Bocox for Erectile Dysfunction: Innovative procedure improves erections (Bocox™ Cellular Medicine Association)

There’s a new procedure which helps men achieve and maintain an erection.  Erectile dysfunction, or ED affects many men and increases with age.  It can be mild, moderate or severe.  Until now, treatments have been limited to certain well known medications, like the little blue pill.  Now at least three separate clinical studies have shown that Bocox is a safe and effective way to improve ED by improving blood flow to the penis and erectile tissue.​1–3​


What is Bocox for erectile dysfunction ?

Bocox is a new procedure using injections of Botulinum neurotoxin (BoNT) for the treatment of erectile dysfunction (ED).  BoNT is a neuromodulator produced by a well known bacteria named Clostridium botuinum.  There are several licenced forms of BoNT including Botox, Dysport, Nuceiva, and Xeomin.

BoNT causes temporary muscle relaxation (paralysis), which lasts from 3-6 months.  Precise doses of BoNT are most commonly used for cosmetic reasons to treat facial lines and wrinkles such as forehead and frown lines.  BoNT can also be used for medical treatments such as chronic headaches, TMJ pain (masseter hypertrophy), and hemi-facial spasm (HFS). 

More recently, there are clinical studies showing that BoNT can be used to treat erectile dysfunction. 

How does Bocox help to improve erections?

Bocox uses 4 injections of BoNT injected into the corpus cavernosum (erectile tissue of the penis) along the sides.  This improves erections by relaxing the smooth muscles that control blood flow.  This is the mechanism of action of other common ED medications, PDE5 inhibitors.  However BoNT seems to work even better than these types of medications, as Bocox has been shown to work in patients where PDE5 inhibitors have stopped working.

Is the Bocox™ procedure really safe?

Studies have shown that Bocox and Botulinum toxin used for ED is very safe with no reports of local or systemic negative side effects.  This includes no reports of priaprism (sustained, painful erections).  BoNT has been used for over 20 years to treat both cosmetic and medical concerns and dose of BoNT used in the Bocox procedure is very safe, 100 times lower than the dose deemed to be dangerous (LD50).

What’s the difference between Bocox and other ED medications?

Compared to other well known medications for ED (e.g. Viagra, Cialis):

  • Bocox does not cause headaches, nausea, flushing, stuffy nose or other side effects
  • Bocox lasts for around 6 months after a single treatment.
  • Bocox can work even when oher medications have failed.

Bocox vs P-Shot procedure improve erections?

Both Bocox and the P-Shot may improve erections and both procedures may be used together for increased benefits.   While Bocox uses neuromodulator medication, the P-Shot uses platelet-rich plasma.  This is known as the BoPriapus™ (Bocox™) and P-Shot 100™ procedures by the Cellular Medicine Association.  For more information about using PRP for erectile function, please see this page about the treatment with PRP P-Shot for Erectile Dysfunction.

What are the side effects of Bocox Injections?

At least three separate clinical studies have reported no systemic or local side effects of Bocox injections.  However, as with any procedure involving needles, there is a risk of: pain, bleeding, bruising, infection.

Does Bocox treatment hurt?

Bocox is very comfortable and painless for almost all patients.  We use topical numbing cream and a specially designed needle (made in Japan), with a very thin profile, so most patients report no pain or 1-2 on a scale of 1-10.

How long do Bocox Results last?

Results from a Bocox treatment usually last from 3 to 6 months.  A lower dose of 50 units tends to have shorter duration, and 100 units lasts longer.

Who is a good candidate for Bocox?

Men with erectile dysfunction can benefit from Bocox.  Men with mild ED will generally see better results, but even in severe ED, one study of 70 men showed that 65% reported improvement in erections.  Even men with diabetes had improvement and there was no difference between diabetic and non-diabetic patients.

Will Bocox Increase Penis Size?

Bocox may increase flaccid penis size due to relaxation of the smooth muscle, but Bocox™ will not increase size of erect penis. If you’re looking to increase penis size, consider the PRP P-Shot.

What are other ways to treat ED?

Other medical conditions which may be addressed to improve erectile function include:

Conclusion: Bocox may be a safe and effective way to treat ED

If you’re interested in learning more, please feel free to schedule a free consultation with our doctor.


  1. 1.
    Ghanem H, Fathy I, Abdel Raheem A, Shamloul R, Abdel Hamid M. 024 The Effect of Botulinum Toxin on Penile Vascular Parameters and Clinical Outcome in Patients With Severe Ed: A Pilot Study. The Journal of Sexual Medicine. Published online January 1, 2017:S11-S11. doi:10.1016/j.jsxm.2016.11.026
  2. 2.
    El‐Shaer W, Ghanem H, Diab T, Abo‐Taleb A, kandeel W. Intra‐cavernous injection of BOTOX            ®            (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial. Andrology. Published online April 20, 2021:1166-1175. doi:10.1111/andr.13010
  3. 3.
    Abdelrahman I, Raheem A, Elkhiat Y, Aburahma A, Abdel-Raheem T, Ghanem H. Safety and efficacy of botulinum neurotoxin in the treatment of erectile dysfunction refractory to phosphodiesterase inhibitors: Results of a randomized controlled trial. Andrology. 2022;10(2):254-261. doi:10.1111/andr.13104