Malleable lifespan

[YC1990]

Hello guys,

Anyone with malleable implant more than 15 years?
From YT videos they mention that are more durable than IPP. For IPP is 10-15 years and from studies more than half of them are going strong after 20 years. For malleable what are the numbers? What percentage last more than 15 or 20 years??

[RoboCock69]

I got my implant at 39 and seriously considered the malleable because, with potentially 50+ years ahead of me, I didn't want to face multiple revisions. Dr. Perito mentioned there was a good chance a malleable could last the rest of my life, even considering my age, but ultimately, he talked me out of it. He pointed out the downsides: less girth, less concealability, a wobbly and unstable base over time, and the big one—it doesn't allow you to cycle and potentially regain lost size due to ED. In the end, I chose the IPP, knowing that if I experience an early malfunction, I can always switch to the malleable later. For what it’s worth, Dr. Perito also said, "The only malleable I'd put in you is the Coloplast Genesis."

[LastHope]

Malleables are undoubtedly more durable than inflatables in terms of mechanical malfunctions.

However, like any mechanical device, they are not immune to failure. Rod fractures can certainly occur, although the reported mechanical failure rate in the literature is low.

They were noted to have a 0.5% failure rate over 6 to 9 years.

I've attached an image of fractured AMS silicone rods with stainless steel cores.

"Minervini and colleagues reported 2 cases of mechanical failure (1 with AMS 600 and 1 with Mentor mal­leable (Mentor, Goleta, CA) in their series of 393 malleable penile prostheses implants. In these cases, the fractures also occurred late (after 79 months with Mentor malleable, after 112 months with AMS 600) as is seen in our case. Lee and colleagues reported on the first 2 cases of bilateral mal­leable penile prosthesis breakage with AMS 600 malleable penile prosthesis (62 and 78 months after implantation)."

Spontaneous breakage of malleable penile prosthesis:
https://pubmed.ncbi.nlm.nih.gov/9884923/
https://cuaj.ca/index.php/journal/artic ... /1893/8306

[easymoney]

Please make note that this information posted seems ro be from a medical paper written in 2014 ..much has happened with implants since then. The original questions were there any mallabble implant 15 yrs or old ..I'm not sure when they perfected the mallabbles and started implanting them anyone else have information? By the way I have a Rigicon implant 6-2024 1st revision due to being undersized from the beginning 6-2023.

[LastHope]

Good point, easymoney. Keep in mind that the Coloplast Genesis (formerly Mentor) has been in use since 2004 and hasn't seen any product updates in the past 20 years. 90s Mentor malleable is nothing but Coloplast Genesis without the hydrophilic coating. Genesis is essentially a 90's product, completely unchanged except for the hydrophilic coating.

As for Tactra or Rigicon, which were only introduced in 2019, obtaining 15 years of data is simply not possible yet.

We can only draw conclusions from the research data we have.

The fractures in the AMS rods (90s AMS malleable) occurred with the stainless steel rod in the silicone sheath. Since the Industrial Revolution, I'm confident we've perfected stainless steel manufacturing

[easymoney]

Tactra replaced Spectra which from what my dr. told me was a great implant. He won't use the Tactra matter of fact he told me last year when they discontinued the Spectra he bought up all he could for his patients. Yes time will tell and time tells all does it not?

[LastHope]

Agreed, only time will tell!

With just 2 failures out of 395 malleables studied, I’m very confident in the longevity of these devices.

The primary concern for patients with any implant should be infection, and a hydrophilic coating is particularly important in an IPP infected salvage situation where malleables are used as a spacer.

It’s 2024 and hopefully Boston Scientific will introduce a Tactra 2.0 with a hydrophilic coating!

[easymoney]

One issue is with the Tactra is some men complain if the rods are 13mm or larger it can be tough to bend them .. I have a Rigicon with 13mm rods and I'm having a hard time bending them where I want them ..

[LastHope]

AMS Spectra has a completely different design to address the bending issue, using multiple ball-and-socket joints similar to those in a traditional lamp stand. The downside is that it has more mechanical moving parts.

Don't you think that by the time you reach 6+ months, the bending issue should resolve as the internal tissues mature up during the healing process?