Alma Duo is an in-office, aesthetic treatment that uses gold standard shock wave technology, focused low-intensity extracorporeal shock wave therapy (LI-ESWT), clinically validated to stimulate better blood flow and restore his natural sexual performance – bringing spontaneity back to your life.

• Alma Duo is a quick, 15-minute in-office treatment
• No topical anesthetic and no downtime required.
• No pills. No needles. No surgery.
• Long-lasting results clinically validated at least 2 years post treatment.

source: https://www.hopkinsmedicine.org/health/conditions-and-diseases/erectile-dysfunction 

Here is the flashy promo video:

Neat.

If you are like me, you probably would prefer to see the video given to the doctors, which better illustrates how it works…minus the fruits and veggies.

Technology Overview

First introduced for stone fragmentation in the 1970s, focused low-intensity extracorporeal shock wave therapy (LI-ESWT) has since evolved to successfully address additional medical concerns in orthopedics for its anti-inflammatory benefits and in cardiology to promote angiogenesis, the formation of blood vessels.

What is LI-EWST?

Focused LI-EWST, delivered with Alma Duo’s patented electrohydraulic applicator, consists of a short pulse of about 0.5µs duration or a near instantaneous jump to a peak positive pressure, which is referred to as a ‘shock’, followed by a longer-lasting period of negative pressure. Shock wave peak pressure is nearly 1000X greater than the peak pressure in ultrasound waves.

How does LI-EWST work?

The peak pressure exerts direct mechanical stress. This shear stress sets off a cascade of wound healing responses that induces neovascularization and angiogenesis (formation of new blood vessels) to restore better blood flow and natural function to the treatment site.

Unlike other shock wave technologies Alma Duo’s patented electrohydraulic applicator is designed to reach in deeper depths (135mm) with 3X fewer pulses and lower energy to effectively treat not just the penile shaft but the penile crus – where 50% of the cavernous bodies that comprise the corpora cavernosa is located.

300 pulses are administered to 5 unique treatment sites, 3 along the penile shaft and 2 directed to the penile crus. Two treatments per week for three consecutive weeks is recommended.

The restorative properties of Alma Duo’s focused LI-EWST has been clinically validated, with the most studies published studies dating back to 2010 that includes hundreds of male patients around the world:

Go ahead, do your own research.

• Can Low-Intensity Extracorporeal Shockwave Therapy Improve Erectile Function A 6-Month Follow-up Pilot Study in Patients with Organic Erectile Dysfunction

• Does Low Intensity Extracorporeal Shock Wave Therapy Have a Physiological Effect on Erectile Function? Short-Term Results of a Randomized, Double-Blind, Sham Controlled Study

• Low-Intensity Extracorporeal Shock Wave Therapy—A Novel
  Effective Treatment for Erectile Dysfunction in Severe ED Patients Who Respond Poorly to PDE5 Inhibitor Therapy

• Low intensity extracorporeal shockwave therapy for erectile dysfunction: a study in an Indian population

• Low-Intensity Shockwave Therapy Improves Hemodynamic Parameters in Patients with Vasculogenic Erectile Dysfunction A Triplex Ultrasonography-Based Sham-Controlled Trial

• Low-intensity shockwave therapy for erectile dysfunction: is the evidence strong enough?

• Shockwave treatment of erectile dysfunction

• https://pubmed.ncbi.nlm.nih.gov/?term=shockwave+therapy+AND+erectile+dysfunction

P-Shot

Also known as platelet-rich plasma injections

I often use the P-shot to enhance the effects of shockwave therapy in cases of moderate to severe ED. It is also often requested by the more adventurous, who have no current ED issues, because it can often increase size and sensitivity.

A P-Shot prepared from your own blood. First we get 120 ml of blood from an arm vein (like a normal blood draw) and then take it to our Emcyte Centrifuge and spin off all the red blood cells. Next we transfer the amber plasma into a different tube and concentrate it again, removing most of the water and platelet poor plasma. What we are left with is about 10 ml of very concentrated plasma that is rich in growth factors that promote growth of new blood vessels and nerve, repairs and rejuvenates tissue, and promotes the growth of healthy new cells.

After seeing that, the most common question is, “Does is hurt?!”

Thankfully, the answer is that it is minimally painful. No more than any other shot, such as a vaccination. In fact, it hurts less than that because this layer of tissue is designed to hold blood. There is a quick jab from the needle, then pretty much nothing. Some guys want to get a nerve block, which is always offered, but nerve blocks themselves are painful. Most would rather just get on with it, with minimal discomfort. Almost every guy says, “Is that IT? I was expecting worse…”

Extra info on the P-Shot

If you would like to read more about the experience, here is a somewhat hilarious article by fitness guru Ben Greenfield, who just had to go and try this for himself: https://www.menshealth.com/sex-women/a19540927/stronger-erection-shot/

The official site of the P-shot inventor, Dr. Charles Runnels, has some interesting info as well: www.priapusshot.com

The research page is particularly interesting: https://priapusshot.com/research/

Finally, here is a link to study of 60 men, showing the P-shot is a promising treatment for ED: https://pubmed.ncbi.nlm.nih.gov/33906807/