Inflatable vs Malleable - My Experience with Both & Infection

The final frontier. Deciding when, if and how.
LastHope
Posts: 965
Joined: Sun Feb 18, 2024 1:26 am

Re: Inflatable vs Malleable - My Experience with Both & Infection

Postby LastHope » Thu Dec 19, 2024 1:53 am

ready2go wrote:...and now i see online that the new shaw mpp has a hinge of some kind ? i dont know what that means .


The Shah Indian malleables always had what they call as flexible hinge (or WH - With Hinge) and a non-hinge (OH– nO Hinge) version for shorter dicks or for fibrosed corporas with differential lengths. The hinge area (see attachment #3) is softer silicone for forced concealment (no memory like you noted).

"......there was good stiffness once the base was supported during insertion and there was good concealment when the implant was sized so that 2–3 cm of the hinge protruded beyond the symphysis. Therefore, we had to create a range of implants of different sizes so as to achieve an optimal fit in penises of different lengths. Based on our clinical experience, we opted for 4 models which differed in the length of the anterior stiff zone. To make it easy for the surgeon, the models were numbered to match the stretched penile length (SPL) from symphysis pubis to mid glans.

WH09
With Hinge (WH) WH09 was meant
for a SPL of 9–10 cm and had a 7 cm anterior stiff segment followed by the hinge segment.

WH11
WH11 for a SPL of 11–12 cm and had a 9 cm stiff segment followed by the
hinge segment.

WH 13
WH 13 for a SPL of 13–14 cm with 11 cm of stiff segment.

WH15
WH15 for SPL of 15 cm and above, with a 13 cm stiff segment.

Non-hinged model
The original nonhinged model was also retained with the code OH01 (OH– nO Hinge) and was recommended for short penises (<9 cm) which had insufficient length for adequate hinge action, and also for very fibrosed corpora where there was marked discrepancy in the length of the
two corpora, requiring implants of different lengths, since OH01 could be shortened by being cut anywhere without concern for hinge action.


Twenty‑five years of the low‑cost, noninflatable, Shah Indian penile prosthesis: The history of its evolution

Indian Journal of Urology 2021 Apr 1
37(2):113–115. doi: 10.4103/iju.IJU_60_21


https://pmc.ncbi.nlm.nih.gov/articles/PMC8173931/

This malleable is famous for its long life due to elimination of possibility of metal fracture/metal fatigue. I've heard stories of 20+ years of active sex life. However, in the last few months, two different Indian surgeons on YouTube/X have reported very similar silicone fractures. Seems like they are having a pattern of quality control issues lately. I was thinking it was a one in a million factory defect but when confirmed on two different patients just after a year of implantation, it makes me wonder about factory manufacturing issues.
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Born early 80s. Congenital ED. Pills worked great for a while. Jan 2025 - Coloplast Genesis. 22cm (1cm RTE)-13mm.

moes35
Posts: 12
Joined: Wed Feb 19, 2020 4:01 pm

Re: Inflatable vs Malleable - My Experience with Both & Infection

Postby moes35 » Thu Dec 19, 2024 12:19 pm

Wow thanks for the info, that is quite concerning. I was hesitating between having the Shah implant or the Rigi10, but now I'm wondering if the low cost indian implant is really worth it.

User avatar
duke_cicero
Posts: 170
Joined: Tue May 28, 2024 2:58 pm

Re: Inflatable vs Malleable - My Experience with Both & Infection

Postby duke_cicero » Thu Dec 19, 2024 12:32 pm

Sometimes, you get what you pay for.
Born 1990. ED since age 20 after a bicycle accident. Coloplast Genesis malleable implanted December 2024. Read my implant journal here.

Gatorman97
Posts: 18
Joined: Thu Nov 14, 2024 8:49 pm

Re: Inflatable vs Malleable - My Experience with Both & Infection

Postby Gatorman97 » Thu Dec 19, 2024 5:22 pm

Guys to add to this topic, I had a Titan classic implanted on 10/28. Four and a half weeks later I developed an infection. My Dr. was able to do a salvage operation with a malleable Rigicon 2 weeks ago.

I’m not able to really compare the two because I only had the Titan for 4 weeks. But I will say the Titan had a more natural feel, was harder when fully pumped and walking around with a hard on 24-7 is an adjustment even when you’re not well endowed.

Depending on “field testing” I’ll probably stay with the malleable just cause I don’t want to develop an infection.

The one thing that’s a real bummer is that I lost length: 1/2 inch from the first surgery to the second, which in my case is important to me.

Anyone have any ideas on how to regain some of this length through a reaction device or VED? Even 2 cm would be important for me.

I’m 51 and in decent shape and weigh same as I did in college.

LastHope
Posts: 965
Joined: Sun Feb 18, 2024 1:26 am

Re: Inflatable vs Malleable - My Experience with Both & Infection

Postby LastHope » Fri Dec 20, 2024 6:25 am

Gatorman97 wrote:Guys to add to this topic, I had a Titan classic implanted on 10/28. Four and a half weeks later I developed an infection. My Dr. was able to do a salvage operation with a malleable Rigicon 2 weeks ago.

I’m not able to really compare the two because I only had the Titan for 4 weeks. But I will say the Titan had a more natural feel, was harder when fully pumped and walking around with a hard on 24-7 is an adjustment even when you’re not well endowed.

Depending on “field testing” I’ll probably stay with the malleable just cause I don’t want to develop an infection.

The one thing that’s a real bummer is that I lost length: 1/2 inch from the first surgery to the second, which in my case is important to me.

Anyone have any ideas on how to regain some of this length through a reaction device or VED? Even 2 cm would be important for me.

I’m 51 and in decent shape and weigh same as I did in college.


I think it's wise to first decide between goal #1 and #2 before considering the risks versus benefits of stretching (under surgeon's guidance).

1) Stretching makes sense if the goal is to prep the tissues around the malleable rods for an optimally sized inflatable in an upcoming revision.

2) Stretching the tissues around the malleable rods with no upcoming revision plans might lead to floppy glans because the malleable rods and tips won't expand proportionally with the tissues.
Born early 80s. Congenital ED. Pills worked great for a while. Jan 2025 - Coloplast Genesis. 22cm (1cm RTE)-13mm.

FenderStrat_93
Posts: 9
Joined: Wed Dec 25, 2024 5:20 pm

Re: Inflatable vs Malleable - My Experience with Both & Infection

Postby FenderStrat_93 » Fri Dec 27, 2024 4:28 pm

niceguy1 wrote:I have the unique experience of being implanted first with an inflatable (Titan) and then later a malleable (Genesis). I’ll break this post into parts, which includes:

- Getting the inflatable implant
- Surviving an infection
- The process of recovering from an unsalvageable infection and how to preserve your original penile length while you are waiting months for the replacement
- Getting the malleable implant
- A comparison of an inflatable vs a malleable implant

I am posting my perspective so that it may help those considering an implant and those considering a revision to make the best decision on inflatable vs malleable vs sticking with other forms of ED treatment.

GETTING THE INFLATABLE IMPLANT (TITAN)

In December 2023 I was implanted with a Titan 26cm inflatable by Dr. Eid. Everything went totally fine. Normal recovery, no complications. I started using the implant in January and continued to use it on a daily basis for the next three months.

In April 2024, four months after the surgery, I randomly developed a low-grade fever (100 degrees) late at night. Penis and scrotum looked and felt perfectly normal. No swelling, no redness, no physical symptoms at all. Just a small fever. I went to sleep, and when I woke up 8 hours later the scrotum was so massively swollen that I could not even hold it in my hand, and I could no longer feel the definition of the pump. It was a Sunday morning. I called Dr. Eid’s personal cell phone and he immediately responded. I sent him pictures and he said that I likely had an infection and to get on a plane to NYC right away. 8 hours later I was full blown septic in the emergency room, where Dr. Eid removed the infected Titan. Due to the infection spreading everywhere, it was not possible to perform a “salvage,” where the doctor replaces the infected implant with a malleable at the time of the surgery, so I was left with no implant.

To be clear, Saturday at 7pm I was 100% fine, just having dinner at my house. Sunday at 7pm I was septic in the ER. There were no symptoms or warnings that this was coming. It was a completely spontaneous infection that spread everywhere within less than 24 hours, randomly after 4 months of normal usage, with no previous complications whatsoever. I am 40 years old and had not had a single other health issue in my life up until this point. I don’t drink or smoke, I am normal weight, and I have normal bloodwork. None of that helped to prevent this.

On a Sunday morning with zero notice, Dr. Eid picked up the phone, made the right call to have me get on the next flight to NYC, prepped my room at the ER in advance while I was flying in, arrived at the ER exactly when I did, and performed the surgery immediately. Dr. Eid absolutely saved my life and is a hero. This thing went from 0 to full blown sepsis so fast that without immediate intervention I would have either died or had permanent organ failure. I am super lucky to be alive and tremendously grateful to Dr. Eid for his quick response.


RECOVERY FROM INFECTION & HOW TO MAINTAIN ORIGINAL PENILE LENGTH

After the removal surgery I was hospitalized on IV antibiotics for 7 days. Dr. Eid came to visit me every day in the hospital. On day 1, Dr. Eid told me that I would have to wait 3 months in order to get a replacement because the tissue was inflamed from the infection and it had to cool off before it would be possible to re-operate. During this time scar tissue would attempt to form, which if left unchecked, would significantly reduce the length of the penis on the subsequent surgery, but there was a way to prevent that from happening and to maintain the original length. I needed to start using two devices as soon as possible: RestoreX and a VED. RestoreX looks like a medieval torture device which holds the penis in a stretched position lengthwise, and the VED expands both the length and also the girth. I was instructed to use these devices in 10-15 minute intervals, alternating between them, as much as I possibly could for the next 3 months. Dr. Eid explained that if I kept the penis manually expanded both lengthwise and girthwise, this would prevent the scar tissue from forming and I would be able to maintain most of my original penile length. I overnighted both devices to the hospital and started using them on day 2.

Out of the 8,000 surgeries that Dr. Eid has performed over 30+ years, he has had a total of 33 infections (0.4% infection rate). Out of those 33 cases, Dr. Eid told me that I am the only case that became infected 4 months after surgery, and the only case that presented spontaneously without any symptoms. I am also younger and generally healthier than the average patient.

For the next three months, May - July 2024, I basically sat in bed all day and stretched with both devices nonstop. I’ve now watched more movies than I’ll ever want to watch in my life.

For those who are considering an implant for the first time, please pay close attention to this part before making the decision to move forward with surgery:

When I chose to get an implant I still had natural function, but success in the bedroom was hit-and-miss. Sometimes the pills would work and sometimes they wouldn’t. Bimix injections always worked, but I was quickly building a tolerance to it and found myself having to progressively increase the dosage to achieve the same effect. But in my case the implant wasn’t absolutely necessary. I could have kept increasing the injection dosage and maybe eventually the tolerance would have plateaued off and would have worked long-term. Or I could have just kept using pills and dealt with the fact that half the time they didn’t work. In any case, my situation wasn’t an “implant as a last resort” situation, but rather an attempt to improve a suboptimal situation.

When you get an infection and have it removed without the possibility of replacement, you are unable to get a full erection. It is a bizarre feeling. Your penis will actually still fill with blood and expand as if you’re getting a normal erection, and it will get quite engorged, but it won’t ever become stiff. Neither pills nor injections will make it hard enough, so it is impossible to have sex during this time.

I cannot describe to you the depth of depression that you will experience if you end up in this situation. Imagine you’re in the hospital on day 1 with the realization that you’re going to be spending the next 3 months of your life with your penis being stretched in various devices all day long, with the best-case scenario being that you manage to preserve most of your penile length and praying that the subsequent surgery will be successful. The psychological impact is devastating. Especially if you did still have natural function and this wasn’t an absolutely last resort decision for you, because you could have stuck with your suboptimal sex life, and it would have been a million time better than the situation you’re in now, which is zero sex life and a traumatic near-death experience. Trust me, in this moment it is going to be exceedingly difficult to forgive yourself, and the regret will consume you. And by no means did I go into this already a depressive person. I am a happy person. I have good health, money, many friends, many girls, a good life in general, but nothing could save me from this crushing depression.


GETTING THE MALLEABLE IMPLANT (GENESIS)

After 3 months of non-stop stretching the penis, it was time to get the replacement. I opted for a malleable implant for the sole reason that it generally does not require revisions, and there was no way in hell I was going to risk getting another infection from a subsequent surgery. My expectation going into the second surgery was that the malleable implant would be an inferior experience to the inflatable implant, but I didn’t care about that at this point, as you can imagine I only cared that I would never have to have another surgery again.

The day before the surgery the stretched penis was measured and found that the length was the same as my original pre-op length. There was also no scar tissue that could be felt. It also had the same elasticity as before I ever had the first surgery. So therefore, it was proven that the protocol that Dr. Eid gave me was successful in maintaining the length. It also certainly helped that Dr. Eid removed the infected implant so quickly to prevent tissue damage.

I was implanted with a Genesis malleable in the last week of July 2024 (10 days ago) by Dr. Eid. I received the 13mm diameter model, with the length 1 cm shorter than my inflatable implant.


INFLATABLE (TITAN) VS MALLEABLE (GENESIS) EXPERIENCE

Obviously, I have not yet tried out the malleable because the surgery was just last week, and I had planned to wait a few months before making this post so that I could speak with the experience of having sex with the malleable, but I have some strong first impressions about it, so I thought that if I post now, I might be able to help people that are due to be implanted soon. I will update this thread again when I conduct “field research” a month from now.

When reading the points below, keep in mind that Dr. Eid has a unique approach to implanting in that he does not replace the corpus cavernosa tissue with the implant. Rather he dissects a new space between the cavernosa tissue and the wall, and then “slips” the implant along the side of the wall, leaving the cavernosa tissue mostly intact. The cavernosa tissue is compressed by the new neighbor, but it is still present. This improves natural blood flow/engorgement for the patient. If the surgeon you are using goes “straight up the middle” and basically replaces the corpus cavernosa tissue with the implant, then some of what I’m describing below about natural blood flow/engorgement may not be true of your experience.

Let me reiterate that my expectation going into the second surgery was that I would prefer the inflatable to the malleable, but I went for a malleable anyway to eliminate the need for future revisions. My actual experience is the opposite and I am surprised. I already significantly prefer the malleable to the inflatable for the following reasons:

1) 10 days into recovery, the malleable already feels significantly more like my natural erection than the inflatable ever did after 4 months. This is what surprised me the most. The malleable is almost indistinguishable from my natural erection on Bimix. I never felt that way about the Titan because the Titan expanded so much and compressed the natural tissue so hard that I always felt like I had a second plastic penis inside of my actual penis. The best way I can describe it is that the malleable feels like my actual penis on Bimix, and the Titan felt like a dildo inside of my penis. I did not expect this and I am so happy about it.

2) The sensitivity of the penis is better 10 days into a malleable than it ever was in 4 months of using the inflatable. I can easily feel that difference by touching the skin with my hand, even without having had sex, the improvement in sensitivity is already obvious to me. When I would expand the Titan, it would press so hard inside me that the penis would become somewhat numbed. Due to this reduced sensitivity, it took me a lot longer to finish during sex with the Titan than when I had a natural erection on Bimix. Based on how it feels right now, I expect sex with the malleable to be the same degree of sensitivity as my natural erection was. With the inflatable I would try to inflate it to 80% or 90% to reduce the pressure, but then it would buckle in the shaft during sex. Maybe because I had a 26cm cylinder which was quite long, it really had to be pumped up a lot in order for the shaft to not buckle during sex, which did cause reduced sensitivity in my case.

3) I significantly prefer the feeling and the look of the malleable to the deflated state of the Titan inflatable. Because my Titan cylinders were so long, in the deflated state I had a massive “dogear,” a sharp right angle that poked into the side of the penis and caused constant discomfort. I would try to pump it a few times to remove the dogear, but then I created a different problem where it would then bend at the base inside my pants and cause discomfort there. Probably an issue of the cylinder being so large. The malleable feels exactly like having a natural erection in your pants, which is obviously not as comfortable as a natural flaccid state, but I find it more comfortable than a dogear poking me 24/7. I also disliked the visual appearance of the Titan in the deflated state. It made the penis appear disfigured like a piece of bent plastic, whereas the malleable just looks like normal erect penis.

4) I already have more blood flow/natural engorgement of the malleable 10 days into recovery than I ever did after 4 months of the inflatable. It again goes back to the fact that the malleable does not expand and compress your natural tissue, so you get more blood flow. I find this unbelievable after just a week. It’s clearly going to get even better as time passes.

5) The malleable is the exact same girth as my original penis was and my inflatable was. However, the shape of the penis with the malleable is like a round circle, where the shape of my inflatable was an oval. This is because the malleable rods are just two fixed circular rods adding to your existing anatomy, so the shape of your natural penis stays the same, whereas the inflatable is expanding and compressing your existing anatomy. Visually, the round shape of the malleable looks better to me than the oval shape of the inflated Titan.

6) The post-op recovery process of the malleable is a significantly less painful experience than my inflatable recovery process was because there is no cycling. With the inflatable Dr. Eid had us in the bathtub on day 3, inflating twice a day for 30 minutes each time for the next 4 weeks. The cycling hurt so much during this time. With the malleable you don’t do anything. You just lie in bed with ice packs for 3 days and then switch to a heating pad. I had some swelling the first few days, by day 10 the swelling is all gone and I can already see my final result.

7) When you have an inflatable and you get aroused with it in the deflated state, you cannot get a full erection. It would just be like a feeling of “fullness” with the blood filling up, but you can’t get hard without actually pumping it. It’s a frustrating feeling when the girl is sitting on your lap and the blood is rushing to the penis and its being held back from getting hard by the deflated implant. It’s actually quite an uncomfortable feeling with the dogear poking you at the same time. With the malleable when you get aroused, the blood fills up around the rods and becomes more full and hard. So when you have your clothes on, the feeling of becoming aroused is better with a malleable. And when you want to have sex spontaneously, with the inflatable you have find a bathroom to pump it up and come back (unless you don’t care about the girl knowing), whereas with the malleable you’re always ready to go.

8) I am so happy to get rid of the pump. I always hated that pump. You’re going to have sex with a new girl, you gotta make an excuse to go to the bathroom, pump it up, after you’re done its been up for 30 minutes and its compressing you so hard that its starting to hurt so you have to put it down, so you go back to the bathroom to deflated it. Then you want to do it again 30 minutes later so you gotta go back to the bathroom, pump it again, come back. Then back to the bathroom to deflate. Back and forth back and forth. Unless you don’t care about the girl knowing or it’s a long term partner who already knows, if you’re hooking up with different girls it’s a lot of work and you have to be sneaky. I am relieved that I won’t have to do that anymore. This may not be a big deal to everyone but it was to me. Also this was my experience 4 months into the inflatable. After a longer period of time it may eventually be possible to have sex for hours without having to deflate in between rounds due to the pain.

There are 3 things I preferred about the inflatable/dislike about my malleable:

1) My penis was 1cm longer on the Titan. When you implant a malleable, the doctor needs to shorten the rods by 1cm in order for them not to be pressing hard against the top of the glans. There cannot be constant pressure on the glans because it can cause tissue atrophy and erosion over time. So to eliminate this risk, the doctor takes off 1cm to give you more breathing room.

2) Dr. Eid explained to me that over the years the skin around the base of the malleable will loosen up, and the axial rigidity of the base of the penis will become reduced, which will cause the penis to fall in the direction of gravity rather than stand straight up on its own. Therefore, years from now I will need to lift it with my hand and place it inside. The inflatable does not have this problem and remains rock solid at the base forever. This to me is the biggest downside of the malleable and the biggest advantage of the inflatable.

3) A permanent erection is obviously not ideal. I still prefer it to the deflated look and feel of the dogear Titan, but it is definitely a drawback of the malleable. I’ve heard the AMS inflatable has a superior deflated state. That is probably a more comfortable deflated experience than the malleable.

Overall, I already significantly prefer the malleable over the inflatable, and I am super surprised by this. I never even considered a malleable before I went for my initial surgery. I only considered the two inflatable options and completely disregarded the malleable options without even researching them.

My advice to those considering surgery for the first time: don’t do it unless it is absolutely necessary and you have zero left to lose. If pills and shots are still somewhat working, even if its hit-and-miss, stick with it. Keep increasing the dose of the injections and the pills if it is medically safe to do so. Try shockwave, PRP shots, acupuncture & Chinese medicine, everything that exists. Be patient and maybe you’ll get lucky and find some combination of things that works for a while. And then when it doesn’t work anymore because you’ve built a tolerance, try to take a break for a while and then reintroduce them to see if the tolerance you built will reset. Do everything possible to avoid this surgery until you’re completely out of options. Because if you’re the 1 out of 200 people who gets an infection, you are going to regret this decision like nothing you’ve ever regretted in your life I promise you. And you know what -- considering all the health issues a person could get in their lifetime, a 1 out of 200 chance isn’t all that low. I know people who have been diagnosed with cancers and other diseases that are a whole lot more rare than 1 in 200. I’m sure you do too if you think about it. Do not underestimate the devastation of an infection and think “it won’t happen to me.” I am younger and generally healthier than the average implant patient and I went with a world-class surgeon and none of that mattered. It can absolutely happen to you, so don’t get greedy and try to improve your suboptimal sex life if you still have a sex life to lose. If you are completely out of options and you decide to move forward, research and consider the malleable options just as much as you consider the inflatable options.

My advice to those looking at a revision, if the issues of the inflatable I described above are also issues for you, be open-minded to the possibility of a malleable on the next round. If hadn’t gotten an infection I never would have considered the malleable, but now I’ve ended up happier than when I had the inflatable, and I am totally surprised by this.

I hope that this has been helpful. If it can improve even one life it’s a mitzvah. Please feel free to ask questions. I will update you again in a month after I am cleared for use, and I will then be able to either confirm or refute some of my above stated hypotheses about the malleable experience.

And lastly, I’d like to reiterate my thanks to Dr. Eid who literally saved my life. If you decide to do this surgery and it is possible for you, go with Dr. Eid.


Niceguy - popping in to say thanks for this excellent thread. I’ve been reading Franktalk threads for a long time and officially joined the forum this week. This was one thread that helped a ton in my own research when it comes to IPP vs MPP. For me personally, I’ve decided on just starting with a malleable in an effort to minimize risk of infection. I’m currently evaluating my options for a surgeon (I’m between Hakky, Eid, Taj, and Carrion and plan on doing a consultation with all of them).

The IPP’s are incredible devices - but as a younger guy who would need continued revisions based on the lifespan of the devices, the MPP just seems to make the most sense for me.
31 years old. ED for majority of my life - pills effectiveness highly limited. Looking to get a malleable implant sometime in Summer 2025!


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