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.

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