damage and small-nerve damage in erectile tissue. Diabetic ED is one of the strongest indications for the Enhanced protocol because both pathways are active.

Neurogenic. Pelvic nerve injury, most commonly after radical prostatectomy, but also from spinal injury, multiple sclerosis, or severe diabetes. PRP supports nerve regeneration but the extent of recovery depends on the degree of nerve preservation.

Hormonal. Low testosterone, thyroid dysfunction, prolactin excess. Hormonal correction comes first; regenerative treatment can be added once levels are optimised.

Iatrogenic. Caused by treatment for another condition, such as post-prostatectomy, post-radiotherapy, post-pelvic-surgery. See /conditions/post-prostate-recovery/.

Psychological. Performance anxiety, depression, relationship factors, trauma. Where psychological factors dominate, psychosexual therapy is more appropriate than a P-Shot, and we'll tell you straight if that's what your consultation suggests.

Most real-world ED is multifactorial. The job of the consultation is to identify which factors are driving yours and recommend the protocol that matches.

The Standard P-Shot, £1,250. Best for mild-to-moderate ED, particularly with tissue and sensitivity components. One 60-90 minute appointment. 12-18 month results in responders.

The Enhanced P-Shot + Shockwave, £1,350. Best for vasculogenic ED, diabetic ED, age 55+, sub-optimal PDE5 response, or any case with significant vascular contribution. Both modalities in a single same-day appointment.

Standalone focused shockwave course, from £500/session. Best where PRP is contraindicated or where you specifically want shockwave alone. Typically 6 sessions over 6 weeks.

Referral out. Where the right answer is hormonal correction, psychosexual therapy, urological surgery, or another specialty entirely, we'll refer you on rather than treat what won't respond.

PDE5 inhibitors (Viagra/Cialis) are excellent rescue medications. They work in 30-60 minutes, they're cheap, and for many men they're sufficient. What they don't do is fix the underlying problem. Every successful erection requires a fresh dose, and the tissue underneath continues to age.

The P-Shot and shockwave address the cause. After a successful treatment, many men either stop using PDE5 inhibitors or substantially reduce the dose they need. They don't replace the medication on every occasion of intimacy; they make the medication less necessary.

See the full comparison: P-Shot vs Viagra →

In published series of properly-selected patients with vasculogenic mild-to-moderate ED, roughly 7 in 10 men report a clinically meaningful improvement after PRP treatment. The improvement typically presents as: firmer and more reliable erections, easier achievement of erection without medication, longer duration, better morning erections, and improved confidence.

About 3 in 10 men are poor responders even with perfect technique, usually because the underlying mechanism doesn't match what PRP and shockwave can address. We try to predict this at consultation, but it cannot be predicted with certainty. If you don't respond, we will tell you honestly and discuss what next.

Every ED treatment package includes:

• Initial consultation with your doctor (in person at Wimpole Street, or by secure video)
• The procedure itself, performed by your doctor personally
• All disposables, anaesthetic, and clinical setup
• 6-week follow-up review
• 12-week follow-up review
• Direct email access to the clinic for clinical questions between follow-ups

What is not included: travel, accommodation, treatments outside the agreed protocol, and any imaging or hormonal blood tests if ordered. These are quoted separately and only ordered with your consent.

Is private ED treatment covered by insurance? PRP for ED is not currently covered by UK private medical insurance. Some shockwave courses are covered in some policies. Confirm with your insurer.

Can I combine private treatment with NHS care? Yes. Many of our patients continue to see their NHS GP for general health and use us for ED treatment specifically. We do not contact your GP without your explicit consent.

Will my partner need to be involved? Not unless you want them to be. Some men come to consultation with a partner; most come alone. Either is fine. The consultation is private and shaped to whoever is there.

How quickly can I be seen? Initial consultations are typically available within 1-2 weeks; treatment appointments usually within 2-4 weeks of consultation, depending on availability and any pre-treatment optimisation needed.

Is the consultation confidential? Yes. Consultations are confidential, and GP or third-party communication only happens with patient consent unless disclosure is required by law.