My opinion about Implant Longevity: - Worry is the Thief of Joy

[Jgoody]

Agreed! I added the over reporting possibility because aussieguy said there are sometimes duplicate reports but feel like most likely failures would be under reported in there. Can't say I disagree with anything else said there

[Jgoody]

Very interesting topic, guys. I think Tooyoung is right in his assumption that even without a denominator, one can estimate life expectancy from the median failure times reported in MAUDE. At the same time, Woody/GPT’s argument also makes sense: MAUDE reports are voluntary, meaning that patients who get 10 years of use from their device are far less likely to report it.

I would also like to add that if someone doesn’t trust official studies about failure rates, it is still possible to form a general idea of IPP life expectancy from studies that mainly address other purposes but indirectly provide data on device failures during the study period. For example: https://bacandrology.biomedcentral.com/ ... 21-00123-x

That being said, I prefer not to focus on things I cannot control, but rather on the things I do have influence over. So the real question we should ask is: how can we extend the life expectancy of these devices?

Cylinder leaks → Could avoiding pumping to the maximum 100% reduce the likelihood of leaks?

Tubing breaks → Could avoiding twisting the pump while inflating help prevent this?


After all, we are talking about hydraulic devices manufactured in series, so they are likely very similar. If some last 10 years, then (excluding defective units that fail within the first few months),it seems reasonable that others of the same series could last just as long, provided we adopt a few precautions.
Actually it wuold be interesting starting a thread specifically for discuss this potential strategies
What do you think?

Great response. I looked at that study you shared & see 84% survival rate at 6.6 years I believe, which seems about in line with what we've been told.

I'm interested in the subject of implant longevity myself. In fact, I pretty much avoided peritos exercises for that reason because I don't see how that is good on the system. Despite wanting more potential "growth" from doing them. I wish I could definitively say it's harmful or harmless or not because I'd do them if there was potential for growth & no harm done to the system but I just can't imagine they don't cause at least unnecessary ware & tear. Whether that's the reason I'm down a half inch in girth & length or not is debatable. It seems that plenty of guys lose a small amount, so I'm okay with that & good with where I'm at.

I decided I'm taking a more conservative approach & only was max, max pumping the 1st year. I'm hoping to get a long time out of mine, especially being I had to pay out of pocket. I totally get tooyoungs concern. I'm fortunate that at that age pills worked still or I woulda wanted to nuke the planet, if nothing worked for me. I didn't even know about implants until maybe 2 years ago.

Hoping these companies have trustworthy products for young men to use in the very near future. Also really hoping that insurance can get their shit together & cover implants more for all of us "younger" guys.

[Kiwias]

I know I said I didn't intend to post further on this topic but I have been following it and believe the discussion is worthwhile. That being said I don't have a strong position because I'm an oldie, albeit a fit and active one, and am more likely to be dead, decrepid or demented before any device I have implanted fails.
I would probably feel completely differently if I was facing this challenge at a younger age.
In my opinion there are 2 issues that need to be looked at
1. Early failure - What are the causes of these? Quality control? Surgeon error etc?. It seems likely to me that if these are better understood they can be mitigated against.
2. Eventual failure. In my opinion this is most likely due to built in obsolescence rather than technological issues. Unfortunately this is a byproduct of our economic system. This one will be very hard to prove, challenge or change.

I don't find tooyoung's arguments irritating but that being said I do feel strongly about misunderstanding, misinterpretation or misuse of statistical methodology. This is much too common nowadays and can be seen across the internet, media, politics and even peer reviewed research.
This does push my buttons:-)

> tooyoung wrote:
“I’m only looking at time to failure … with ~350 reports a month in MAUDE and ~20–25k implants a year, that shows 20–30% yearly revision. Doesn’t that prove reliability is poor?”

I think this needs to be unpacked carefully, because “time to failure” has a very specific statistical meaning.

1. Time-to-failure requires patient-level data.
To analyze “time to failure,” you need to follow a cohort of implants from insertion until event (failure or censoring). That’s how Kaplan–Meier survival curves are built.
MAUDE reports don’t provide that. They’re a pile of adverse events with no denominator, no total exposure time, and no survival curve. Using them as a proxy for time-to-failure is methodologically invalid.

2. Mixing counts and survival leads to distortion.
Taking “350 reports per month” and dividing by “20–25k new implants/year” is not a time-to-failure curve. It’s a rough ratio of adverse reports to new implants, ignoring that:
• Many failures are of older devices implanted years ago.
• The at-risk population is cumulative (hundreds of thousands of men with implants in situ).
• Revisions may be for infection, erosion, or surgical error, not just mechanical wear.

3. True time-to-failure looks different.
In proper survival analyses:
• Griggs et al. (2025): Median time to failure ~48 months for Boston devices, ~41 months for Coloplast. Failures were mainly cylinder ruptures, pump failures, or tubing fractures.
• Other long-term series: 85–95% survival at 3–5 years, 60–85% survival at 10 years.
That’s a gradual attrition curve, not a sudden 20–30% annual wipeout.

4. Why the fish-in-pond analogy breaks down.
If you only look at the “fish floating on the surface” (visible failures), you’re ignoring the vast majority still swimming.
To calculate time-to-failure properly, you need to know how many fish were in the pond to begin with, how long they swam, and when they died. MAUDE doesn’t give that.

Bottom line: Saying “I’m only looking at time to failure” doesn’t fix the problem. Without structured survival data, you can’t infer median failure times or annual rates. The only valid way to do that is through published survival analyses; and those consistently show a very different picture than the 20–30% yearly failure claim.

That said, I do want to acknowledge your concerns. It’s valid to be skeptical and to keep pushing for better data, especially for younger men who may face multiple revisions over a lifetime. Raising questions about reliability helps keep the discussion honest and motivates manufacturers and surgeons to improve. Please do keep looking critically at the evidence; just know that we need to ground those concerns in survival-curve data rather than raw adverse-event counts, or the picture can look more dire than it actually is.

[Courage]

I do feel strongly about misunderstanding, misinterpretation or misuse of statistical methodology. This is much too common nowadays and can be seen across the internet, media, politics and even peer reviewed research.

Applause.

cartoon-concept-of-clapping-hands-vector.jpg

[PowerliftingDad]

I've seen a lot of recent posts concerned about lifespan. I just wanted to bump this up for those that haven't seen it.

[Cololovin]

I've seen a lot of recent posts concerned about lifespa. I just wanted to bump this up for those that haven't seen it.

Yeah powerdaddy...teach us how to live day by day and not think about tomorrow at all...yesterday I bought a car for 30k..had the sweetest ride of my life...today it just went kaput...but I ain't mad...I even let the sales man as well as the previous car owner to fuck me for giving me the shitty car I paid for.

[PowerliftingDad]

I've seen a lot of recent posts concerned about lifespa. I just wanted to bump this up for those that haven't seen it.

Yeah powerdaddy...teach us how to live day by day and not think about tomorrow at all...yesterday I bought a car for 30k..had the sweetest ride of my life...today it just went kaput...but I ain't mad...I even let the sales man as well as the previous car owner to fuck me for giving me the shitty car I paid for.

Would worrying about have made any difference?
Changed the outcome in any way?

I assume you're gonna handle your situation and get it worked out right? Or are you gonna walk everywhere you go?

[Cololovin]

I've seen a lot of recent posts concerned about lifespa. I just wanted to bump this up for those that haven't seen it.

Yeah powerdaddy...teach us how to live day by day and not think about tomorrow at all...yesterday I bought a car for 30k..had the sweetest ride of my life...today it just went kaput...but I ain't mad...I even let the sales man as well as the previous car owner to fuck me for giving me the shitty car I paid for.

Would worrying about have made any difference?
Changed the outcome in any way?

I assume you're gonna handle your situation and get it worked out right? Or are you gonna walk everywhere you go?

I respect you are resuming this as a healthy debate.

First of all lets just agree that "worrying" is not modifiable..I can't tell myself not to worry and then voilà...yes your post about life can turn upside down in a blink of an eye or vice versa might comfort me a bit for a day or two...but afterwards certainly worry will creep in back again. What is modifiable though is the causes of this worry..and I don't think you would disagree that implant reliability is one.
What I would do after my car failing ? I will certainly not guve a good feedback on a forum for cars and will definitely not boast the car company or the guy who sold me the car...and I won't excuse them by saying I'm just one of the extreme minority where everyone in my neighbourhood who bought it got problems..mostly related to reliability....I don't think if I persist in delivering positive feedback even after my 4th car of the same model, the car company would give a damn about R&D to prolong that car's lifespan.

Worrying is integral to living...worrying is actually healthy and progressive..what is not good excessive worrying which is anxiety...HOWEVER, anxiety consitiutes unreasonable worrying or worrying out of no where...and that's not the case with Ipps...when almost every implantee reported to this site as a virgin case (before implanting) got a failure within a few years...a huge chunk within 1 to 2 yrs.
And why is that worrying ?...especially for young guys who are starting families...it is because repeated revisions will inevitably result in infections that very probably may result in penis shrinkage and ultimately end-stage penis where the penis is no longer implantable...not to mention financial and emotional burden throughout revisions...Many men can't stand the fact that their sex life ends so early in marriage where they will have to tell wife : sorry my penis gone kaput..I can buy you either a vibrator or Im ok you fucking behind my back...or saying goodbye to a 5 year old daughter cause you can't bear life impotent.
You yourself got a failure so early and chose to raise your daughters as a celibate which i truely admire (you know me I don't asskiss) but we can't generalize such such a strong attitude...some men will survive some men wouldn't bear it.

How do we solve that ? Not by clicking the worry button off because there isn't one unfortunately....the solution to that is to simply provide a proper feedback and force companies to fix the problem and that we get what we pay for....atleast to have the dignity of an informed consent.

That's my take and we can agree to disagree on that..but no one has the right to defame a criticizer as a troll or fear mongerer.

[GoodWood]

Yeah powerdaddy...teach us how to live day by day and not think about tomorrow at all...yesterday I bought a car for 30k..had the sweetest ride of my life...today it just went kaput...but I ain't mad...I even let the sales man as well as the previous car owner to fuck me for giving me the shitty car I paid for.

Would worrying about have made any difference?
Changed the outcome in any way?

I assume you're gonna handle your situation and get it worked out right? Or are you gonna walk everywhere you go?

I respect you are resuming this as a healthy debate.

First of all lets just agree that "worrying" is not modifiable..I can't tell myself not to worry and then voilà...yes your post about life can turn upside down in a blink of an eye or vice versa might comfort me a bit for a day or two...but afterwards certainly worry will creep in back again. What is modifiable though is the causes of this worry..and I don't think you would disagree that implant reliability is one.
What I would do after my car failing ? I will certainly not guve a good feedback on a forum for cars and will definitely not boast the car company or the guy who sold me the car...and I won't excuse them by saying I'm just one of the extreme minority where everyone in my neighbourhood who bought it got problems..mostly related to reliability....I don't think if I persist in delivering positive feedback even after my 4th car of the same model, the car company would give a damn about R&D to prolong that car's lifespan.

Worrying is integral to living...worrying is actually healthy and progressive..what is not good excessive worrying which is anxiety...HOWEVER, anxiety consitiutes unreasonable worrying or worrying out of no where...and that's not the case with Ipps...when almost every implantee reported to this site as a virgin case (before implanting) got a failure within a few years...a huge chunk within 1 to 2 yrs.
And why is that worrying ?...especially for young guys who are starting families...it is because repeated revisions will inevitably result in infections that very probably may result in penis shrinkage and ultimately end-stage penis where the penis is no longer implantable...not to mention financial and emotional burden throughout revisions...Many men can't stand the fact that their sex life ends so early in marriage where they will have to tell wife : sorry my penis gone kaput..I can buy you either a vibrator or Im ok you fucking behind my back...or saying goodbye to a 5 year old daughter cause you can't bear life impotent.
You yourself got a failure so early and chose to raise your daughters as a celibate which i truely admire (you know me I don't asskiss) but we can't generalize such such a strong attitude...some men will survive some men wouldn't bear it.

How do we solve that ? Not by clicking the worry button off because there isn't one unfortunately....the solution to that is to simply provide a proper feedback and force companies to fix the problem and that we get what we pay for....atleast to have the dignity of an informed consent.

That's my take and we can agree to disagree on that..but no one has the right to defame a criticizer as a troll or fear mongerer.

I see this a bit differently.

First, I do think worrying is modifiable. Entire fields like psychiatry and psychology focus on helping people manage and reduce excessive worry. Nearly every major religion also teaches ways to let go of unnecessary worry, and even the self-help world has plenty to say about managing it.

That said, I agree with you that worry can serve a healthy purpose when it’s proportional to the risk. If you’re in the jungle, it makes sense to worry about a large snake. If you’re sitting in an office, probably not. I think the real question in this discussion is what level of concern is reasonable when it comes to IPPs.

I may be misunderstanding your point, but are you suggesting that all IPPs fail within a few years, with a large number failing within 1–2 years? If that’s what you mean, I’d be interested in seeing documentation supporting that claim. If not, then I may simply be interpreting your comment incorrectly.

It’s certainly true that many men who post on FT have experienced failures. But the men who post on a forum like this aren’t necessarily representative of all men who receive implants. People who are having problems are naturally more likely to seek out and post on forums than those who are doing well.

Another point that often comes up is the idea that each revision increases infection risk until it eventually becomes inevitable. While it’s true that a revision generally carries more risk than the initial surgery, the idea that repeated revisions inevitably lead to infection isn’t supported by evidence. My understanding is that the risk increases with the first revision but then tends to level off rather than continually climbing with each subsequent procedure.

As an example from another area of medicine, I’ve had a cardiac defibrillator since I was young and I’m now on my third device. Based on battery life, I expect to need a fourth in a couple of years and likely several more over my lifetime. The risk associated with revisions hasn’t been described to me as increasing indefinitely; rather, it stabilizes after the first replacement. Infection is a risk, but it’s certainly not inevitable.

Disagreement is part of healthy discussion, and some of the most interesting threads here come from people seeing things from different perspectives. I try to assume good intent from everyone who posts.

When the term “troll” gets used, it’s usually not simply because someone disagrees. It’s typically because the tone of a post comes across as mocking, belittling, or intentionally provocative. For example, the opening of your reply to powerdaddy reads that way to me.

On another note, I completely agree that there is still room for improvement with IPPs. I do believe the manufacturers are trying to improve the devices, but progress takes time. Stronger tubing would be welcome, and I also think having more cylinder diameter options would help. I ultimately chose a Titan largely to avoid losing girth. I might have preferred the more natural flaccid state of the LGX, but the diameter options didn’t work as well for me. If LGX cylinders were available in larger diameters, I might have seriously considered them.

Medical devices do improve over time. Using my defibrillator as an example again: my first device, implanted in 2001, was larger than a deck of cards and the battery lasted about seven years. My current device is less than half that size and is projected to last around eleven years. I’m told the newest models are even smaller and may last close to fifteen years.

I hope my IPP lasts many years. Realistically, though, it will eventually fail. I’m 57 and intend to remain sexually active for a long time. When the device eventually needs replacement, I’ll look at the best available technology at that time, research the most experienced surgeons, and get the revision done so I can get back to enjoying life.

[Cololovin]

I think the real question in this discussion is what level of concern is reasonable when it comes to IPPs.

Couldn't agree more on what you said prior and yes that's the whole point of the disucssion.

I may be misunderstanding your point, but are you suggesting that all IPPs fail within a few years, with a large number failing within 1–2 years? If that’s what you mean, I’d be interested in seeing documentation supporting that claim.

Fair enough. I have several points to support this claim:

1) ​MAUDE Report Statistics: Data posted monthly by Lasthope shows an average of 350 failures per month. Over 60% of these are due to mechanical issues. The average lifespan is 5 years for the Titan and 4 years for the AMS (though the range is wide, spanning from a few months to 7 years). These figures remain remarkably consistent month-over-month. In statistics, this consistency is a hallmark of reliability, which refers to the degree to which a measuring tool produces stable and consistent results by controlling for random error.
​One might argue that because MAUDE does not capture every single failure, it isn’t a perfect representation of the total population. My counter-argument is that because MAUDE does not selectively report early failures—but rather collects reports randomly as they occur—it serves as a statistically valid sample.
​Furthermore, last September, after Lasthope persistently presented this data on FT and I joined in calling it out, industry leaders like Steven Wilson, Perito, and Tobias Kohler published the first paper in the 50-year history of IPPs to discuss MAUDE data in Nature. While some have downplayed this milestone, the timing is undeniable. It is unlikely to be a coincidence that the first-ever MAUDE-focused paper appeared just as we were relentlessly highlighting these numbers. My point isn't just to take credit; it’s to show that the biggest names in the industry now acknowledge MAUDE as a legitimate sample—ironically, even while some patients continue to argue against its relevance.

2) Social Media and FrankTalk Anecdotes:
Many often argue that 'only those with complaints appear online, while the satisfied majority are busy enjoying their results.' While it may be true that many are satisfied, those users often eventually become the ones posting about failures—and here is why.
​The vast majority of FrankTalk members join the forum as 'virgin' cases—men who are either about to get an implant or have just received one. Their journey is documented from day one through their signatures and post history. When a significant portion of this same group returns a few years later reporting revisions or failures, it invalidates the 'selection bias' argument. What we are witnessing is an anterospective (prospective) sample rather than a retrospective one. These aren't just random people showing up only to complain; these are users whose entire surgical journeys we have followed from the beginning. Just this week, for example, three members we’ve known since their initial surgeries reported broken IPPs after only 1–2 years.
​Furthermore, I have rarely seen a community so dedicated to 'cultish positivity.' I understand this as a mental defense mechanism, but it is damaging. Even a respected figure like Rodsmen, when facing a failure just two years post-op, felt the need to say, 'As much as I want to bury the lead, I’m sorry to tell you guys my implant failed.' That specific phrase—'bury the lead'—speaks volumes about the community’s creed. This pressure to maintain a positive front ironically harms the community more than it preserves its mental state, as it obscures the clinical reality of device longevity.

3) The 15-20 year hoax study: The '15-20 year study' is a complete hoax for three reasons. First, there is a glaring, declared conflict of interest. Second, even renowned experts in the field have called it a 'stretch,' refusing to back such an obvious exaggeration. Most importantly, the study is riddled with at least six fatal statistical errors. I’m happy to break those down in a separate post if you're interested.

4) Engineered Narratives and Demographic Shifts:
The current narrative, including most major studies, is largely published by beneficiaries—a point I can break down in more detail in a future post. To put it simply: if I buy a phone charger from Samsung, I cannot blindly trust a study they published claiming it endured a billion bending cycles or has a 1% annual failure rate. Independent verification is essential.

​Even if we accept the current published data at face value, these numbers rarely reflect the experience of a younger man. The mean age in these studies is typically between 60 and 65. The activity of a 70-year-old prostate cancer survivor iss likely very different from that of a 20-year-old with a venous leak.
​Furthermore, the demographics are shifting. Erectile dysfunction is becoming increasingly prominent in younger men, yet the industry continues to rely on data derived from an older population with different lifestyle demands and longevity requirements. A device that 'lasts' for a 70-year-old may be woefully inadequate for a young man with decades of life ahead of him.

My understanding is that the risk increases with the first revision but then tends to level off rather than continually climbing with each subsequent procedure.

A systematic review published by Tobias Kohler confirms an exponential increase in risk with each subsequent revision. This is common sense: if you were undergoing a fifth knee replacement, the infection risk would be sky-high due to altered anatomy, tissue changes, compromised perfusion, and the presence of inactivated biofilms established during the first surgery. It should go without saying.
​Even if one were to argue against the 'exponential' nature of the risk, we should certainly not be celebrating revisions with the 'easier recovery and longer-lasting implant' mantra. This is a 'death cult' narrative—and kudos to Perito for engineering it. To frame a surgical failure and subsequent re-operation as a benefit to the patient is a complete reversal of clinical logic.

Infection is a risk, but it’s certainly not inevitable.

With the kind of inevitability we’re discussing, for a young man with a life expectancy of another 50 or 60 years? Oh yeah, I bet it is.
​I also completely disagree with the comparison to internal defibrillators. A defibrillator battery has a predictable lifespan, and its replacement is nowhere near as nuanced as surgery in a delicate, active, and sensitive mechanical region like the penis. We are talking about an organ that is subject to physical movement, sweat, and high-use activity. To compare a static battery swap in the chest to a revision in the complex, vascularized tissue of the penis is a gross oversimplification of the surgical and biological stakes involved.

I try to assume good intent from everyone who posts.

I couldn't agree more and I respect that.

When the term “troll” gets used, it’s usually not simply because someone disagrees. It’s typically because the tone of a post comes across as mocking, belittling, or intentionally provocative. For example, the opening of your reply to powerdaddy reads that way to me.

Believe me, that shift in tone only happened after I was labeled. For instance, I was using this exact same tone during my debate with PowerliftingDad earlier in this thread. When he disagreed, his response was, 'I won't be responding to your negativity.' In my view, labeling someone as 'negative' just to avoid a difficult conversation is the very definition of toxic positivity.
​Even if we assume for a moment that I’m just one big asshole, sociopathic 'mofo'—does that kill my argument? Doesn't the data I'm presenting concern the entire community? In fact, isn't it the primary concern?
​You don’t have to like Winston Churchill’s or Truman’s attitude to agree with the facts they state. This is an anonymous forum—it is the perfect niche to be as brutally honest as possible. I truly don't understand why taking things personally is so common here when we should be focused on the evidence.

I do believe the manufacturers are trying to improve the devices, but progress takes time.

In a capitalist world, let's be realistic: companies won't spend a dime on durability R&D unless the feedback is overwhelmingly negative and sales take a hit. And don't get me wrong—I'm not a socialist either. Under socialism, the implant probably wouldn't even exist in the first place.
​All I am asking is that we speak our minds and remain honest about our fears and what we are actually witnessing. 'Burying the lead' helps no one. If we want better technology and longer-lasting devices, we have to stop sugarcoating the failures and start demanding accountability through honest data.

Stronger tubing would be welcome,

the most important priority I believe.

and I also think having more cylinder diameter options would help. I ultimately chose a Titan largely to avoid losing girth. I might have preferred the more natural flaccid state of the LGX, but the diameter options didn’t work as well for me. If LGX cylinders were available in larger diameters, I might have seriously considered them.

very constructive ideas and thoughts ( and you know me I don't sugarcoat/asskiss)

get the revision done so I can get back to enjoying life.

Some men believe that dismantling this morbid narrative—one engineered by figures like Perito and Wilson—is the first essential step toward reducing the frequency of revisions. And let's be clear: replacement is a medical necessity. My criticism doesn't mean I won't replace my own implant when it eventually goes 'kaput.' It simply means I intend to have the courtesy of being angry about it when it happens, rather than 'ass-kissing' the perpetrator.
​If your defibrillator lasted only 1–2 years before failing unexpectedly, you would obviously replace it to stay alive—but I’m certain you wouldn’t be thanking the cardiology community every few days for the 'great invention.' You paid for that device. You are a taxpayer. You work and innovate in your own job, you get paid, and you don’t expect society to thank you day in and day out for simply doing what you were hired to do. We should expect the same level of professional accountability from the medical device industry.