Penile Prosthesis – Happiness Stick Surgery (Penis Prosthesis)

What is Erection Problem? What are the reasons? How Is It Diagnosed?

The happiness stick can be a treatment method for patients with erectile dysfunction, that is, erection problems. Erectile dysfunction is also called impotence, and it is the event that a man cannot achieve and / or maintain sufficient penile erection (hardening) for sexual performance, either continuously or repeatedly. Considering all age groups, it is seen as mild, moderate and severe at a rate of approximately 31%. Roughly one in 3 early suffers from ED.

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Age, diabetes, hypertension, hyperthyroidism, used drugs, previous surgeries are the causes of cerebrospinal diseases, basilica erectile dysfunction. A good physical examination, laboratory investigations and penile Doppler ultrasonography should be performed for its diagnosis. Further investigations such as penile cavernosometry and angiography should be performed when necessary. In treatment, if there is an underlying treatable disease, it should be treated, and if sufficient hardening cannot be achieved despite this, medical treatment should be performed.

What Are The Treatment Alternatives For Erection Problem?

The first choice in medical treatment should be oral drugs such as sildenafil, vardenafil, avanafil, and tadalafil. These drugs are taken orally and are very effective in mild to moderate erection problems and patient satisfaction reaches 80%. They have side effects such as headache, muscle pain, gastrointestinal problems, nasal congestion and facial flushing. When oral medications are not enough, injection treatment into the penis is available. For this, a test dose is applied first and if the response is obtained, penile injection treatment is taught to the patient with double or triple mixture (bimix, trimix), just like insulin treatment in diabetic patients.

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15 minutes before the intercourse, the patient makes an intra-penile needle on his own and gets erection as a result of stimulation. The most important side effect of this treatment is priapism of the penis for a long time. If this situation exceeds 4 hours, it causes serious penile pain and should be treated urgently. If the patient does not want and can not tolerate these treatments, alternative treatments such as ESWT and PRP can be performed. If all these treatments are answered and penile hardening is not achieved, surgical treatment, ie penile prosthesis (happiness stick) is required. Penile prosthesis is the ultimate and its results are very pleasant for both the patient and the partner. Satisfaction is over 90%.

What Should We Understand When We Say Penile Prosthesis?

Penile prosthesis is a medical device that is surgically inserted into the penis of patients who cannot provide erection despite all medical treatments. It is not the case that the penis is cut and replaced with this device. It is the placement of a device made of a special silicon-like substance into the tunica albuginea layer that provides the rigidity of the penis. Penile prosthesis can be made with a 4-5 cm incision between the penis and the bag, and it is very difficult to understand from the outside.

What are the Types of Penile Prosthesis?

  • A one-piece happiness stick, that is, a semi-rigid cylinder, is surgically placed inside two penises, right and left. It is bendable. The most important disadvantage is that it is always hard and felt from the outside. The avant-garde, on the other hand, has a low risk of mechanical deterioration and is easy to use.
  • Two-piece prosthesis consists of two parts. The first part consists of two pieces on the right and left sides of the penis and the second part is the pump part placed next to the testicle. In the part placed on the penis, there is also a reservoir, that is, the reservoir part of the water that will provide hardening. When the pump next to the testicle is pressed, the water in the tank placed inside the penis passes into the parts placed in the penis and hardening is achieved. It stays hard for as long as you want, then when the penis head is pressed, the water goes back to the reservoir and the penis softens. The most important disadvantage is that the penis is always semi-rigid.
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  • Three-piece prosthesis are happiness sticks that provide the closest physiological hardening to real erection. This prosthesis consists of 3 parts, namely the reservoir (reservoir), cylinders and the pump. The reservoir part takes about 60 cc of water and is placed in front of the bladder in the abdomen. If the cylinders are pump into the penis, they are placed next to the egg. There are connection ways in between, that is, 3 parts are interconnected. When the pump is pressed, the water in the reservoir passes into the penis and hardness with tyether is obtained. Stays tough for the time you want. Afterwards, the water returns to the reservoir by pressing the area above the pump and the penis softens. It is the closest type of prosthesis to reality.

How is Patient and Partner Satisfaction in Penile Prosthesis?

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The satisfaction rate for those who start to use after the happiness stick is made is over 90%. The satisfaction of the partners of the patients is the same. During my clinical experiences, I heard a lot of patients saying that they were happy to have it done.

What is the length of stay in the hospital and when to start use?

It is operated upon after hospitalization. The operation time is approximately one hour. After staying in the hospital for one night, they are discharged the next morning. They are called for control one week later. Then, 6 weeks later, it is checked again and if everything is in order, use is allowed.

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What Are The Success Rates Of Penile Implants And What Are The Complications?

It is allowed to use 1.5 months after the penile prosthesis is placed. The success rate is about 98%. The most important complication is infection. In cases such as severe penile and region pain, fever, chills, swelling in the penis, the prosthesis should be thought to be infected and the prosthesis should be removed in this implant. The infection rate is about 2%. In the long term, situations such as prosthesis coming out of the skin, passing into the external urethra, which we call urethra, breakage, mechanical malfunction can be seen.

Prof. Dr. Abdullah ArmağanUrology Specialist

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