Does it really matter which PRP Centrifuge you use for a P-Shot?

Question

I am interested in getting this procedure done but am somewhat overwhelmed due to reading that some centrifuges are not as effective as others, and there is no way to know which one each P Shot provider uses in their clinic. Any thoughts would be appreciated.

Farhan Malik, MD · Answer

The PRP kit that is utilized to draw the blood and the centrifuge used to spin the blood to get the platelets matters. Some kits do not get as many platelets from the blood. The P-Shot involves taking platelet-rich plasma (PRP) from your blood and injecting it into your penis. This means your doctor takes your own cells and tissues and injects them into your penile tissues to promote tissue growth and purportedly give you better erections so it is important to get as many platelets as possible. Ask your provider before to see how many platelets will be drawn from the kit used.

Ryan Welter, MD · Answer

I agree with the sentiment that most centrifuges, when used properly, can achieve adequate results for the P-Shot. While the specific centrifuge and PRP system play a role, what truly matters is the provider's technique, experience, and track record of delivering successful outcomes. Ultimately, the “science” is in the results. Choose a provider with a proven history of patient satisfaction and effective treatments.

Jennifer R. Berman, MS, MD · Answer

Yes, the type of PRP centrifuge used for a P-Shot (Priapus Shot) does matter. High-quality centrifuges designed specifically for PRP ensure proper separation and concentration of platelets, which is critical for effective tissue regeneration and improved outcomes. Using a subpar centrifuge may result in lower platelet concentration, reducing the treatment's effectiveness. Patients seeking optimal results should consult physician who uses FDA-cleared PRP systems tailored for regenerative procedures like the P-Shot. Proper equipment directly impacts the success of the treatment and patient satisfaction.

Larry Thiesen, MD · Answer

Thank you for the timely question, I believe the type of centrifuge absolutely impacts the ultimate result/outcome of the procedure. Preparations of PRP can vary in many areas, including, platelet concentration, number of WBC’s, presence or absence of RBC’s, and activation status of the preparation. Of major importance is the absolute platelet countin the injection itself.
In order to achieve a favorable outcome, one must have between 1M and 1.5M platelets in the injection. This requires an ability to concentrate platelets to 5-9x’s the concentration of whole blood. Various centrifuges have differing qualities and capabilities, therefore it is important to discuss this with a qualified provider prior to your procedure.
Hope this helps, and best of luck.

Lisa Vuich, MD · Answer

Thanks for your question. We have performed the P Shot since 2015. We use a "high volume" PRP kit meaning we routinely draw 60 or 120 ml of blood and have never had any adverse outcomes/events. The volume of blood draw is critical to the best outcomes from the procedure. We participated in research in this whereby we measured the patient's platelet count through a fingerstick and used a specially formulated computer program to determine based on that platelet count what the ideal blood draw volume would be to get the best level of platelets in the PRP. We did this because there is a certain minimum platelet count you want in order for the PRP to have the best angiogenic effect (creating new blood vessels). This research showed us time and time again that the 120 ml blood draw was the winner in producing the desired platelet count in the final PRP (which we also tested and documented!). Our results have been consistently rewarding. The process is called the Transcend Customized PRP Protocol. We use the Emcyte Pure PRP II kits which are one of the best in the industry and have both the 60 ml and 120 ml options. It is true that there are "cheap" kits/systems out there that will not be as efficient in creating the highest quality PRP. These kits are usually based on drawing blood into "test tubes" and doing a "single spin". Look for providers utilizing the Emcyte kits or at least a similar double spin processing, and remember the VOLUME of the blood draw is just as important in my experience!

W. Christopher Croley, MD · Answer

I have been a provider of the P Shot procedure for many years and used several centrifuges during that time. In my experience, a double spin system provides the highest quality PRP and patients tend to have the best results when I use this system. It is important that your provider is using a FDA cleared device.

Patrick Yam, MD · Answer

Excellent question. It's good to see attention being given to the different types of PRP systems. It can be confusing with so many different PRP systems on the market. It would be great if they all produced consistent, concentrated PRP but unfortunately this is not the case. This is apparent even on the visual appearance of PRP. An interesting demo was done at a major conference in Europe where one researcher donated blood on stage and PRP was prepared using 8 different PRP systems. The PRP samples all looked different, ranging in color from straw-yellow to deep blood-red and concentrations of platelets, red blood cells within also varied by several orders of magnitude. 
A good starting point would be what is PRP? "Platelet Rich Plasma" is defined exactly as it sounds, plasma which contains a high concentration of platelets; the classic definition (Marx, 2001) is that PRP should contain at least 1 million platelets per microliter (µL). A microliter is a cubic millimeter. In comparison, whole blood usually has a concentration around 200,000 /µL, so this represents 5x increase in concentration, which is usually achieved by separating the blood components in a centrifuge. 
Although the principle is quite simple, in practice it's a delicate process, and it's easy to spin a bit too long or hard. When this happens, instead of increasing concentration, the platelet concentration actually decreases as platelets get lost in the red cell layer or stuck in the gel of commonly used tubes. Unfortunately this is common in many systems. In 2019, a comprehensive review from the Mayo Clinic School of Medicine looked at 33 different PRP systems available on the market today.  Only 10 of the 33 systems met the effective concentration levels described above. And 3 of these systems produced PRP with a concentration of platelets which was actually less than the starting blood sample. 
The concentration and overall dose of platelets in PRP is very important. After all, it's the platelets which contain the growth factors and cytokines which are responsible for all of the benefits of a PRP treatment. This is why we test every sample of PRP with a hematology analyzer for concentration and purity before use. If there are not enough platelets the sample is not used. 
Without a hematology analyzer, one can only make an educated guess about the concentration, but in general, only double spin systems are capable of approaching a concentration of 1 million/µL. Also, one has to start with enough blood in the first place, in order to have enough platelets in the initial sample. This is because due to the laws of physics, no system is perfect and at least 10-20% of the platelets are usually lost in any preparation method. 
Some types of PRP treatments don't seem to be as dependent on high concentration and may even be better suited to lower concentration, such as under eye treatments, microneedling aka "Vampire Facial." But for the P-Shot, O-Shot or hair, higher concentration is recommended and the research does seem to show that better results are achieved.
In conclusion, for certain PRP procedures, high concentration is recommended. The best confirmation of concentration would be with on site testing using a hematology analyzer. In order to reliably obtain platelet concentrations over 1 million/µL some type of double-spin preparation system is used, and a minimum starting volume of 50-60mL of blood is required to yield 10mL of high concentration PRP for the P-Shot. Hope this helps.

Samer Muala, MD - Account Suspended · Answer

It's not the centrifuge- it's the PRP separation tubes or method used that is important.  You want to have a concentrated PRP that is used for injection.  Your doctor uses what he knows works best for his practice.  I think as long as there is a treatment plan you will get there with the right PRP.  Most kits out there do the job well.

Yasar Basaga, MD - Account Suspended · Answer

Actually PRP is prepation tubes' quality, and quality of materials(like centrifuge) is important for the effect of P-shot. You can search for stem-cell treatment, which is more effective than PRP

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