Penis Botox: Therapeutic Botox for Erectile Dysfunction (BOCOX™)

Originally developed as a solution to remove wrinkles, Botox has become a promising treatment for erectile dysfunction. Over the last five years, medical research has begun to suggest that Botox is a safe and seemingly highly effective treatment not just for ED but also for enhancing performance and improving sexual confidence.  

Several promising studies have shown that a one-time injection of Botox helped treat ED by improving vascular health and function in the penis, with results lasting an average of six months. What’s convincing about these particular placebo-controlled studies is that the cohort of men treated were patients who had no longer responded to ED medications. These patients were very challenging to treat, and many responded well to Botox.

What is BOCOX™, aka Penis Botox?

“BOCOX™” is a non-surgical treatment that uses Botox to help men with ED by improving penile health and function. Botox (also known as botulinum neurotoxin) is a neuromodulator produced by the bacterium Clostridium A. Botox was approved by the FDA in 2002 to treat wrinkles. Since then, hundreds of millions of Botox injections have been administered to treat a range of conditions, including wrinkles, migraine headaches, and urinary problems.

How Therapeutic Botox for Erectile Dysfunction Works 

Penile Botox works via the following mechanisms:

  • Reduces Constriction - As men age, the endothelial lining becomes more dysfunctional, meaning the blood vessels in the penis become more contracted, more regularly. Botox blocks the nerve impulses sent to the vessel walls, resulting in a more relaxed state with a wider diameter, allowing vessels to expand and carry a greater volume of blood, which improves erections. The mechanism of action for Botox seems to be effective not just for age-related erectile dysfunction but also for other types of neurogenic vasoconstriction.

  • Relaxes Smooth Muscle - Botox works by temporarily relaxing the smooth muscle in the walls of the blood vessels in the penis, resulting in improved dilation, expansion, and filling of these blood vessels. 

  • Improves hemodynamics or blood flow - Through the mechanisms listed above, several studies have demonstrated, via Doppler ultrasound, improved hemodynamics to the penis (i.e., enhanced circulation and blood volume).

Penile Botox Benefits for Erectile Dysfunction

According to several placebo-controlled trials, patients with ED receiving Botox penile injections have reported several benefits:

  • Firmer and longer-lasting erections: many men have reported firmer and more sustainable erections

  • Increases Erection Size: Men reported that Botox increased erection size and fullness

  • Increases Penile Size at Rest: Men report that Botox increased flaccid penile length and girth

  • Improved Medication Responsiveness:  men reported that Botox improved their response to PDE5 inhibitors (Viagra and Cialis). Botox appears to have a synergistic effect with PDE5 Inhibitors. Some men required less medication / lower doses. 

  • Increases Sexual Satisfaction: Some men have reported a more intense and satisfying sexual experience.

Botox for ED: What the Research Says

Several high-quality, placebo-controlled studies have demonstrated the safety and effectiveness of Botox in treating ED. According to one study, a one-time treatment with intracavernosal injection of Botox showed significant improvement in all areas, including the Sexual Health Inventory for Men (SHIM) score & Erection Hardness Score (EHS), Global Assessment Score (GAS), Sexual Encounter Profile (SEP), and Doppler (ultrasound evaluating blood flow) parameters.

While intracavernosal Botox is well-supported and safe according to scientific literature, this treatment approach is not yet referenced as a standard treatment protocol by governing boards.  We encourage patients to review the relevant literature and discuss it with their doctor to support informed treatment decisions.

Many of our patients have already tried conventional treatments and turned to KPM for innovative approaches.

For your reference, here are the accepted national treatment protocols from the Canadian Urological Associationand the American Urological Association.

1. Ghanem H, et al. Botulinum Neurotoxin and Its Potential Role in the Treatment of Erectile Dysfunction. Sexual Medicine Reviews. 2018;6:135-142.

2. Reddy A, et al. Application of Botulinum Neurotoxin in Male Sexual Dysfunction: Where Are We Now? Sexual Medicine Reviews. 2021;9:320-330.

3. El-Shaer W, et al. Intra-cavernous injection of BOTOX® (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial. Andrology. 2021;9:1166-1174.

 

The Penis Botox Procedure: What to Expect

Here’s what to expect before, during and following the procedure:

  • Topical anesthesia is used to numb the penile tissue before the injections are administered.

  • A clinician will inject precise amounts of Botox into each side of the penis, specifically the two columns of spongy tissue in the corpus cavernosum.

  • The procedure is typically completed in under three minutes.

  • Some patients may experience minor swelling or tenderness for a few days after the procedure.

Timing and Length of Results

  • The effects of therapeutic botox generally improve and progress over the span of two weeks, with some noticing results within a few days. Typically, maximum observable results are achieved within six weeks. 

  • Published literature on therapeutic Botox for ED showed that 100 units of Botox usually lasted around six months. 

  • Patients can return every four to six months for additional treatments. 

Combining Botox with the P-Shot: Enhanced Results

For more significant results, we recommend combining Botox with the P-Shot. The P-Shot promotes new blood vessel formation and improved endothelial function in the penis and pairs synergistically with Botox. You can learn more about the P-Shot on our The P-Shot for ED page. 

Synergistic Effects of Therapeutic Botox for ED and the P-Shot

Botox™ Function

Enhances parasympathetic tone, i.e. relaxes smooth muscle in the lining of the blood vessel, improving dialation and expansion of blood vessels.

P-Shot Function

Improves erectile function by improving blood vessel density, improving endothelial function, and increasing nitric oxide production in penile tissues.

Combined Benefits

Enhances blood flow, stimulates vessel regeneration, and optimizes sexual function when used together.

Reported Outcomes

Patients report global improvements in sex life, including enhanced sexual performance, more sensitivity, increased confidence, and improved penile size with erections and flaccid size.

Goal of Integration

To capture the regenerative benefits of PRP while also recognizing the immediacy and benefits of Botox.

Long-term Enhancements

Increased penis size and long-lasting improvements in sexual function and health.

Therapeutic Botox Compared with Shockwave Therapy

Patients who complete therapeutic Botox are often also good candidates for low-intensity shockwave therapy. Both treatments aim to improve the function of blood vessels in the penis. Shockwave differs in that it stimulates revascularization (regeneration of blood vessels in the penis) through low-intensity shockwaves.

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