摘要

Objectives: Objective: To review and synthesize available scientific evidence on the use of BOCox and P-Shot — individually and combined — for improving erectile function, perceived length/rigidity, and penile tissue health, highlighting reported clinical outcomes, pathophysiological rationale and knowledge gaps. Introduction: Introduction: Interest in minimally invasive interventions to improve penile function and structure has driven study of two complementary approaches: injection of botulinum toxin into the cavernous bodies (BOCox) to modulate smooth muscle relaxation and lower the intracavernosal pressure required for erection, and PRP (P-Shot) to promote angiogenesis, tissue remodeling, and preservation/regeneration of erectile tissue. A synthesis of current evidence on mechanisms, clinical efficacy and safety of each technique and their combination is needed. Materials / method: Methods: Narrative review of preclinical and clinical literature (in vitro studies, animal models, case series and pilot clinical studies) up to the present. Analyzed topics included mechanisms of action (effects on smooth muscle, innervation, vascularization), outcome measures (rigidity, functional length, erectile function scales, hemodynamic measures), safety and durability, and available evidence on combined treatments Results: Results (summary): - Mechanisms: Preclinical and physiological studies indicate botulinum toxin can reduce local cholinergic and adrenergic activity, decrease smooth muscle tone and facilitate cavernous relaxation, theoretically lowering the pressure threshold for erection and potentially increasing perceived functional length. PRP delivers growth factors (VEGF, PDGF, TGF-β) that promote angiogenesis, cell proliferation and extracellular matrix repair, with potential to preserve or improve the microarchitecture of erectile tissue. Conclusion: Conclusions: Current evidence suggests a plausible physiological basis for combined BOCox and P-Shot to improve penile function and tissue health, but clinical literature is preliminary and heterogeneous. Randomized controlled trials, mechanistic studies with objective hemodynamic measures, and standardized protocols (dose, technique, intervals) are needed to confirm efficacy, safety and optimal combined strategy. Until such data exist, the combination should be considered experimental and used in contexts with informed consent and prospective registry.