What is a Happiness Stick (Penile Prosthesis, Stick of Happiness)? Why is it used, and what is its purpose?
In urology, the condition known as Erectile Dysfunction is commonly referred to as impotence. It is medically defined as the inability of the penis to achieve the hardness necessary for vaginal penetration or the loss of hardness before penetration.
The general prevalence of erectile dysfunction in the population is about 25%, with 9.6% experiencing severe erectile dysfunction (inability to achieve an erection). Erectile problems can be organic (due to an underlying cause) or psychological (no identifiable underlying cause). Organic issues develop gradually and worsen over time, while psychological issues typically start suddenly and often resolve on their own.
An important point to note: patients diagnosed with organic erectile dysfunction are very likely to develop vascular problems within five years, such as heart attacks, strokes, and vascular blockages. Therefore, patients with organic erectile dysfunction should definitely undergo a cardiological evaluation.
What is a Penile Prosthesis? (Happiness Stick, Stick of Happiness)
Commonly known as a Penile Prosthesis or Happiness Stick, this surgery typically lasts between 1-2 hours (except in exceptional cases). The procedure involves placing a prosthesis into the corpus cavernosum, the spaces in the penis that normally fill with blood to provide an erection, thus ensuring hardness.
MEN WHO UNDERGO THIS SURGERY HAVE AN 85% SATISFACTION RATE FOR BOTH THEMSELVES AND THEIR PARTNERS.
Types of Happiness Sticks
There are three types of happiness sticks
1. Simple Silicone Rods: The simplest type involves inserting two silicone rods into the penis. This method solves the problem completely but has the drawback of keeping the penis always erect, without the ability to revert to a flaccid state post-intercourse.
2. Two-Piece Prosthesis: This type is less complex, with fewer components inside the body, thus reducing potential issues. However, it is rarely used globally because it doesn’t provide sufficient hardness.
3. Three-Piece Prosthesis: The most commonly used type involves three components: two silicone rods placed inside the penis, a reservoir filled with fluid implanted in the abdomen, and a pump placed next to the testicle. Squeezing the pump transfers fluid from the reservoir into the penis, and pressing a button returns the fluid, deflating the penis.
Lifespan of a Happiness Stick (Penile Prosthesis)
Questions often arise about the lifespan of penile prostheses. Technically, they last indefinitely. However, within five years, about 15-20% may experience some malfunction. The most physiologically appropriate prostheses are the three-piece, complex types, which can be inflated and deflated at will. The rate of device malfunction is quite low.
What Happens If a Penile Prosthesis Fails?
If the prosthesis malfunctions, it can be surgically removed and replaced with a new one. It’s crucial to use prostheses that have been refined through years of experience to minimize the risk of malfunction.Penile Prosthesis Treatment
Treatment generally follows two steps:
1. Medication*: Initially, oral medications are tried. If these are ineffective or pose risks due to other medications like heart or blood pressure drugs, alternatives are considered.
2. Self-Injection*: Patients are taught by a urology specialist to self-inject the penis. However, due to pain and difficulty, this method is often abandoned quickly by patients.
THE MOST PERMANENT AND SATISFYING TREATMENT IS PENILE PROSTHESIS IMPLANTATION.
Important Notes About Penile Prostheses
– Three-piece prostheses have a 15% malfunction rate within five years, requiring surgical replacement if needed.
– Infection is the most undesirable complication, with a 3% occurrence rate.
– Post-prosthesis surgery, there is a slight reduction in penile length and girth. The longer the interval between cancer surgery (such as for prostate, bladder, or rectum cancer) and prosthesis surgery, the greater the loss in penile size.
Are Penile Prostheses Suitable for Diabetic Patients?
Penile prostheses are frequently used for young, insulin-dependent diabetic patients, as diabetes particularly affects small blood vessels, including those in the penis, leading to erectile dysfunction over time. While there is a slightly higher risk of infection for diabetic patients, proper techniques and precautions can prevent issues.
Risks of the Happiness Stick (Penile Prosthesis)
There are no inherent risks with penile prostheses, which are designed for individuals who no longer respond to medications or injections. Advanced technology prostheses, particularly those from the USA, provide significant patient satisfaction by expanding both in length and girth.
Minor risks include a small chance of device malfunction within five years, necessitating replacement surgery, and a two-month period of pain for 40% of patients due to tissue formation around the prosthesis.
Causes of Erectile Dysfunction (Impotence)
1. Smoking
2. Hypertension
3. Diabetes
4. Obesity
5. Sleep problems and sleep apnea
6. Chronic kidney failure and dialysis (even post-transplant)
7. Thyroid disorders
8. Drug and high-dose alcohol use
9. Medications: antidepressants, antipsychotics, antihypertensives
10. Brain and spinal cord diseases: tumors, injuries, Parkinson’s disease, multiple sclerosis
11. Hip fractures from traffic accidents
12. Radical Prostatectomy for prostate cancer results in a 65% incidence of erectile dysfunction
13. Radical Cystectomy for bladder cancer results in an 85% incidence of erectile dysfunction
14. Rectal cancer surgery
15. Radiotherapy for prostate cancer: 65% incidence, with brachytherapy at 31% and a 57% incidence of erectile dysfunction within five years
Treating Erectile Dysfunction After Prostate Cancer Surgery
Today, penile prosthesis surgery is performed to place a penile prosthesis (commonly known as a happiness stick) to fully restore sexual function and relieve patients from their ordeal.
Why Perform Penile Prosthesis Surgery?
Seven years ago, during a Radical Prostatectomy for advanced prostate cancer, the nerves responsible for erection were not preserved to ensure complete cancer removal. This extensive surgery prevented any prostate cancer issues for the past seven years. Now, the decision for prosthesis implantation has been made to restore sexual function. It’s important to note:
Nerve preservation during Radical Prostatectomy is not suitable for every patient, as it increases the risk of leaving behind cancerous tissue. Therefore, for high-risk prostate cancer (scores 7-10), nerves are not preserved, MEN WHOand penile prostheses restore sexual function to youthful levels.
This article is based on updates from the European Association of Urology (EAU) and the American Urological Association (AUA) for 2024.