Maximising longevity of implant

[Eloquent]

Hello,

I have recently been implanted with a Coloplast Titan, and since I am very young, I am looking for ways to maximize the implant lifetime from a patient's point of view. I am looking for both strategies what to do and what not to do.

Of course, I know it will fail one day probably and not using it is not an option for me

[fl1pstar]

To answer this question reliably we would need studies or at least some sort of collection of questionnaires of people who had early failures and their habbits/hobbies.

I myself love mountainbiking. I did something between 50 and 70 km on the weekends and added 2 or 3 sessions on a smart trainer during the week to keep the fitness needed for the weekend trips with the buddies. Nothing extreme for sure, BUT:

Every single pedal rotation will at least slightly move the pump and the tubing in your scrotum. Even if you have a special saddle with big cutout your tighs will somehow touch your scrotum and cause some minimal movement of the pump parts.

These are thousands and thousands of rotations every biking session. Doing it every week for years and years is going to sum up I am sure of that. It's like water carving rocks.

What are we gonna make out of it? Everybody has to decide on their own. I for my part called it quits because I am young and like to have as few revisions as possible (infection risk etc.). Also there's so much to do. Bought a guitar some years ago and started making music, forming a band right now.

But I think you have many members here biking a lot so it's definitely possible. But scientifically thats anecdotes.

[LastHope]

What can Coloplast do to maximize its durability on the tubing?

Journal of sexual medicine, 2023-06, Vol.20 (7), p.1044-1051 Netherlands
Mechanical indications for inflatable penile prosthesis revision: analysis and implications for revision surgery
https://pubmed.ncbi.nlm.nih.gov/37189017/

[fl1pstar]

What can Coloplast do to maximize its durability on the tubing?

Journal of sexual medicine, 2023-06, Vol.20 (7), p.1044-1051 Netherlands
Mechanical indications for inflatable penile prosthesis revision: analysis and implications for revision surgery
https://pubmed.ncbi.nlm.nih.gov/37189017/

That's crazy. What is Coloplast doing? If they could bring down the tubing failures they would have a significantly higher durability than AMS which would bring them a big ass market advantage.
Some member posted that Coloplast brings a new device in ~ 3 years. Most likely the will focus on improving the tubing one should think.

For now since the tubing is located mostly in the scrotum one could conclude to reduce wear and tear in this area as much as possible for longer durability.

[Time2Change]

Hello,

I have recently been implanted with a Coloplast Titan, and since I am very young, I am looking for ways to maximize the implant lifetime from a patient's point of view. I am looking for both strategies what to do and what not to do.

Of course, I know it will fail one day probably and not using it is not an option for me

These suggestions are based on conversations with my urologist.

Inflate regularly to keep the parts in good working condition.

Don't frequently stay inflated for hours on end to avoid erosion.

Be prepared for the implant to fail sooner than most men you hear from on this site. As a young man, you will probably be using the implant more for sexual activities than us middle aged and older guys. The implant is like a car in that more mileage causes more wear and tear.

Others may have different ideas and insights.

[Donkeykong]

I would just use it as much as you want. In my opinion it would totally defeat the purpose to ration use to last longer.

[LastHope]

I've heard Dr. Eid mention that Coloplast tubing is outsourced and not manufactured in-house like the AMS tubing.

Some insights from the paper on tubing fracture....

Tubing fracture is one of the most common indications for IPP revision. Regardless of brand, we have noted that tubing fracture occurs most commonly along the segment connecting the cylinders to the pump, usually at the exit junction of the kink-resistant tubing. This is likely due to more acute bends in this region,in addition to inherent weakening of the tubing in areas where 2 tubes rub together. In our cohort, we found that Coloplast (CP) devices malfunctioned more frequently due to tubing fracture than Boston Scientific (BSCI) devices.

We hypothesize that the difference in the rate of tubing fracture between manufacturers maybe attributable to differences in pump mechanics and ease of use for patients. CP utilizes 2 pump designs (Titan Classic and Titan Touch) whereas BSCI uses the MS pump. In an ex vivo study evaluating patient preference operating these 3 pumps, patients preferred the CP Titan Classic due to ease of inflation but reported easier deflation with the BSCI MS pump. As compared with the Titan pumps, the MS pump features a deflation nipple that is approximately twice as tall, which allows for easier tactile Identification of the button in the scrotum. It is possible that increased difficulty deflating CP pumps may place more torque on device tubing, particularly in areas immediately adjacent to the pump, ultimately resulting in tubing fracture.

Moreover, we found that patients with CP devices in our study were slightly younger and had a significantly longer median cylinder size by 2 cm. As longer cylinders require more pump activations to fill to capacity, one might hypothesize that the additional pumps increase the cumulative wear at the exit of the kink-resistant tubing over time. Others have shown that younger men have a higher risk of requiring revision surgery, perhaps due to higher sexual frequency. Perhaps the combination of increased frequency of use and greater number of pumps required to obtain maximal rigidity leads to more accelerated wear at this flexion point. While our study was underpowered to assess these speculations, future multi-institutional studies may shed light on these topics.

[Tuscan_Order]

What can Coloplast do to maximize its durability on the tubing?

Journal of sexual medicine, 2023-06, Vol.20 (7), p.1044-1051 Netherlands
Mechanical indications for inflatable penile prosthesis revision: analysis and implications for revision surgery
https://pubmed.ncbi.nlm.nih.gov/37189017/

Does that paper have any data on actual numbers of failures by component? (I can't see the article without a subscription). Since that table is normalized for each manufacturer, no comparison can be made between Coloplast and BS on the actual number of failures, or if Coloplast tubing is really more failure prone than BS. BS could have a much higher tubing failure rate in "fielded units" but you can't tell that from the table. It would be interesting to compare the actual number of failures between Coloplast and BS.

[LastHope]

Does that paper have any data on actual numbers of failures by component? (I can't see the article without a subscription). Since that table is normalized for each manufacturer, no comparison can be made between Coloplast and BS on the actual number of failures, or if Coloplast tubing is really more failure prone than BS. BS could have a much higher tubing failure rate in "fielded units" but you can't tell that from the table. It would be interesting to compare the actual number of failures between Coloplast and BS.

Here is some additional info....

[Gt1956]

I'm a contrarian. What sense is there in trying to make your IPP last longer? Didn't you get it to use it? To a degree, its like a car. They wear out & need to be replaced.

I've posted this several times before. FT had a member that had a stroke during his recovery time. This stroke took away all of his desire for sex. He dutifully inflated it every 1-3 months. Intil several years later it just stopped working. Please tell us what strategy that you can think of that will make your IPP last longer than his? Your best strategy is to use it as designed & save money for a revision when it wears out. Just like buying a new car. Remember, you'll have several years to save the money. Just make it a habit to save the money every month.