Transcript (references and other helpful links at the bottom of the page)

Good evening. We have several things for show and tell tonight. Welcome to our webinar. We have a lot of press about our new discussions concerning Botox for erectile dysfunction, which we didn’t invent, but we are refining and embracing, and progressing with. So, I want to show you some of that. And there are a couple of papers that are out that I think are worth looking at, but let’s start with the press that’s out. It’s pretty remarkable.

And then we’ll come back to what it is we are doing that I think will help make it safer and better for our patients. Let’s flip over to this. Hold on a moment, and I’ll show you some of the press.
Right here.
Okay. First of all, we had this come out where we didn’t ask for it. Someone made the connection, finally, between our Vampire Facial® procedure and lichen sclerosus.
I don’t recommend you guys use this picture because she doesn’t want us to use her picture, but the Daily Mail used it, and they made the connection. Hopefully, it will result in more people looking for us. They mentioned here, if you look at the studies that are out (see the references at the bottom of this page), let me pull this over so you can see, it’s quite a number of them that are very good in supporting the use of PRP for lichen sclerosus.

Saline is Not a Placebo

But there was the one study where I haven’t talked about it for a while, but there was one study where saline was used as a placebo and there was no difference between the placebo and PRP.
Here are the studies. Not a short list, but all of the others showed benefit. And the trick with the one that they refer to here is that the one study that showed no difference between placebo… well, saline was the placebo, and in soft tissue studies, saline isn’t a very good placebo (see references at the bottom of this page). I’m going to show you something else over to another… Here. All right, so I just put this out and I’ll put the link in the chat box. These are some of the papers into things we’re talking about tonight. And I put a whole list of papers where saline is being used to treat acne scars, basically to promote healing because of its higher dissection properties.
And if you look at the saline arm, over 50% of them got well with biopsy, which I can’t find another study where on pathology, on biopsy, more than 50% got better with the placebo arm. It doesn’t exist. And PRP did better than placebo. It just wasn’t statistically significant. So, I think the conclusions of that paper were wrong. And I think, really, it had a more important observation in the data in that when we do our procedures, we’re not only causing a change in the tissue from the PRP, the actual hydrodissection makes a change.

And when I talk with surgeons who do cosmetic work, a lot of liposuction, which I did in the past and have seen this, but people much more experienced than I ever was with liposuction, you can take a divot and just irrigate it with saline and it will cause adipocytes to proliferate and fill in the place. Anyway, this is pretty well known among surgeons and dermatologists, but it wasn’t even talked about in the conclusions of the lichen sclerosus study.
And so because of that, I think a lot of people are being turned away from it, even though we have a growing list of papers that show benefits. And if you go to our website, to the O-Shot® website, and just put in lichen sclerosus, these and others will come up. And of course, many of you on the call have dramatic life-changing stories about how it’s helping people. It’s unfortunate, but it’s okay. It means that we just have to keep plugging and doing the research and putting stuff out there.

Okay. So, back to what we’re talking about tonight. Some of the press now, if you want to, you’re treating lichen sclerosus, remember [inaudible 00:06:07] this journal club with pros in marketing. So, if you’re treating lichen sclerosus, if you go to that link, I just put it in the chat box and click on it; you’ll be on this page right here, with links to everything.  You could take that, you send it out to your people and say, “Hey, I’m offering this, and here’s where it’s talked about in the news.” And then, if you go to our O-Shot® website, you’ll see listed a lot of the research and you can point that out and offer to treat people.

Bocox™ Procedure Press

Now, here’s what came out. Here are three different articles that you could refer to in your emails talking about Botox. It is going viral. Here’s the Sun, and here’s the Daily Mail. And here is The Times. This is out of London, the Sunday Times, all talking about Botox helping with erectile dysfunction. I put some of those papers right here and I want to tell you some of those, over 500 of you have already taken our test. I want to show you some of the mechanics of that, how it’s working and how you can get rolling with the procedure in your office.

JAMA makes a correction in our favor

All right. Before I do that though, I want to show you this because it points out the reason for what we’re doing. If you look at the… And JAMA just made a correction, an article they put out. And if you look at the original article, the main gist of the article is that lots of people are using PRP in the penis for erectile dysfunction, but there are no protocols. And so for that reason, it’s all over the map what people are doing and what the qualifications might be to do it. And we don’t think that’s a good thing.
I wrote to JAMA and to the authors, and it took five months and a lot of negotiations, and I’m stumbling over that word because it was expensive negotiations. But we had convinced them that they didn’t need to keep that error in their article. And it is an error because those advertising with the P-Shot and the Priapus Shot® do have a protocol. So, they published and they were gracious enough to correct their erroneous article because it hurt our reputation.
It wasn’t about the science. Nothing in the article was about whether PRP helps or not. It was just that they didn’t think there was enough research. That’s debatable, whatever. I’m not going to say anything about that. There’s not a finish line like there is in a triathlon or something where everybody knows, “Okay, now we have enough research.” It’s a gradual acceptance that goes on with every new idea.
But what bothered me was the false statement that there is no protocol. And so we persuaded them to make a correction about that. The reason I bring it up now is that this is not an insignificant thing. As you guys know, I don’t legitimately do not want this organization or these procedures to be about me. If you go to, I don’t know, go to the Vampire Facelift website, you’ll have trouble finding me on the website. You couldn’t find me on the website for the first three or four years until my attorney said, You have to put your name out there or you can’t protect the mark and you can’t protect the integrity.
So, back to what we’re doing here.  We do have a protocol that we’ve all agreed upon. In that case, we’re able to, because of that standard, have some reassurance to people that they’re going to have a provider that, if they’re advertising with that name, that’s following that protocol. And then that allows us to do things like get malpractice insurance and take up for each other if someone was to say, “This is not a good thing.” Like this, which is why I made them correct it. I didn’t make them, but we persuaded them. That could not have happened without the amazing people in our group and our strong reputation. If you extrapolate, around 4,000 doctors doing procedures regularly, we’re pushing two million procedures and we’ve never had a serious sequelae that we know about. That’s huge.

For those of you who want to do our procedures, you’ve often needed a certificate. And although I’m signing it, I don’t consider it from me. It’s me representing the agreement of our group that we are going to follow certain protocols. Of course, we all make changes based on the patient we’re seeing, but they’re within the boundaries and the parenthesis of what we decide is good medicine. We’re all agreed to follow certain sterile techniques and use certain FDA-approved devices, et cetera.

That will apply to the Botox being used for erectile dysfunction. And it allows us to get malpractice insurance and present to the public that we have a protocol. And I wanted you to see where that protocol is. Many of you, like I said, have already seen it and see the mechanism we have for starting to offer this to our providers. So, let’s go through this one step at a time. And I want your comments, and I want your questions and I want you to tell me how you think we can make this better.
All right.

First of all, this is our process for offering Bocox to our patients so that we can present it in a standardized fashion. First of all, I mean, anybody can shoot Botox in the penis if they want to, just like anybody can shoot PRP in the penis and they don’t necessarily have to interact with the CMA at all. I just showed you with that JAMA correction why it’s important that someone has a protocol. And the thing that’s different about PRP and Botox, very different, is that there’s still not a board of any specialty that governs it. None. And so we’re filling in a much-needed thing. In the end, it has to be best for patients or it’s all smoke and mirrors.

And because there’s no board that covers PRP or that covers Botox, none, not even the Plastic Surgery Residency, last time I heard, no testing or standardization of it, and so we are filling in that gap and saying, “Well, at least this group of doctors are going to follow these particular guidelines and assist that people have these particular licenses to be able to do this procedure.” If you’re doing the P-Shot already, there’s no extra cost at all for what I’m about to tell you, none at all.

But I think it’s helpful to make sure that the people who offer Bocox, or Botox for the penis, under this umbrella of Bocox, are also certified to do the P-Shot because some people will want both. And I have found that over half of my P-Shot people now want both. If they can afford it, they want both.

For those of you that are new, the idea that… I’ll explain it quickly the way I explain to patients. Botox is known to relax and smooth muscle. It’s used in the bladder of women, who have bladder spasm. And it’s also known to relax and smooth muscle that controls the diameter of the arteries. And when it’s put into the penis, it’s shown to improve blood flow by relaxing the muscle and increasing the diameter of the arteries that flow to the penis. It’s pretty simple. And they say if they can afford it, they say, “Okay, add it into my P-Shot.” But then you have people that haven’t had a P-Shot yet. I mean, they’ve already had a P-Shot, and maybe they wanted to get the Bocox by itself.

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All right. That’s what we’re going to do. And those of you who already have the license for the P-Shot, we just spent five months and a fair amount of money taking up for our reputation and making sure JAMA acknowledges that we have a protocol and we will do as a group, we’re able to do the same thing with Bocox. All right. We covered that.

Okay, the Bocox protocol. I have notes here to remind myself to do stuff for you guys. All right, so I put it in to… I’ll show you where it lives. I put it into the Botox website. So, if you go to… Here’s some of the people that have taken the test already, over 500 people. But if you go into the Botox, I’m coming in the backside. But if you go into the Botox website, when you land on the dashboard, you can look at the top and it’ll say, “Bocox.” And when you click on it, you’ll be on this course. Let me just come in from a different way so you’ll see what I’m talking about.

When you log in, you’ll be looking at the following page, right? Like this. And at the top of it, you’ll see Bocox and P-Shot. When you click on that, you’ll see the course. And the course it’s one page. It’s three videos. Altogether, a little less than an hour long. And again, I don’t plan to be the inventor or the be-all, know-all, but here’s a protocol we can agree upon. And if we decide that needs to be changed, just like we have with the O-Shot®, we can change it as we think about it.
But what I did was read all the research that’s out so far about this and combine it. For example, there were two studies. There was a double-blind placebo-controlled study where 50 units wore often three months and 100 units lasted six months. And these were in people that had very resistant ED, that had extreme comorbidities like spinal cord injuries. And they still responded. Not everybody, but it was statistical, and they did better than placebo.
Anyway, that’s all embedded into this, including videos, short videos, it’s just a shot. So, there’s four-minute and five-minute video, seven-minute videos, about how to do the thing, either with PRP or as a standalone. This is more about the science. And you can see it’s just reviewing a journal club we’ve already done. Okay, but I’ve tuned up the references, they’re all at the bottom as well. So, there’s your references.

Where to take the tests for Bocox certification

After you do that and you say, “Complete the course,” then it’s going to want you to take a test. Let me get to that test. There. And the quiz is just… Oh, I clicked on the wrong thing. Here’s the quiz. The quiz is eight questions long, and I didn’t make it easy. I mean, I didn’t make it stupid easy. These are shots. It’s not doing calculus… I did it again, clicking the wrong thing. Hold on one second. There.
There’s a quiz.

Okay, so it’s eight questions and I wanted it to be thought-provoking so that it’s legitimate quiz. In other words, you guys are all good test takers or you wouldn’t be physicians. I wanted it to be legitimately that people… We need to protect the reputation. It can’t be hokey. The name has to mean something. And I showed you that thing with JAMA because if it doesn’t mean something, we’re conmen. For it to mean something, it means we have to demonstrate that we have… Where did it go? We’ve actually read about it and we’ve read the protocol and we’ve agreed to follow it.

Okay. The first one is, how many bottles of Botox is the LD50 for a 180 pound man? And the thing, the point I’m making here, I’ll just give you the first answer is that when you do the calculations on it, it takes about as many bottles as the weight of a person. Bottles. So, the LD50 IV push of Botox for, let’s make the math easy, for a 100 pound person, would be a hundred bottles of a hundred units each, a hundred bottles.

The Toxicity of Botox related to our Bocox Procedure

And if you figure the cost of a Botox bottle wholesale, you’re looking at about 70 grand worth of Botox shot IV to reach the LD50. And we’re using doses less than what’s used to treat migraines. Anyway, that sort of thing that it’s not calculus and all the stuff’s there, but just go through it. It’ll let you take the test more than once. And it’s supposed to automatically, when you’re done, put an icon by your name. It’s a little bit outrageous, so I may decide to change this.
But if you pass the test, it’s supposed to put this icon by your name, but 500 something people have passed it already and my software didn’t work. I just figured that out tonight, and my staff and I need to go manually do this. And I’ll probably change this to something a little less outrageous. But in a way, I kind of like it because if you look at the regular… I want it to be talked about. The best sort of press is free press, word of mouth. And by being a little outrageous, like naming stuff after the Greek God of fertility, which at first sounds a little outrageous, right?

Well, if you Google, that’s an outrageous fresco, but that’s on the wall of… It’s a great work of art on the wall of an amazing place in Italy. And his penis weighs the same as this fruit over here because he’s the god of fertility, of food and procreation of every type. It’s an outrageous visual, but it’s also a medical word that means… it’s [inaudible 00:21:54] for penis.
So, in the same way, I’m being a little bit outrageous with our icon, but all of you who have taken the test, give us a day or two and you’ll have this icon. And we will send you a certificate that looks like this because I’m getting to the malpractice. We have a malpractice carrier. Your carrier will probably cover it, okay? But hold one second, let me see if I can fill this up for you. There it is. It’ll look like our other certificates. It’ll have your name on it and it’ll say, “Successfully completed training for advanced injection of Botox for the rejuvenation and improve function of penile tissue.”

Because there is some evidence that might actually improve the tissue itself, not just function. Anyway, called Bocox. And to do that, people will have to pass our test. I have an insurance carrier that will ensure you to the limits of your state. For some states, like in Texas, the limit is 250 on a malpractice case. So, he’ll insure you to 250,000. But Botox has been used for, like we said, for bladder spasm in women, it’s been used for vaginismus, and it’s been used at much higher doses and very, very safe. Your a malpractice carrier, I hope, will cover it.

This is a new idea. If they don’t, I have someone that will cover it for you, and I’ll put that name out in a second. I’ll have to look it up. I don’t want to slow down right now to pull it up, but it’s the same person that covers our other stuff. They’ll cover your whole practice, but he’ll cover just this procedure or just our procedures if you want.
Okay, back to… Let me look at this again and make sure I’m not forgetting anything. We’re to the wire now, and this is going viral, so we can go viral with you, it can go viral without you. And it could be that you want to sit this one out. If you want to keep doing P-Shot without offering the Bocox part of it, or the P-Shot 100, which is what we’re calling, we do the P-100 and add 100 units of Botox. If you want to not offer that, that’s fine. Just like all of us don’t do shockwave or lasers or radiofrequency, but it’s going viral already.
All right. The protocol we just talked about, where to see it, why we do a test so that it’s a legitimate thing. And the carrier that I’m going to get with knows that we have a decade, over a decade, history of our people not getting in trouble. There are no serious sequelae that have caused any sort of legal misjudgment against us. That can change with anybody at any time. But that’s where we are, and so they’ll write… If you have a certificate from us, from our group, they will write you a policy. Okay, let’s see.
I think that’s about all I wanted to say about the Bocox. Let me see if there are questions. I put the link in the chat box, like I said, to what I was showing you a moment ago, the references, and let me show this to you again. And then I’ll look at questions and we have a couple of papers to talk about and we’ll call it a night. Like I said, mostly it’s show and tell. There’s the page that you’ll see. I don’t think I’m going to keep this one up because it’s nobody else’s business really, unless they’re in our group. But I’ll keep it up for 24, 40 hours or so. And then it’ll be buried into the membership sites.
Let’s see. Research for Bocox. All right. I think that’s covered everything, except I had a couple of papers. Let me see what the questions are. Anybody have anything they want to bring up? We have, like I said, 500 people that have so far taken the test and they’ll have their icons and they’ll get their certificates and… I know one thing else I wanted to show you, is we own… See this Botoxpenis.com? And we own Bocox.com. And I’ll tell you why. It just occurred to me today why I’m stuck building this website because I really don’t want this to be Charles’s picture right here. Let’s just go to one… Go to Priapus Shot® website. PriapusShot.com. I don’t mind it being my picture, but I prefer it to be about the procedure and about the members in our group and not about me.

And I don’t know if you guys know this, but I rotate these videos out. If somebody sends me a good one, I’ll rotate it through and then I’ll take it off the main page and I’ll put it over here on recent posts or something, so it keeps living on the website and it’s about our members and not about me trying to be some kind of pompous, something that I don’t want to be.
Back to what I’m working on here. If you guys have a video or if you shoot a video that talks about the procedure, I’ll put it here. I’ve been wanting to do this website for a week and it just kind of hit me today why I’m so stuck because I just don’t want this to be Charles here. But this is going to be BotoxPenis.com. There’ll be a research page. And the directory won’t be on here, it’ll just be a link to the directory on the Priapus Shot® website, so it’ll still feed those who just do the P-Shot, but it’ll be playing that if you want to have the Botox part of it, find somebody with the icon.

And again, no extra cost if you’re doing the P-Shot. Just log on, watch the video, take the test, and I’ll put the icon by your name. I recommend that you charge… The cost of Botox is significant. I recommend you charge at least an extra $1200 to $1800 for adding in the Botox, depending on the city that you’re living in. I think less than that you, you’re basically giving it away and you’re risking losing money. Because we all have people that sometimes it doesn’t help them. You read the research, nothing works all the time. So, if you’re not charging enough and you give back money, you got to do two or three before you break even again. But you always give back money when it doesn’t work. By having enough profit margin, you stay profitable even if you give back money one out of 10 times.

Okay. I’m requesting that you guys… I’ll put my best email in the chat box. Let’s see. This one comes straight to me instead of going through my staff. If you’ll shoot me a video, a link to a video that you make about Botox in the penis, I will feature it, I’ll rotate it through. I’ll either feature it on the front page or one of the other pages. But this website will be live by Monday morning and there’ll probably be a press release that ties our stuff to what’s out there.
So, if you want to be early in and you want your website search engine optimized, because it’s one of the first stuff, add in the word Bocox and use the keywords Botox and penis when you describe about what it is, and you should be search engine optimized. We’ll have BotoxPenis.com and Bocox.com. You can see it’s already out, but I want somebody else’s video to be here.

And this is instead of saying entrepreneurial words and all that, guess what? We already have stuff, right? It’s going to say, “Daily mail.” It’s going to have journals that it’s been in science and popular press journals, that will be there. And there’ll be an inquiry where they can get on a list and typical sort of page where we’ll try to drive them to your office.
What do you charge for the Bocox? Yeah. If somebody wants to get the… All that’s on the page that I just showed you about suggested prices. And there’s also a link to my page. I’ll put it up there for you right now. This is Alabama prices, right? This is the page I have for my patients where it talks about it and it has prices on it. A first time P-Shot for me is $1,800, repeat is at a grand. And then the Bocox alone, I charge $1,797, combined with the P-Shot, it’s $2,787. I’ll put that link to my page, but you should go up on that. If you’re in a town where it costs more to turn on the lights and… Exosomes.

The exosomes and the amnion and all that, I’m afraid I’ve written out for the FDA. You can do what you’re conscious and your attorney tells you to do. But I’m not playing exosomes or amnion or anything other than PRP right now. The stem cells, I’m afraid of what can happen. So, I’d be careful with that.

Let’s see. All right, so if you’ve taken the test and passed it, if you don’t get if certificate within the next few days, let us know. And I want to show you a couple of papers that caught my eye real quick and then we’ll call it a night. Give me just a second to pull them up here. One of them was in the email that I sent out. Most of you are not doing this, but I think it’s so important to keep talking about this. Here we go. This one.

Some of you are doing, taking care of people that are… The last I heard, people will spend more money on two things than anything else: fighting cancer and trying to get pregnant. Those two things are the things that they’ll spend the most money about. And let’s see, yes, this one. Put the link in the chat box. This is probably the sixth time we’ve had a paper like this on journal club, and there are more that are out. But even if you’re not doing this work, at least let people know that it’s now an option. Not only are they harvesting viable eggs from postmenopausal women, but they’re also treating the endometrium to create a more likelihood of a viable pregnancy.

And then the other thing I wanted to show you is this one right here, which is a nice review article. I’ll put this one in the chat box too. And well, let’s see here. It’s open source. And the reason I wanted to bring it out here is, here’s the link to it. Is that dermatologists, they’re some of our brightest colleagues, you don’t just get to walk into derm school, right? But I don’t think they’re really trained to look at genitalia, if you think about it.
And when I hear some of the world’s experts talk about lichen sclerosus, one of the things they lament is the fact that the gynecologist skips the labia headed for the pat smear, and the dermatologist never takes people’s panties off. And so you have people walking around with lichen sclerosus, get diagnosed for all sorts of things, and not ever getting the proper diagnosis. I like to see our dermatology colleagues talking about the genitalia. It makes me happy to know that they’re going to be actually taking people’s panties off because they need to. They understand it. If you think about it, we have some brilliant gynecologists in our group, but a lot of gynecologists, best I can tell, are not used to doing genital… They’re not as comfortable. They wind up turfing it back to the gynecologist.

So, this was encouraging. You can see they talk about our procedure, they list one of the papers that we publish, but there’s many others that are out there. I don’t think there’s a lot new in here, but it’s a nice little review article. And I think the news to this article is that we’re going more and more mainstream with other specialties other than gynecology, et cetera. Just a couple more questions. Oh, got it. Okay. Yeah, I never gave you the… Thank you, Jeff. I never gave you guys the name of the insurance guy that a lot of you were using. Let me put it in the chat box. Give me a second. Talk to him today. I’m going to give you his… Okay, here. Let me put his email in the chat box and his phone number.
And a lot of times what happens is, I’ve noticed in our group is, someone will talk to their carrier in the early days. 12 years ago, when we were first coming out with the O-Shot®, they’d talked to their insurance carrier, malpractice carrier, and they’d say, “No, we don’t want to cover it.” And then James would offer them a policy and then they’d go back to the carrier and they’d say, “Okay, we give up,” and then they’d cover it. Now, of course, it’s not that big a deal to get our O-Shot® and P-Shot covered, but I don’t know what’s going to happen with the Bocox thing. I just honestly don’t.

So, there you go. It’s James Schroeder: ‭(216) 244-4423‬ . Okay. All in the chat box. And I think with that, we’ll call it a night.
Thank you guys for being on the call. I hope something here was helpful and encouraging to you. Have a good night.

References

PRP for Lichen Sclerosus

Behnia-Willison, Fariba, Nina Reza Pour, Behrang Mohamadi, Nadia Willison, Madeleine Rock, Ian W. Holten, Robert O’Shea, and Joseph Miller. “Use of Platelet-Rich Plasma for Vulvovaginal Autoimmune Conditions Like Lichen Sclerosus:” Plastic and Reconstructive Surgery – Global Open 4, no. 11 (November 2016): e1124. https://doi.org/10.1097/GOX.0000000000001124.
Casabona, Francesco, Ilaria Gambelli, Federica Casabona, Pierluigi Santi, Gregorio Santori, and Ilaria Baldelli. “Autologous Platelet-Rich Plasma (PRP) in Chronic Penile Lichen Sclerosus: The Impact on Tissue Repair and Patient Quality of Life.” International Urology and Nephrology 49, no. 4 (April 2017): 573–80. https://doi.org/10.1007/s11255-017-1523-0.
Chin, Simone, James Scurry, Jennifer Bradford, Geoffrey Lee, and Gayle Fischer. “Association of Topical Corticosteroids With Reduced Vulvar Squamous Cell Carcinoma Recurrence in Patients With Vulvar Lichen Sclerosus.” JAMA Dermatology 156, no. 7 (July 1, 2020): 813–14. https://doi.org/10.1001/jamadermatol.2020.1074.
Corazza, Monica, Natale Schettini, Pierantonia Zedde, and Alessandro Borghi. “Vulvar Lichen Sclerosus from Pathophysiology to Therapeutic Approaches: Evidence and Prospects.” Biomedicines 9, no. 8 (August 3, 2021): 950. https://doi.org/10.3390/biomedicines9080950.
Franic, D, Z Iternička, and M Franić-Ivanišević. “Platelet-Rich Plasma (PRP) for the Treatment of Vulvar Lichen Sclerosus in a Premenopausal Woman: A Case Report.” Case Reports in Women’s Health 18 (April 2018): e00062. https://doi.org/10.1016/j.crwh.2018.e00062.
Garrido-Colmenero, Cristina, Carmen María Martínez-Peinado, Manuel Galán-Gutiérrez, Virginia Barranco-Millán, and Ricardo Ruiz-Villaverde. “Successful Response of Vulvar Lichen Sclerosus with NB-UVB.” Dermatologic Therapy 34, no. 2 (2021): e14801. https://doi.org/10.1111/dth.14801.
Garrido‐Colmenero, Cristina, Carmen María Martínez‐Peinado, Manuel Galán‐Gutiérrez, Virginia Barranco‐Millán, and Ricardo Ruiz‐Villaverde. “Successful Response of Vulvar Lichen Sclerosus with NB‐UVB.” Dermatologic Therapy 34, no. 2 (March 2021). https://doi.org/10.1111/dth.14801.
Goldstein, Andrew T., Michelle King, Charles Runels, Meghan Gloth, and Richard Pfau. “Intradermal Injection of Autologous Platelet-Rich Plasma for the Treatment of Vulvar Lichen Sclerosus.” Journal of the American Academy of Dermatology 76, no. 1 (January 2017): 158–60. https://doi.org/10.1016/j.jaad.2016.07.037.
Goldstein, Andrew T., Leia Mitchell, Vaishnavi Govind, and Debra Heller. “A Randomized Double-Blind Placebo Controlled Trial of Autologous Platelet Rich Plasma Intradermal Injections for the Treatment of Vulvar Lichen Sclerosus.” Journal of the American Academy of Dermatology, January 2019. https://doi.org/10.1016/j.jaad.2018.12.060.
Gutierrez-Ontalvilla, P., F. Giner, L. Vidal, and M. Iborra. “The Effect of Lipofilling and Platelet-Rich Plasma on Patients with Moderate-Severe Vulvar Lichen Sclerosus Who Were Non-Responders to Topical Clobetasol Propionate: A Randomized Pilot Study.” Aesthetic Plastic Surgery 46, no. 5 (October 2022): 2469–79. https://doi.org/10.1007/s00266-021-02718-1.
Krapf, Jill M, Leia Mitchell, Michelle A Holton, and Andrew T Goldstein. “Vulvar Lichen Sclerosus: Current Perspectives.” International Journal of Women’s Health Volume 12 (January 2020): 11–20. https://doi.org/10.2147/IJWH.S191200.
Marnach, Mary L., and Rochelle R. Torgerson. “Therapeutic Interventions for Challenging Cases of Vulvar Lichen Sclerosus and Lichen Planus.” Obstetrics & Gynecology 138, no. 3 (September 2021): 374–78. https://doi.org/10.1097/AOG.0000000000004498.
Mitchell, Leia, Andrew T. Goldstein, Debra Heller, Theodora Mautz, Chelsea Thorne, So Yeon Joyce Kong, Maria E. Sophocles, Hillary Tolson, and Jill M. Krapf. “Fractionated Carbon Dioxide Laser for the Treatment of Vulvar Lichen Sclerosus: A Randomized Controlled Trial.” Obstetrics & Gynecology 137, no. 6 (June 2021): 979–87. https://doi.org/10.1097/AOG.0000000000004409.
Msc, Michelle King, Hillary Tolson, Charles Runels, Meghan Gloth, Richard Pfau, and Andrew T Goldstein. “Autologous Platelet Rich Plasma (PRP) Intradermal Injections for the Treatment of Vulvar Lichen Sclerosus.” Journal of Lower Genital Tract Disease 19, no. 3 (2015): S1–25. http://journals.lww.com/jlgtd/Fulltext/2015/07001/ISSVD_2015_Abstracts.2.aspx.
Pensato, Rosita, and Simone La Padula. “The Effect of Lipofilling and Platelet-Rich Plasma on Patients with Moderate–Severe Vulvar Lichen Sclerosus Who Were Non-Responders to Topical Clobetasol Propionate: A Randomized Pilot Study.” Aesthetic Plastic Surgery, May 31, 2022. https://doi.org/10.1007/s00266-022-02947-y.
Posey, Kathleen, and Charles Runels. “In-Office Surgery and Use of Platelet Rich Plasma for Treatment of Vulvar Lichen Sclerosus to Alleviate Painful Sexual Intercourse.” Journal of Lower Genital Tract Disease 19, no. 3 (July 2015): S1–25. https://doi.org/10.1097/lgt.0000000000000121.
Smith, J G. “The Journal of the American Academy of Dermatology.” International Journal of Dermatology 18, no. 6 (2005): 466–67. http://www.ncbi.nlm.nih.gov/pubmed/19539853.
Vittrup, G., L. Mørup, T. Heilesen, D. Jensen, S. Westmark, and D. Melgaard. “The Quality of Life and Sexuality in Women with Lichen Sclerosus – A Cross Sectional Study.” Clinical and Experimental Dermatology n/a, no. n/a. Accessed August 31, 2021. https://doi.org/10.1111/ced.14893.

Saline is Not a Placebo

Asghar, Aneela, Zahid Tahir, Aisha Ghias, Usma Iftikhar, and Tahir Jameel Ahmad. “Efficacy and Safety of Intralesional Normal Saline in Atrophic Acne Scars.” Annals of King Edward Medical University 25, no. 2 (June 24, 2019). https://doi.org/10.21649/akemu.v25i2.2867.
Bagherani, Nooshin, and Bruce R Smoller. “Introduction of a Novel Therapeutic Option for Atrophic Acne Scars: Saline Injection Therapy.” Global Dermatology 2, no. 6 (2016). https://doi.org/10.15761/GOD.1000159.
Bokey, E. L., J. P. Keating, and P. Zelas. “HYDRODISSECTION: AN EASY WAY TO DISSECT ANATOMICAL PLANES AND COMPLEX ADHESIONS.” ANZ Journal of Surgery 67, no. 9 (September 1997): 643–44. https://doi.org/10.1111/j.1445-2197.1997.tb04616.x.
Cass, Shane P. “Ultrasound-Guided Nerve Hydrodissection: What Is It? A Review of the Literature” 15, no. 1 (2016): 3.
El-Amawy, Heba Saed, and Sameh Magdy Sarsik. “Saline in Dermatology: A Literature Review.” Journal of Cosmetic Dermatology 20, no. 7 (2021): 2040–51. https://doi.org/10.1111/jocd.13813.
Popp, Lothar W. “Improvement in Endoscopic Hernioplasty: Transcutaneous Aquadissection of the Musculofascial Defect and Preperitoneal Endoscopic Patch Repair.” Journal of Laparoendoscopic Surgery 1, no. 2 (January 1991): 83–90. https://doi.org/10.1089/lps.1991.1.83.
Saltzman, Bryan M., Timothy Leroux, Maximilian A. Meyer, Bryce A. Basques, Jaskarndip Chahal, Bernard R. Bach, Adam B. Yanke, and Brian J. Cole. “The Therapeutic Effect of Intra-Articular Normal Saline Injections for Knee Osteoarthritis: A Meta-Analysis of Evidence Level 1 Studies.” The American Journal of Sports Medicine 45, no. 11 (September 1, 2017): 2647–53. https://doi.org/10.1177/0363546516680607.
Searle, Tamara, Firas Al-Niaimi, and Faisal R. Ali. “Saline in Dermatologic Surgery.” Journal of Cosmetic Dermatology 20, no. 4 (2021): 1346–47. https://doi.org/10.1111/jocd.13996.
Sharma, ReenaK, Mudita Gupta, and Ritu Rani. “Delineating Injectable Triamcinolone-Induced Cutaneous Atrophy and Therapeutic Options in 24 Patients—A Retrospective Study.” Indian Dermatology Online Journal 13, no. 2 (2022): 199. https://doi.org/10.4103/idoj.idoj_483_21.

Botox for ED
Abdelrahman, Islam Fathy Soliman, Amr Abdel Raheem, Yaser Elkhiat, Abdelrahman A. Aburahma, Tarek Abdel-Raheem, and Hussein Ghanem. “Safety and Efficacy of Botulinum Neurotoxin in the Treatment of Erectile Dysfunction Refractory to Phosphodiesterase Inhibitors: Results of a Randomized Controlled Trial.” Andrology 10, no. 2 (2022): 254–61. https://doi.org/10.1111/andr.13104.
El-Shaer, Waleed, Hussein Ghanem, Tamer Diab, Ahmed Abo-Taleb, and Wael Kandeel. “Intra-Cavernous Injection of BOTOX® (50 and 100 Units) for Treatment of Vasculogenic Erectile Dysfunction: Randomized Controlled Trial.” Andrology 9, no. 4 (2021): 1166–75. https://doi.org/10.1111/andr.13010.
Emura, Fabián, and David Peura. “Interview with Barry J. Marshall. Winner of the Nobel Prize in Medicine for the Discovery of Helicobacter Pylori,” n.d., 8.
Giuliano, Francois, Pierre Denys, and Charles Joussain. “Effectiveness and Safety of Intracavernosal IncobotulinumtoxinA (Xeomin®) 100 U as an Add-on Therapy to Standard Pharmacological Treatment for Difficult-to-Treat Erectile Dysfunction: A Case Series.” Toxins 14, no. 4 (April 16, 2022): 286. https://doi.org/10.3390/toxins14040286.
Giuliano, Francois, Charles Joussain, and Pierre Denys. “Safety and Efficacy of Intracavernosal Injections of AbobotulinumtoxinA (Dysport®) as Add on Therapy to Phosphosdiesterase Type 5 Inhibitors or Prostaglandin E1 for Erectile Dysfunction—Case Studies.” Toxins 11, no. 5 (May 21, 2019): 283. https://doi.org/10.3390/toxins11050283.
Habashy, Engy, and Tobias S. Köhler. “Botox for Erectile Dysfunction.” The Journal of Sexual Medicine 19, no. 7 (July 2022): 1061–63. https://doi.org/10.1016/j.jsxm.2022.03.216.
Porter, Dr Mark. “Botox: The New Viagra? It’s One Way to Treat Erectile Dysfunction,” sec. times2. Accessed November 8, 2022. https://www.thetimes.co.uk/article/botox-could-help-men-beat-erectile-dysfunction-here-s-what-to-know-8x2vvt9c7.

Safety of Botox

Arnon, Stephen S., Robert Schechter, Thomas V. Inglesby, Donald A. Henderson, John G. Bartlett, Michael S. Ascher, Edward Eitzen, et al. “Botulinum Toxin as a Biological WeaponMedical and Public Health Management.” JAMA 285, no. 8 (February 28, 2001): 1059–70. https://doi.org/10.1001/jama.285.8.1059.
Bhatia, K P, A Munchau, P D Thompson, M Houser, V S Chauhan, M Hutchinson, A H V Shapira, and C D Marsden. “Generalised Muscular Weakness after Botulinum Toxin Injections for Dystonia: A Report of Three Cases.” Journal of Neurology, Neurosurgery & Psychiatry 67, no. 1 (July 1, 1999): 90–93. https://doi.org/10.1136/jnnp.67.1.90.
“BOTOX 100 Units – Summary of Product Characteristics (SmPC) – (Emc).” Accessed September 1, 2022. https://www.medicines.org.uk/emc/product/859/smpc#gref.
Dhaked, Ram Kumar, Manglesh Kumar Singh, Padma Singh, and Pallavi Gupta. “Botulinum Toxin: Bioweapon & Magic Drug.” The Indian Journal of Medical Research 132, no. 5 (November 2010): 489–503. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028942/.
Frevert, Jürgen. “Content of Botulinum Neurotoxin in Botox®/Vistabel®, Dysport®/Azzalure®, and Xeomin®/Bocouture®.” Drugs in R&D 10, no. 2 (July 2010): 67–73. https://doi.org/10.2165/11584780-000000000-00000.
Hefter, Harald, and Sara Samadzadeh. “The Necessity of a Locally Active Antidote in the Clinical Practice of Botulinum Neurotoxin Therapy: Short Communication.” Medicina 58, no. 7 (July 14, 2022): 935. https://doi.org/10.3390/medicina58070935.
Naumann, Markus, and Joseph Jankovic. “Safety of Botulinum Toxin Type A: A Systematic Review and Meta-Analysis.” Current Medical Research and Opinion 20, no. 7 (July 2004): 981–90. https://doi.org/10.1185/030079904125003962.
Nigam, P K, and Anjana Nigam. “BOTULINUM TOXIN.” Indian Journal of Dermatology 55, no. 1 (2010): 8–14. https://doi.org/10.4103/0019-5154.60343.
Omprakash HM, and Rajendran SC. “Botulinum Toxin Deaths: What Is the Fact?” Journal of Cutaneous and Aesthetic Surgery 1, no. 2 (2008): 95–97. https://doi.org/10.4103/0974-2077.44169.
Stephens, Martin L, and Michael Balls. “LD50 Testing of Botulinum Toxin for Use as a Cosmetic,” no. 2 (2005): 5.

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