Official P-Shot®
(Priapus Shot®)
Training & Certification
The official CMA-sanctioned P-Shot® training in Phoenix. Comprehensive male penile anatomy, PRP preparation, the penile nerve block, the complete multi-site injection protocol for erectile dysfunction and Peyronie's disease, adjunctive therapy protocols, live patient injection, and full CMA provider certification. Taught by Naomi Fayzulayev, FNP-C — an officially certified CMA instructor for the P-Shot®, O-Shot®, and Vampire® procedures.
Questions? Call 480-447-8166 or email [email protected]
Bundle with O-Shot® for a combined sexual wellness discount.
What you learn in the
P-Shot® Training course
This is the official P-Shot® curriculum as defined by the Cellular Medicine Association — nine modules spanning male sexual physiology, PRP science, patient selection, nerve block technique, the complete multi-site injection protocol, adjunctive therapies, and practice integration. The morning is structured didactic; the afternoon is supervised hands-on practicum with live consented patients. Every attendee performs the complete P-Shot® protocol.
- Penile anatomy in depth: corpus cavernosum, corpus spongiosum, glans, tunica albuginea, Buck's fascia — the structures you are injecting into and around
- Neurovascular anatomy: dorsal penile artery, dorsal penile nerve, deep dorsal vein — identification, location, and why they define your injection boundaries
- Hemodynamics of erection: arterial inflow, sinusoidal expansion, venous occlusion — the complete physiologic sequence the P-Shot® is designed to support
- Pathophysiology of erectile dysfunction by etiology: vasculogenic, neurogenic, psychogenic, hormonal, and medication-induced ED — what each responds to and how to screen for each
- Peyronie's disease: fibrous plaque formation, penile curvature, pain during erection — pathophysiology and how PRP's anti-inflammatory and regenerative properties address it
- The role of testosterone and hormonal status in erectile function — why hormonal baseline matters before offering the P-Shot® and when to refer or treat first
Anatomy is taught as an injection-planning framework — every structure covered in terms of what it means for your needle placement, target tissue, and the vascular structures you must not compromise.
- Mechanism of PRP in the corpus cavernosum: platelet-derived growth factors, VEGF-driven angiogenesis, nerve regeneration signaling, and smooth muscle remodeling
- What makes PRP "platelet-rich" — concentration thresholds for therapeutic efficacy vs. inadequate preparations
- FDA-cleared centrifuge systems recommended by the CMA for the P-Shot® — selection criteria, tube prep, and draw volume protocols
- Quality assessment during processing: identifying adequate PRP before it reaches the patient
- Activation: calcium chloride approach, when to activate and why the CMA protocol is structured as it is
- Processing-to-injection timing — the window within which PRP retains full therapeutic activity
- Sexual health history-taking for men: the IIEF (International Index of Erectile Function) as a structured baseline and outcome measurement tool
- Absolute contraindications: bleeding disorders, active local infection, platelet dysfunction, full anticoagulation, active penile implant
- Relative contraindications and workup: severe vasculogenic ED (when to refer to urology first), active Peyronie's in acute inflammatory phase, uncontrolled diabetes
- Hormonal assessment: why testosterone level, thyroid function, and metabolic panel are part of the pre-P-Shot® workup — not optional add-ons
- Identifying the ideal P-Shot® candidate: the patient profile most likely to produce a satisfying, reportable outcome
- Realistic outcome communication: the 4–12 week response timeline, variability, and how to frame expectations for a sensitive condition without losing the booking
- CMA consent documentation: what is required and why the official form is structured as it is
- Why topical anesthetic alone is insufficient for deep intracavernosal injection — the sensory anatomy that necessitates nerve block
- Dorsal penile nerve block: landmark identification at the base of the penis, needle angulation, lidocaine concentration (1% without epinephrine), volume, and bilateral vs. unilateral approach
- Ring block: circumferential infiltration technique, depth, and when it is used in addition to or instead of the dorsal block
- Epinephrine: why vasoconstrictors are absolutely contraindicated in penile block — the ischemia risk and the consequences
- Assessing block adequacy before proceeding — the 2-minute wait, sensory confirmation, and how to respond if the block is incomplete
- Local anesthetic toxicity thresholds, recognition of early systemic signs, and management
The penile nerve block is the single most undertaught element in P-Shot® training on the market. This module covers it with full supervised hands-on practice during the afternoon session — including managing incomplete blocks before proceeding to injection.
- Injection site 1 — corpus cavernosum: entry point, depth (intracavernosal), needle angulation to avoid the urethra and dorsal vein, volume per side
- Injection site 2 — glans penis: superficial injection technique, distribution points, volume
- Multi-point injection strategy across the corpus cavernosum — the logic behind distribution and why single-point injection is inadequate
- Peyronie's plaque injection technique: how the protocol is modified for fibrous plaque targeting, needle approach, and volume adjustment
- Sequence of injections, syringe management, and sterile field maintenance throughout the procedure
- Total PRP volume per session and distribution rationale across all injection sites
- Intracavernosal injection safety: urethra avoidance, deep dorsal vein awareness, and real-time patient feedback during injection
Demonstrated by Naomi first, then performed by every attendee on live consented patients during the afternoon session.
- Vacuum Erection Device (VED): mechanism of action post-P-Shot® — how negative pressure promotes engorgement and may enhance PRP distribution and tissue response
- VED protocol: patient sizing, pressure guidelines, session frequency, the standard 6-week post-procedure VED protocol used in CMA practice
- How to prescribe and educate patients on VED use — the devices available, what to recommend, and compliance counseling
- Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT): mechanism of action for ED, evidence base overview, and how it synergizes with the P-Shot®
- LI-ESWT energy settings, treatment session cadence, and the evidence-supported combined protocol when used alongside PRP
- Patient selection for adjunctive therapy: who benefits most, and how to position these additions within your fee structure
- Universal precautions and sterile field for intracavernosal procedures
- Hematoma and bruising: mechanism, management, and how injection technique prevents most cases
- Priapism risk: incidence with PRP (extremely low), recognition, and the emergency management protocol every intracavernosal injector must know
- Vasovagal response: recognition, immediate management, and prevention in subsequent patients
- Infection risk in intracavernosal procedures: incidence data, sterile technique as primary prevention, and antibiotic prophylaxis considerations
- Urethral injury: avoidance technique, recognition if it occurs, and when to refer immediately
- Documentation for adverse events and the medical director notification protocol for RN injectors
- Immediate post-procedure instructions: activity, sexual activity timeline, hygiene, and VED start date
- The first 72 hours: what normal post-procedure response looks like vs. when to call the clinic
- The 4–12 week response window: counseling patients through the collagen remodeling and vascular regeneration timeline before results are felt
- The IIEF at follow-up: using a structured tool to document outcomes, justify repeat treatment, and generate data for your own practice
- The patient who reports no improvement: reassessment framework — hormonal workup, adjunct consideration, repeat protocol, and when to refer to urology
- Annual repeat protocol, long-term patient management, and the maintenance schedule used at Beso Wellness & Beauty
- Activating your CMA membership and directory listing — step-by-step immediately after certification
- Accessing official CMA patient brochures, website content, and educational materials for the P-Shot®
- Ethical and compliant P-Shot® marketing: what you can claim, what you cannot, and how to discuss outcomes without violating FTC guidelines for sexual wellness procedures
- Pricing the P-Shot® in Phoenix metro: current market range ($1,200–$2,000), how to position your fee, single-session vs. package pricing, and bundling with adjunctive therapies
- Appointment workflow: scheduling, intake forms, room setup, VED prescription, and post-procedure checkout
- Combining the P-Shot® with hormone optimization services — the overlap patient who presents for both ED and low testosterone
- Medical director requirements for RNs offering intracavernosal injection — standing order structure and scope documentation specific to Arizona
Four indications. One
standardized protocol.
The most common ED etiology — insufficient arterial inflow due to endothelial dysfunction, atherosclerosis, or diabetes. PRP growth factors stimulate VEGF-driven angiogenesis and smooth muscle remodeling in the corpus cavernosum, supporting improved hemodynamic response over 4–12 weeks.
Fibrous plaque formation causing penile curvature, painful erection, and often psychological distress. PRP's anti-inflammatory cytokines and collagenase-stimulating growth factors address the plaque directly — with injection modified to target the fibrous tissue. Best results in stable (non-acute) disease.
ED following radical prostatectomy, pelvic surgery, or neurological injury where cavernous nerve damage is a primary mechanism. PRP's nerve growth factor and neurotrophin content supports nerve fiber regeneration — typically requiring more patience on outcome timeline and often combined with VED protocol for best results.
Decreased penile sensitivity from aging, medication side effects, or prior circumcision. PRP injection into the glans penis and superficial penile tissue targets nerve fiber density and tissue quality, with patients frequently reporting improved tactile sensitivity and orgasmic intensity alongside erectile improvements.
Early PRP intervention following radical prostatectomy to preserve cavernous smooth muscle, prevent hypoxic fibrosis, and support nerve regeneration during the critical recovery window. Combined P-Shot® + VED protocol increasingly used as a penile rehabilitation strategy in urology-adjacent practice settings.
The P-Shot® and O-Shot® share the same PRP preparation system, CMA infrastructure, and sexual wellness consultation framework. Providers who complete both courses can serve couples — and routinely do, because male patients frequently ask about options for their partners, and vice versa.
Certified, equipped, and
ready to see patients.
Every attendee performs the complete P-Shot® protocol — including PRP preparation, the penile nerve block, and the full multi-site injection sequence — on live consented patients under direct instructor supervision. Not a demonstration. Not a model. The actual procedure.
Official certification from the Cellular Medicine Association designating you as a Certified P-Shot® (Priapus Shot®) Provider. Includes your international provider directory listing — the CMA's patient referral network — and the legal license to use the P-Shot® trademark in your marketing and patient materials.
Access to the official CMA P-Shot® procedure protocol, patient consent form, VED prescription instructions, post-procedure patient handout, patient brochures, and website-ready content — professional materials deployable in your practice the week after training.
Your 3-month introductory CMA membership ($97/month to continue, cancel anytime) includes the provider forum, monthly educational webinars hosted by Dr. Charles Runels, and a peer network of certified P-Shot® providers for clinical Q&A, case consultation, and technique questions.
The dorsal penile nerve block and ring block are trained to clinical competency — not mentioned in a slide deck. You perform the nerve block on live patients under direct supervision, with real-time technique correction, before the injection session begins. This is what makes the difference between a tolerable procedure and a painful one.
You leave with the complete 6-week post-procedure VED protocol and an evidence-based LI-ESWT overview — the tools to maximize P-Shot® outcomes, increase per-patient revenue with adjunctive services, and differentiate your practice from providers offering PRP alone.
Built for providers ready to
lead in men's sexual health
MDs and DOs adding a non-surgical, cash-pay male sexual wellness service. Urology and primary care providers find the P-Shot® a natural clinical extension — particularly for the patient who has failed or refused pharmacologic ED treatment. Anti-aging and regenerative medicine physicians use it as a cornerstone of a men's health service line.
NPs and PAs expanding into men's sexual health and regenerative medicine. In Arizona, NPs with full practice authority can offer and direct the P-Shot® independently. PAs require a supervising physician relationship. The course covers scope of practice documentation in both contexts.
RNs can offer the P-Shot® under written standing orders from a qualified medical director. The course covers the standing order structure and documentation applicable to RN injectors performing intracavernosal procedures in Arizona. Ask about our medical director services if you need one established.
Practices already treating low testosterone frequently encounter patients with ED — and the P-Shot® is the logical complement to TRT for the patient whose erectile function hasn't fully recovered with hormonal correction. The course addresses when to offer PRP alongside, before, or after hormonal optimization.
The P-Shot® course is designed for licensed providers ready to integrate this procedure into active clinical practice. Prior PRP experience is helpful but not required — the course covers PRP science and preparation from the ground up.
- Active, unrestricted license in your field (MD, DO, NP, PA, or RN)
- Arizona licensure for medical director engagements; training open to out-of-state providers
- Ability to perform or be supervised performing injections under your license
- Basic comfort with male anatomy; no formal urology background required
Substituting another licensed attendee is always free with no notice required.
The P-Shot® and Priapus Shot® are trademarked procedures. Only CMA-certified providers with active membership are legally authorized to use these names in marketing and patient materials. Our course provides everything required to practice as a fully compliant, licensed P-Shot® provider from day one — including the trademark license that non-CMA training cannot give you.
Meet Naomi
Naomi Fayzulayev, FNP-C
Founder, Beso Wellness & Beauty · Board-Certified Family Nurse PractitionerNaomi founded Beso Wellness and Beauty to close the gap between clinical training and real-world practice — offering the kind of hands-on, small-group instruction she wished she had when she started. With over 15 years of clinical experience and deep roots in regenerative and aesthetic medicine, she brings active, practicing expertise to every course she teaches.
Her approach is integrative: combining conventional medicine with evidence-based wellness therapies to address root causes, not symptoms. As a Certified Trainer for the Cellular Medicine Association (CMA), Naomi personally trains other medical providers in advanced procedures including the O-Shot® and P-Shot® — a credential held by a small number of practitioners nationally. She holds advanced certifications in functional medicine, hormone optimization, and advanced medical aesthetics, and is known for her meticulous technique and the warm, patient-centered environment she creates in every training session.
She believes a well-trained provider is the foundation of a well-run practice. Every course she teaches reflects that: small cohorts, live patients, real feedback, and the business context to use the skills you leave with.
Clinical Practice
Per Cohort
Trainer
Active Practice
What makes this different from
other P-Shot® courses
Intracavernosal injection — injecting into the erectile tissue of the penis — is not a procedure where a demonstration video and a mannequin are adequate preparation. The nerve block that makes it tolerable for the patient is genuinely difficult to perform well the first time, the injection depth and angulation require anatomic precision in a vascular-dense structure, and the complication you most need to understand (priapism, though rare with PRP) has zero margin for delayed recognition.
Every attendee performs the complete P-Shot® protocol on live consented patients — nerve block, full injection sequence, VED instruction, post-procedure documentation. Naomi watches your block placement, your needle angulation, your patient communication during injection. That real-time feedback is not available in a group observation format with 20 attendees watching one instructor inject.
The CMA certification is not a marketing add-on. It is the legal prerequisite for using the P-Shot® and Priapus Shot® trademarks in your marketing. Without it, you can offer PRP injection to the penis — you cannot call it a P-Shot®, list it on the official directory, or access the patient education materials that make patient acquisition possible.
The P-Shot® and Priapus Shot® are registered trademarks. CMA certification from our course gives you the legal license to use both names in your marketing, your website, and your patient materials — and activates your listing on the official provider directory that sends patients to certified providers.
The dorsal nerve block and ring block are the skill that separates a tolerable P-Shot® experience from a patient who never comes back and leaves a one-star review. We teach the technique fully, with supervised hands-on practice on live patients during the afternoon session, including what to do when the block is incomplete.
The VED protocol and LI-ESWT overview are a dedicated module — not a slide at the end. You leave with the specific 6-week VED protocol and an evidence-informed framework for combining shockwave therapy with PRP, giving you multiple revenue streams and better outcomes from a single patient visit.
Full refund with 21+ days notice. Full credit at 7–20 days. 50% credit under 7 days or no-show. Substituting another licensed attendee is always free. We publish the policy because it should be the standard in clinical training — not a discovery at the point of cancellation.
Common questions
Ready to become a
P-Shot® provider?
The P-Shot® Training & Certification course is $1,999 — comprehensive didactic and hands-on training, all supplies, official CMA P-Shot® Provider Certification, 3-month introductory CMA membership with directory listing and trademark license, course manual, and lunch all included. Cohorts are small and scheduled regularly; spots fill in advance. Bundle with the O-Shot® for a combined sexual wellness training discount.
Inquire & Enroll →