Does it last really 10 years?

[Fourtytwo00]

Hi mates. I'm doing some math.

In my country private insurances don't cover impotence treatment nor implant as a rule. There are some exceptions if you have Peyronie but it's not my case. So basically the choice is between National Healthcare with its queue and lack of choice or paying everything out of pocket.

Out of pocket means something between 18000-34000 USD. Reading here I understood that for the same amount you can have a top surgeon in the US. Since it's not a once in a life surgery, at least if you're in your 40s or 50s, having a reliable device would be quite important.
Yes I know, implants are marketed for 10-15 years and there are some statistics but.. actually I read many more buddies having to go to the surgeon again before 10 years than 10-15 years success stories. Also digging into the data and reading some studies it seems to me there is a 1 out 3 or 1 out 4 chance of needing a revision before 10y. If someone reaches 10 chances of arriving at 15 aren't so bad. Statistically speaking the distribution of outcome looks skewed.

What's your opinion?
How many of you are implanted since 10 years?

[TANGERINE]

Here is an abstract that gives some statistics:

J Sex Med
. 2010 Jul;7(7):2602-7. doi: 10.1111/j.1743-6109.2010.01801.x. Epub 2010 Apr 1.
AMS 700CX/CXM inflatable penile prosthesis has high mechanical reliability at long-term follow-up

Dong Suk Kim 1 , Kwang Mo Yang, Hyun Jin Chung, Hyun Min Choi, Young Deuk Choi, Hyung Ki Choi
Affiliations expand
PMID: 20384938 DOI: 10.1111/j.1743-6109.2010.01801.x
Abstract

Introduction: AMS 700CX/CXM inflatable penile prosthesis is increasingly applied for the treatment of erectile dysfunction (ED). However, there are a few long-term survival data of the inflatable penile prosthesis (IPP) over 10 years.

Aim: To determine the long-term mechanical reliability of AMS 700CX/CXM inflatable penile prosthesis in patients with ED.

Methods: A total of 438 consecutive patients with ED received implantation of an AMS 700CX/CXM penile prosthesis at our institution from January 1991 to April 2009. In 397 patients (90.7%), the medical records were available and current status of penile prosthesis could be obtained by a direct telephone interview. The overall and mechanical survival rates of penile prosthesis were evaluated using Kaplan-Meier method.

Main outcome measures: Assessing the mechanical and overall survival rates of the AMS 700CX/CXM penile prosthesis using Kaplan-Meier analysis, and looking for clinical factors related to survival of the CX/CXM using log-rank test.

Results: Mean age of 397 patients was 63.1 years (range, 24-93) and follow-up duration was 113 months (range 1-219). Eighty-two patients (20.6%) experienced mechanical failure at a median follow-up of 82 months. Mechanical survival rate of the penile prosthesis was 97.6%, 93.2% and 78.2% at 3, 5, and 10 years after implantation, respectively. 12 patients (3.0%) experienced nonmechanical failure including infections, tissue erosion resulting in cylinder protrusion at the meatus and chronic discomfort. Overall survival rate of the penile prosthesis was 95.0%, 91.0% and 75.5% at 3, 5, and 10 years after implantation, respectively. Patients with neurogenic cause for ED showed lower median overall survival of penile prosthesis compared with patients with non-neurogenic cause. Patient age, obesity, and diabetes mellitus had no association with overall survival of penile prosthesis after implantation.

Conclusions: The AMS 700CX/CXM could be accepted and applied in more patients as a reliable treatment alternative of ED.

[Elyrev]

I believe as these are becoming more popular as a choice this incentivized companies to make improvements. The implants they have in 5-10 years may be so improved, you will want the revision.

[dg_moore]

Mine lasted 12 years. But I never used it, so there's that...

[TANGERINE]

yes dg_moore ..... your point is interesting

Lasted ten years and then quite working even though I did not use it.

This suggests to me that the mechanism by which the implant breaks is not necessarily dependent on cycle count (ie, number of inflations). Instead, here is a possible explanation for your failure:

1) the titan fails because of tube fatigue at the insertion into the scrotum inflation bulb
2) repetative flexing of those tubes leads them to weaken/kink/break
3) the repetative flexing can happen maybe just from bouncing around of the bulb in your scrotum (likely in your case ?)

So, activity which leads to scrotum bouncing and moving may be bad. Activities that I can think of would be:

a) horseback riding
b) riding on a mower that bounce a bunch
c) driving a bouncing bus
d) rubbing your balls continuously on a bicycle seat or motorcycle seat

The above is speculation. The key is that dg_moore's implant failed at ten years even though he did not use it hardly at all, so the above idea regarding other activity coming into play as a failure mode is worth exploring and understanding.


ANy thoughts guys ?

[wolfcreek]

My first one leaked/stopped working after 4.5 years, and the replacement stopped working after just 2 years (pump won't reset).

[Fourtytwo00]

12 years with no use isn't a good news for me actually.

TANGERINE, there is one problem when you have access only to abstract and conclusions of medical surveys. One is criteria of exclusions, which is the reason why they didn't include some patients in the survey or how many patients didn't show up, refused to answer, etc. I'm not saying they're hiding data. A study should give a minimum of comparability and it's not so easy to track people lives for 10 years. But having read more studies about that my feeling is that numbers tend to be biased upward. Mechanical failure is the main reason for early replacement but not the only one. Obviously you may have a retrospective study of relatively old model.

[defiant]

12 years with no use isn't a good news for me actually.

TANGERINE, there is one problem when you have access only to abstract and conclusions of medical surveys. One is criteria of exclusions, which is the reason why they didn't include some patients in the survey or how many patients didn't show up, refused to answer, etc. I'm not saying they're hiding data. A study should give a minimum of comparability and it's not so easy to track people lives for 10 years. But having read more studies about that my feeling is that numbers tend to be biased upward. Mechanical failure is the main reason for early replacement but not the only one. Obviously you may have a retrospective study of relatively old model.

I would stop trying to determine longevity by analysing user feedback and reports from this website. Indeed, people who have issues, problems, an axe to grind, will flock to the Internet and find the number 1 resource pertaining to that which ails them. In this case, Franktalk is one of if not the most pertinent online resource for men with or considering implants.

Keep in mind that the majority of implanted men receive their devices and from what I can certainly discern having read studies and articles alike, go off on their merry way, not to be heard from again until many years down the line.

I do believe the majority of implants placed today will last at least 8 years.

[Hrc714]

My implant failed after 3.5 years. I am finding out one of the limits on the amount of revisions you will need is the time expended between failure and repair. I estimate it will be 6 months. The time for consultation scheduling, follow up exams, insurance approvals, the inevitable appeal on initial rejection, and surgical scheduling all lead to delay. Also implant surgery is not critical so getting bumped from OR is not uncommon*. Need to figure that into the calculation on number of expected revisions.

*On my initial surgery, I was medicated and being wheeled to OR when I was bumped for an emergency. That I understood. I had trouble accepting the hospital and pharmacy bill for all the work up leading to being sent home a bit loopy with no implant.

[Fourtytwo00]

I would stop trying to determine longevity by analysing user feedback and reports from this website. Indeed, people who have issues, problems, an axe to grind, will flock to the Internet and find the number 1 resource pertaining to that which ails them. In this case, Franktalk is one of if not the most pertinent online resource for men with or considering implants.

Keep in mind that the majority of implanted men receive their devices and from what I can certainly discern having read studies and articles alike, go off on their merry way, not to be heard from again until many years down the line.

I do believe the majority of implants placed today will last at least 8 years.

Respectfully I disagree a little bit. It may happens you have to pay out of pocket for all your life, so feedback about durability and even feedback from malleable users have value. Yes people tend to jump on the web more often when have issues and walk away when they are fine. That's preatty common and reasonable. But since it's marketed as a 10 - 15y device I would expect to see more 10 - 15y revisions. Actually I would like to read more of that.