Best consumer device for structural penis improvement for harder erections?

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I am looking for the wisdom of people in this forum for the current most proven solutions to structurally improve the penis for harder erections, without meds, without trimix injections, and without rings. Basically some device that makes the penis improve as the gym does for training muscles.

Sildenafil, Tadafil, Citrulline Malate and Red Light all seem to help, but I would like to get as hard as possible without them, because the spontaneity of life does not always allow to get the timing right.

In this regard, I heard Ben Greenfield a while ago talking about putting his penis in some device that created micro-damage and then the penis got harder over-compensating (maybe this was shockwave theraphy), anybody that can vouch for some consumer device based on this or other technology?

I have not tried anything yet in this regard, but a google search led to Vertica:
This looks interesting at first, however:
1) The only evidence seems to be a study of 28 people with 89% of users reporting improvements.
2) Some people report burns and ultrasound gel application awkwardness
3) The device is crazy expensive, ~1.8k EUR, not a problem for me, but I don't want to throw away money either

So, can anybody vouch for a device that is generally available to consumers and structurally improves the penis for harder erections? is there any device with more reliable data behind it?
More broadly: Is there benefit in going to a urologist to get a Doppler ultrasound to diagnose venous leakage before trying anything to measure the results more scientifically later?

Thank you!
 
Defy Medical TRT clinic doctor
Forgot to mention other concerns from this other website:
For example, the only study they use as data is also by the Companies consultant Professor as a co-author:
The effect of radio frequency on human tissues has been studied for decades; the effects of mobile phones/masts, is always in the news. I don’t think the effect of RF on human tissues is well understood. This device claims to help blood flow etc in the penis to help erection and maintain it for long enough for sexual activity. Whether this device can help men with ED problems, particularly men like us who have undergone PC treatments, remains to be shown with credible evidence.



The device was developed by Vertica-Labs Company in Israel. There is one research paper (by the Companies consultant Professor as a co-author) which reports a study carried out on 28 men. The writers claim that these men in a 6-month follow-up trial reported a range of benefits. They also state that the study requires a larger study and longer follow-up period. It seems somewhat unethical to me that the company uses such a hard sell approach, with no clear evidence that it is effective, at a basic cost of £1500 with no meaningful guarantee.



As a retired academic I am always suspicious of such claims. It is interesting to note that Professor IIan Gruenwald (Israel) and Professor David Ralph of University College London are consultants for Vertica. The Vertica representatives who had two entries on this stream I am pleased to see that they have been removed. Also Professor David Ralph who had a video link on the Vertica website has now also been removed. In my experience I am very aware that academics try to build on success stories to enhance their reputations and prospects for promotion and also chase further research fundings.



With the above facts in mind I leave readers to make a careful judgement on whether they wish to invest such a large sum. The company policy has no credible returns policy if the device fails to help, though it supposedly has a guarantee.
 
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Have you considered the Priapus Shot? It has been reported to also increase sensitivity.


Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial

Evangelos Poulios <a title="First Department of Urology, G. Gennimatas Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece." href="Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial - PubMed">1</a>, Ioannis Mykoniatis <a title="First Department of Urology, G. Gennimatas Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; Institute for the Study of Urological Diseases, Thessaloniki, Greece. Electronic address: [email protected]." href="Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial - PubMed">2</a>, Nikolaos Pyrgidis <a title="First Department of Urology, G. Gennimatas Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; Institute for the Study of Urological Diseases, Thessaloniki, Greece." href="Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial - PubMed">3</a>, Filimon Zilotis <a title="First Department of Urology, G. Gennimatas Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece." href="Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial - PubMed">1</a>, Paraskevi Kapoteli <a title="First Department of Urology, G. Gennimatas Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece." href="Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial - PubMed">1</a>, Dimitrios Kotsiris <a title="First Department of Urology, G. Gennimatas Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece." href="Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial - PubMed">1</a>, Dimitrios Kalyvianakis <a title="First Department of Urology, G. Gennimatas Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; Institute for the Study of Urological Diseases, Thessaloniki, Greece." href="Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial - PubMed">3</a>, Dimitrios Hatzichristou <a title="First Department of Urology, G. Gennimatas Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; Institute for the Study of Urological Diseases, Thessaloniki, Greece." href="Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial - PubMed">3</a>
Affiliations Expand

Abstract

Background: Animal studies postulate that platelet-rich plasma (PRP) injections improve key elements of the pathophysiologic mechanisms leading to erectile dysfunction (ED).

Aim: To conduct the first double-blind, randomized, placebo-controlled trial assessing the efficacy and safety of PRP injections in patients with mild and moderate ED.

Methods: Sixty sexually active patients with mild and moderate ED were randomly assigned to two sessions, with a one-month difference, of 10 mL PRP (n = 30) or placebo (n = 30) intracavernosal injections. An FDA-approved separation system was used. Patients were evaluated at 1, 3 and 6 months after completion of the treatment protocol. A per-protocol analysis was applied. All participants withheld any ED treatment during the trial.

Outcomes: The achievement of minimal clinically important difference (MCID) in the International Index of Erectile Function - Erectile Domain (IIEF-EF) from baseline to 6 months after final treatment. Erectile function at all time points, as well as safety of PRP injections, were also evaluated.

Results: At 6 months, a MCID was achieved by 20/29 (69%) patients in the PRP group compared to 7/26 (27%) in the placebo group. The risk difference between the two groups was 42% (95%CI: 18-66), P < 0.001 and the baseline-adjusted mean between-group-difference in the IIEF-EF score was 3.9 points (95%CI: 1.8-5.9). Similarly, a statistically significant difference of both the number of participants attaining a MCID and the IIEF-EF score was also observed at the 1- and 3-month evaluation between the two groups. Accordingly, patients receiving PRP were more satisfied with the treatment. No adverse events were observed during the study period.

Clinical implications: Intracavernosal PRP injection therapy used as outlined in this trial appears to be a safe and effective short-term treatment for the management of mild to moderate ED.

Strengths & limitations: We conducted the first clinical trial exploring the role of PRP in the management of ED. Conversely, our findings lack external validity due to single-center design. Furthermore, our results cannot be extrapolated to other PRP separation systems.

Conclusions: PRP intracavernosal injections may be a promising addition to the urologist's armamentarium for the management of ED. Still, further high-quality studies are warranted to corroborate our findings. Evangelos P, Mykoniatis I, Pyrgidis N, et al. Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial. J Sex Med 2021;18:926-935.
 
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