Why are some women getting a shot of PRP in such a sensitive area? Is it worth it? What should you know if you are considering the O-Shot? Will it work for you, or are you better off trying something else?
Click to see a diagram of where PRP is injected for the O-Shot
Does the O-Shot® Really Work?
The short answer is.. it depends. The O-Shot® is an off-label, experimental use of platelet-rich plasma, PRP, which is designed to help with different aspects of the female urogenital system. It tends to work well with conditions such as stress urinary incontinence (bladder leaking with sneezing, coughing, running, jumping etc), and skin conditions such as lichen sclerosus. With sexual dysfunction the improvement rate is lower (approximately 85% after two treatments). In all situations, it should be remembered that using PRP is considered experimental, even though it is very safe.
History and Research of the O-Shot®
The O-Shot® was invented by Dr. Charles Runels in 2010 and describes a method of injecting PRP into the female urogenital area as a way to rejuvenate the vagina and help women with urinary incontinence and sex problems. Dr. Runels reported positive results in a small series of patients in a pilot study.1 The use of PRP in various gynecologic disorders has been described by other authors, and include improved wound healing after caesarean section, lichen sclerosus, cervical ectropion and more. 2,3
New Research on the O-Shot: A Pilot Study in 2021
Quite recently, in 2021, a pilot study was published in which a group of 20 women with stress urinary incontinence were treated with a single injection of PRP in the anterior vaginal wall and results were assessed 1 and 6 months later. Overall, there was a 60% rate of improvement after a single PRP treatment.4
Click to show a diagram of where the PRP was injected for stress urinary incontinence
The official website for the O-Shot® can be found here.
Dr. Yam was recently invited to be a featured speaker for IMCAS Academy in February 2021 to teach about Practical aspects and quality control of PRP for female urogenital concerns.
What is the O-Shot used for?
The O-Shot is a non-surgical medical procedure which uses highly concentrated PRP from a patient to treat the female urogenital system. It is used to improve female sexual dysfunction, urinary incontinence, and lichen sclerosis. There are also anecdotal reports of improvement in interstitial cystitis in patients. Read more about the history and use of the O-Shot here.
How does the O-Shot work?
This new procedure works by using the body's own natural growth factors to heal and rejuvenate the female urogenital system. The key is autologous PRP from a sample of the patient's own blood, prepared at the time of the procedure. The PRP is then activated with a tiny amount of calcium and then injected into the periurethral area to support the bladder and stimulate the Skene's gland. The activated PRP releases growth factors and cytokines, which stimulates and supports healthy tissue including blood vessels, nerves, and other connective tissue.
Is the O-Shot® effective?
Overall, the O-Shot® is quite effective, but it's better at treating some conditions than others. For example, the O-Shot® tends to work very well as a non-surgical treatment for urinary incontinence, with a success rate of over 90% after a single treatment, according to most surveys. This includes urinary frequency (eg. urge incontinence) and stress incontinence (urinary leakage with coughing, sneezing, jumping, running or other activity). There are even reports that it can help with interstitial cystitis, although this is anecdotal. Most research suggests that the most effective concentration for PRP is 5-8x baseline, prepared using a double-spin system.
Other important factors which which can influence the result of the O-Shot® include medical history, medication, diet, and lifestyle. Training and experience of the medical provider is also important.
Is the O-Shot Procedure Safe?
Yes, when performed by properly certified and trained medical provider, the O-Shot® is considered very safe. Since 2010, there have been hundreds of thousands of these procedures performed wordwide, including the USA by many doctors, including several gynecologists and urogynecologists. No serious side effect or lasting harm has ever been reported. The O-Shot involves an injection of autologous PRP which is derived from a patient's own blood, so it's very safe with virtually no risk of allergic reaction. PRP was first recognized for its ability to heal tissue in the 1970s and used several medical and surgical fields since the 1980s, including sports medicine, orthopedics, oral and maxillofacial surgery, etc. Over the past ten years, PRP has seen a surge in interest and many scientific studies have been published on using PRP to treat skin, hair, acne, scars, etc.
What are the side effects from the O-Shot®?
The O-Shot is usually well tolerated with few side effects, but you may experience slight swelling, soreness or pain, sensitivity, spotting, for a few hours to a few days. Urinary frequency and or a sense of urgency may also occur.
How long does it take for the O-Shot® to work?
For urinary symptoms such as incontinence, the O-Shot® tends to work very quickly, leading to improvement within a few days. For improvements in sensitivity and lubrication, the affect can take longer, up to 8-12 weeks as it takes time for the body to build new blood vessels and nerves. In general about 80% of the effect should be apparent by about 12 weeks.
How long does the O-Shot® last?
The effects of the O-Shot® are generally long lasting, a year or more, as it induces the formation of new tissue by the body. However, as time goes on, age related changes are always inevitable, including hormonal changes which can affect the female urogenital system, especially major changes such as menopause. For this reason, a patient may want to repeat the procedure, for example, once a year.
Is the O-Shot® Painful?
With an experienced and well trained injector, the O-Shot® is very comfortable, and most patients report no pain at all. Usually the most painful part of the is drawing the blood sample, which is just like when you provide a sample for a blood test at the lab. We use a prescription grade numbing cream, and nerve block with local anesthetic which is so effective that most patients report no pain or discomfort at all.
There is usually no downtime with the O-Shot®. Normal activities are ok even the same day as the procedure.
How to prepare for the O-Shot®?
Be well rested and stay hydrated on the day of treatment. Avoid fatty meals up to 6 hours prior to the procedure. Avoid smoking and alcohol up to 5 days before and after the procedure as they can have a negative affect on platelet function and blood flow. Avoid over the counter medication, (eg. advil, ibuprofen), and supplements (eg garlic, ginseng, ginger, green tea, fish oil, Vitamin E) which may also interfere with platelets . Do not stop any medication which has been prescribed by your doctor.
What to expect after the O-Shot® (Post-treatment Instructions)?
Following the treatment, there may be some sensitivity after the numbing wears off, but most patients tolerate the mild discomfort. Plain or extra-strength tylenol (acetaminophen) may be used if necessary, although most patients do not need it. We recommend waiting about 24 hours before resuming sexual activity, to allow the PRP to rest in the area. Avoid advil, ibuprofen or other anti-inflammatory medications which may interfere with platelet function. For the same reason, try to avoid or limit alcohol and tobacco products.
How to get a good O-Shot®: Important Considerations?
If you are thinking about the O-Shot®, it's important to look for a clinic that understands PRP and uses a high quality PRP kit approved by the FDA or Health Canada. As for concentration, it's generally accepted that the best results will be with a double-spin PRP kit in order to obtain PRP that is 5-8X above baseline concentration. However there is a sweet spot for PRP and "Super high" concentrated (>8X) PRP may actually lead to worse results. Also, make sure your provider is trained, certified and experienced to provide a comfortable treatment that is safe and effective.
- Runels C. A Pilot Study of the Effect of Localized Injections of Autologous Platelet Rich Plasma (PRP) for the Treatment of Female Sexual Dysfunction. J Women’s Health Care. Published online 2014. doi:10.4172/2167-0420.1000169
- Sanoulis V, Nikolettos N, Vlahos N. The use of Platelet-Rich Plasma in the Gynaecological Clinical Setting. A review. HJOG. 2019;18(3):55-65. http://hjog.org/?p=1766
- Dawood AS, Salem HA. Current clinical applications of platelet-rich plasma in various gynecological disorders: An appraisal of theory and practice. Clin Exp Reprod Med. Published online June 30, 2018:67-74. doi:10.5653/cerm.2018.45.2.67
- Long C-Y, Lin K-L, Shen C-R, et al. A pilot study: effectiveness of local injection of autologous platelet-rich plasma in treating women with stress urinary incontinence. Sci Rep. Published online January 15, 2021. doi:10.1038/s41598-020-80598-2