AMS Ambicor 2-piece

[jubaman]

I'm a newby here, but I'm going in for implant surgery in just a few days (Aug. 30). I'm scheduled to have the 2-piece Ambicor implant. My doctor said that over the last few years, he's started using this almost exclusively rather than a 3-piece. Besides the surgery being less complex, he says that he found the patient satisfaction rate to be higher. He showed me some research indicating that they are easier to pump up and deflate and the erection rigidity is as good or better than some of the 3 piece units. He also said that many doctors simply haven't really looked at the latest gen 2-piece and continue with the 3-piece out of familiarity. I also spoke to one person who had one implanted in April who is extremely happy.

I've searched the boards and was surprised to see that there were was so little discussion of the 2-piece Ambicor here. So I figured I'd ask. Anyone have any experience/opinions on this beast?

[LGX_Man]

Hi Jubaman. WOW, isn't that something. I didn't realize that 2-piece implants were even being made anymore. Every time I hear of 2-piece systems being used, I always ass-u-me that the doctor's using them are either lazy or not willing to step up and learn about the latest in technology. There is also talk around here of the AMS CX systems being installed, but I don't even see the CX on the AMS site anymore. My doctor told me that they stopped making the CX years ago but it seems that there are various levels of education amongst implant doctors so the research continues.

I looked at the Ambicor section of the AMS page http://www.americanmedicalsystems.com/m ... bicor.html and it states that the fluid is located at the end of each cylinder, as opposed to the LGX which has a separate solution cylinder. This raises a question of whether or not the "extenders" can be added to body side of the Ambicor (as was done on my LGX) to increase the length to match the size of the penis that it's being put into OR if it will just turn out being however long the Ambicor is with no regard to restoring original size to the penis? Hopefully you already know the answer to this question if you did your research.

I liked the LGX because it came with the latest InhibiZone™ Antibiotic Surface Treatment and a special wear-reducing Parylene micro coating that increases the reliability and durability of the cylinders. I also like the LGX because the pump has those little grippy things on it, making it much easier to grip and squeeze inside of my already slippery scrotal sac. This is a somewhat recent addition and has been very well received, according to my surgeon. It looks as though the Ambicor is smooth and might slip out of one's hands while trying to grip. I, myself, was not given the option of the Titan Coloplast but it is also very widely used by many implant specialists out there http://www.us.coloplast.com/products/ur ... loplast%29

The Ambicor page states:
Advantages
Simple to use
Fast and simple one-step deflation
Natural flaccidity compared to non-inflatable implant
Totally concealed within the body

Disadvantages
Requires some manual dexterity
Possibility of leakage or malfunction
Flaccidity not as natural as 3-piece device

I gave you a few links so that you can do a bit of research, in case you haven't yet. Just wondering if you consulted with other doctors, or did you just see the one?

Best of luck with your operation. Let us know how it goes, I'd be interested in hearing about this particular implant as I've never yet heard of the Ambicor mentioned here or on the penile-implant groups at Yahoo.

LGX_Man

[jubaman]

Thanks for the reply LGX. I believe this doctor is pretty highly regarded. He’s heavily published on a variety of urological topics including, among other things, debunking the myth of testosterone being linked to prostate cancer (which many doctors still believe), and the practice seems to be very forward thinking.

Regarding the Ambicor, it does look like can be sized. I have a brochure from AMS that indicates that something called “RTEs” provide 13 length options.

Since there isn’t much info available, here’s some more info from the brochure:

“AMS Ambicor is a potent combination of Ease of Implant and Patient Satisfaction."

Features/Benefits
2 piece IPP Design
- Eliminates the technical challenges associated with reservoir placement
- Smaller pump intended to make insertion easier
- Stackable, snap cone RTEs for secure fit
- Fewer pumps needed to inflate cylinders
- One-step deflation
- All devices are pre-filled and pre-connected
- RTEs provide 13 length options

Quickest Cylinder Inflation at 20 PSI
- Ambicor high pressure cylinder provides support for patients with Peyronie’s disease
- Unmatched patient and partner satisfaction data

Concealability of an Inflatable device
- Patient and partner satisfaction


It then cites a study showing 96.4% patient and 91.2% partner satisfaction.

Then there are 2 bar charts that compare the Ambicor with the LGX (15 and 18 cm) and the CX (15 and 18 cm).

The first chart shows cylinder pressure in psi for each device after 5, 10, 15, 20, and 25 pumps. The Ambicor reaches 20 psi in 5 pumps. None of the others reach that pressure at all. The CX 15 cm almost gets there after 25 pumps, but the others max out at around 15psi.

The second chart is very similar but measures rigidity in pounds of force (lbf) at buckle. The results are also similar. The Ambicor exceeds 4.5 lbf after 5 pumps. The others never get above 2 lbf except the CX 15 cm which slightly exceeds the Ambicor after 25 pumps.

Now all be the first to admit that all this is new to me, and I’m well aware that a little knowledge is a dangerous thing. I don’t know how meaningful these metrics are (and it wouldn’t be the first time a vendor hyped meaningless data). However, if they are important metrics then the data is impressive (Rock hard erections maybe?? ).

It looks like I’m going to be the guinea pig for this group. I’ll post a follow on to let you know what happens.

[knotreel]

Ouch!! never tried to "buckle" my lgx but the thought has me squirming as I think it would hurt. I guess this Ambicor unit stays full of fluid so that the pressure will come up quickly as opposed to my lgx which requires some pumping to fill then more pumps to pressure up the cylinders. About rigidity, which one is the stiffest would be sorta moot in my my experience as my lgx exceeds any amount of rigidity I ever had. I did not think it was as hard as I used to be as a young man but that has changed now that it seems to be "broken in" at seven now at seven months. I don't think anybody could argue with the simpler surgery, that is a plus. Good luck with your implant. Can we start calling you Quick Draw?
Ron

[LGX_Man]

Indeed. I look forward to having another new implant to study here at FT. Best of luck. This should be very interesting.

[tukusmax]

The more I think about this thread, the more intrigued I am. I am seeing Dr. Gerard Henry in a couple of weeks and be sure this topic will come up.

I would think that AMS would build the Ambicor to the same high standards as the CX and the LGX, so quality shouldn’t be an issue. My thinking is the fewer parts, the fewer things to go wrong. I like the idea that it is pre filled and the tubing, pump and the cylinders are all pre assembled and tested by AMS before delivery and it’s implanted as a single unit. It would seem that by not having to implant a separate reservoir, the recovery time and discomfort level would be less.

Add that to the information that jubaman listed above, I would think this would be a no brainer.

Ron

[Robbin_Dale]

Hi Jubaman, how did the surgery go? I had an Ambicor implanted in early August. I'm still waiting for the swelling in the scrotum to go down. In mid September I should get the green light to try it out.
It looks like the Ambicor's bulb in the scrotum is much larger than the 3 piece units. I feel very sensitive to this piece in there. Hopefully this will go away with time. I also feel the point where the connecting lines hook into the tubes.
My doctor said that he put in a 16cm unit with a 3cm extension (which have 1cm increments), totalling 19cm. I don't know how far the base of the tubes go. I'm curious to see just what I will end up with. He likes the Ambicor because of the simpler design and better rigidity and fewer pumps required. He showed me the same data sheet that you described. He also inferred that AMS hypes the 3 piece unit because it costs more.
After four weeks I'm still waiting for the semi-erect shaft to settle down. This causes a lot of discomfort.
Good luck with your recovery and take it easy.

[jubaman]

Hi all,
I know that I’ve waited far too long to post a followup, but I simply didn’t feel up to writing till today. I’ll split this into two posts. This first one is about the surgery and recovery just to share my experience with everyone, and the next will be my thoughts on the Ambicor thus far.
I had my implant surgery on Aug 30 as scheduled. The surgery went very well . Of course, the only things that I remember were being wheeled into the OR and waking up in recovery – just the way I wanted it! No problems with anesthesia and no significant pain issues for the first day. The operation was done at Beth Israel in Boston and I must say that the staff that I interfaced with during my stay was simply outstanding. The overall experience was far easier than I ever would have imagined.
There was only one glitch, that fortunately turned out to be minor: In addition to the catheter there was also a collection device (don’t know the proper term) with a thin inserted into my scrotum to drain any residual blood. I remember the nurse checking it once during the night and remarking that there was very little blood collected. This sounded like a good thing. At 7am the next morning, however, when the chief urology resident and his team removed this device, blood started rushing from the hole where the tube was inserted. Apparently there was an unnoticed kink in the tube so it wasn’t draining properly. They covered me with pads to absorb the blood and “milked” my scrotum to absorb the remaining accumulated blood. I know this sounds gross, but it wasn’t at all painful – just a little messy.
Prior to this, I had been anxious to get the okay to be released. Needless to say this did not happen and they decided that I should remain in bed until after noon when they would make a call as to whether I could be released. They checked me a few times and were concerned about a continued dripping of blood. This was the first time that I actually looked at my scrotum and saw that it had swollen to at least 4x normal size. Still I wasn’t really feeling any serious discomfort which absolutely amazed me. What little I did have felt more like razor burn or chafing than anything else. I was finally given the okay to be released at 3pm and went home with a wad of gauze pads cushioning my scrotum.
The next morning, my wife and I checked the dressing and wound, and there were no signs of any bleeding, alleviating our major concern at that point. The swelling was still quite pronounced however, and I was actually beginning to feel more discomfort – maybe in the 4-5 range on a 10 point scale. I had been trying to minimize the pain meds, but started using them a little more – fortunately they worked!
It is now one day shy of a week since the surgery. Each day things have gotten a little bit better, but I am still feeling discomfort when I get up and start to move. Once I’m moving I seem to be okay. I actually went for a nearly 1 mile walk today. My scrotum is still swollen (maybe 2X normal) and is still black and blue as is my penis (except for the head). Clearly I’m on the mend, and it’s only a matter of time.
Next post, my current thoughts on the Ambicor.

[jubaman]

Here are some initial thoughts on the Ambicor, and I’ll try to address Robbin_Dale’s comments directly.
The Ambicor was implanted through what looks like about a 2” incision in the middle of my scrotum near my penis. I expect that once the wound heals it should be almost unnoticeable. I definitely think that this device requires a less intrusive surgery – as I’ve said a few times, I was just amazed at how good I felt coming out of the operation.
The implant seems to be in (I think) a partially inflated state, and I’ve been told to keep it pointing up to my navel except to pee. At first I thought it was fully erect, but some of that may have been just swelling in my penis – it feels more semi-erect now. This makes it difficult to urinate, but fortunately I brought home a urinal bottle from the hospital so I don’t have to push downward too much to aim for the toilet.
The bulb seems to be sharing space with my left testicle, and I find that sometimes I become very aware of it, and it can be uncomfortable particularly when I sit down. This is the side of my scrotum that is still the most swollen. I’m not worried about it at this point. I’m still thinking it’s simply a matter of continuing to heal and my balls getting used to their new roommate. Robbin_Dale mentioned that he thought the size of the bulb might be larger than the one in the 3 piece. I can’t really say. I know that when I was shown the devices a while back, I thought that the 3 piece bulb was squarer and thought that might be more uncomfortable, but I didn’t really notice a significant size difference. Overall, I think time will tell on this.
Robbin_Dale mentions that his doctor put in a 16cm unit with a 3cm extension. I don’t know what size my doctor put in, but will try to ask him this Thursday when I have an appointment. Right now, girth looks pretty similar to normal and length also looks close to normal, but I haven’t tried to measure anything and I don’t think it’s fully pumped up, so again time will tell.
I will say that I agree that managing my new equipment is a bit of a challenge at this point. We went out to a restaurant last night and I felt that I had to keep surreptitiously keep adjusting myself. I’ll be concerned about this as it sounds like you’re a month ahead of me and it’s still an issue. I’ve reverted to wearing briefs to give me support and keep me pointing north. I fear that the days of boxers is no more. If that’s the main accommodation that I have to make, it’ll be a small price.
So, thus far, I’m okay with how things have gone and will provide more details as time goes on.

[antelope]

Great posts, Jubaman. Thanks.