Cycling (bicycle) & early failure

[Stewy78]

Im 61 years old. I've had 1 virtual and 3 in person consults after the breakage and did not mention anything about my physical activities; I didnt even think to bring it up. I just wanted to know if it needed to be replaced immediately and if a repair was an option as opposed to a replacement. I dont blame you at all for being off put by the AMS device after your experience, they also have a higher cylinder failure rate than the titan. I really did not like the titan flacid for over a year. now that the cylinders have softened up a bit and there is no fluid it doesnt bother me much. Pros for getting another titan: reservoir can be retained and reused, no cost for the implant due to warranty and its a known quantity - ams might be a letdown in terms of girth/rigidity.
Are you sure that the tubing was the issue and not the pump? Dr Eid told me he would use the legacy pump in a revision since I had good dexterity, and a lot of touch pump failures were being seen. I hope you can work things out with Dr Eid but I think if you find surgeon closer who does a lot of revisions and is meticulous about infection control, you should be ok. Dr Eid has already done all the work fitting you with the largest implant possible. You might want to go with the legacy pump also, if that turns out to be the issue.
Can I ask if you saw any difference in girth with the titan as opposed to the AMS and were you bothered by the change in stiffness when soft with the titan?

Yes, the issue is for sure in the tubes as confirmed by Eid. With the titan my girth is 14.3 cm, with ams I was 13.5 cm. As for rigidity when soft, the ams has very few dog ears and it has a more natural appearance. Titan is stiffer and with more dog ears. But when inflated the titan is more rigid and stable.

[Jage64]

(AMS)they also have a higher cylinder failure rate than the titan.

What study are you looking at?

This one says there's no statistical difference, and actually AMS CX is more reliable. Also, Titan does not release their cylinder failure rate, but AMS does.

"While there was no statistically significance in device survival between the two devices, the trend favored AMS 700 CX over Titan (5-year Kaplan-Meier estimates of mechanical survival were 91% vs. 87%"

https://urology.wisc.edu/wp-content/upl ... .20131.pdf

[Stewy78]

(AMS)they also have a higher cylinder failure rate than the titan.

What study are you looking at?

This one says there's no statistical difference, and actually AMS CX is more reliable. Also, Titan does not release their cylinder failure rate, but AMS does.

"While there was no statistically significance in device survival between the two devices, the trend favored AMS 700 CX over Titan (5-year Kaplan-Meier estimates of mechanical survival were 91% vs. 87%"

https://urology.wisc.edu/wp-content/upl ... .20131.pdf

Various studies and many high volume surgeons say that cylinders failures are more common in ams. Bioflex titan cylinders are extremely durable, they almost never fail. But tubes sucks. Coloplast tubes are the most common cause of failure. Ams is definitely better for tubes. Many studies confirm that, for example this one :
https://academic.oup.com/jsm/article/20/7/1044/7162715?login=false

[iride111]

Thanks for the info. This is a tough decision. If you intend on flying to NY I would suggest January or February when the hotels are cheaper.
The paper you linked is excellent and confirms what I have been told during my consults with high volume surgeons and anecdotally, the roughly 100 revision surgery videos I have watched on youtube. In this video Dr Clavell states he has never seen a coloplast cylinder failure: https://youtu.be/vMyIOsHJoUs?t=398

Of course coloplast evens things out with their tubing failures. I wish this paper provided a breakdown of the number of cases considered for review by manufacturer: ams, coloplast and unknown, so we could get an rough idea of the percentages of mechanical failure by manufacturer.