Semi-rigid malleable implants

[james1947]

What about some knowledge regarding Semi-rigid malleable implants?
AMS and others still manufacturing them.
They are not used anymore?

James

[Hawk]

They are used but to my knowledge, they are used mostly as "space savers" in case a man gets an infected implant and cannot get a new inflatable implant for many months,  They prevent size loss during that time.  They are also sometimes used for men that have no hand dexterity to pump up an implant (it takes more grip than you would ever expect).

The problem with them is that because they are always pushing on the glans and never retract that they can erode right through the glans in time.  Not a pretty picture.  They also are never close to flaccid and annoy men rubbing against their pants etc.

[james1947]

I made a search in the subject and I got a few topics on the subject:
Malleable semi rigid implants - Peyronies Society Forums
Peyronies Disease has destroyed me - Peyronies Society Forums
Semi Rigid Implant - Peyronies Society Forums
New to Site - Surgery Upcoming - Peyronies Society Forums
Two months after Peyronie correction and implant of malleable prothesis - Peyronies Society Forums
Malleable semi rigid implants - Peyronies Society Forums

Some people with semi-rigid malleable implants are very happy with them.
It is also a much simpler surgery, much less complications.
I talk with 3 urologists around here, they make mostly semi-rigid implants because of the simplicity.

James

[Alibaba]

They are used as space savers after infection or trauma, for those who do not have dexterity enough to pump, for those who can afford limited cost, by doctors who are quacks that have not updated their mindset since 1948 when they graduated from school. They are the basis for the erosion scares you read about. They are also the cause (due to erosion) that many doctors are afraid to size an inflatable implant to your full size causing many to lose length. All they do is bend up or down. They do not ad any girth. Think of it as a gooseneck lamp that you bend the shaft to aim the light where you need it.  It is very very rare to purchase this type of implant which is nearly 70 years old in design.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355428/

[james1947]

If everything so bad with the semi-rigid implants, I am wandering why AMS, Coloplast, FTM are still making them?
And why Kramer and other reputable doctors are implanting them?

James

[Pfract]

James.... Hawk told you the reason above. I am starting to think you are considering that route. But if you are, please don't. It's a bad choice!  

[james1947]

pfract

The only negative aspect I found is erosion. But erosion is stated as a warning also for the other implants.
I try to find a research regarding semi-rigid implants causing erosion, didn't find yet. For example data regarding erosion vs time.
Hawk also mentioning erosion only.
Unfortunately the forum members that have done semi-rigid implants can't chime in as they not active anymore.
By the way semi-rigid implants have also advantages. For example much simpler surgery, lower risk of infection, lower risk of failure as they don't have moving parts.

James

[Pfract]

James: I apologize but I cannot agree. While those are in fact some positive aspects, ( if you can call it that) there's a full plethora of downsides to it. It's really something to be avoided at all costs, unless you don't have health dexterity or have any specific problem that forbids you from having a three piece implanted. Other than that, it's garbage. See hawks and Alibaba's post on them. I agree 110%.

You can also search YouTube for videos on both and see the differences for yourself. Please... Don't be tempted to go down that route

[Alibaba]

James, the issue with erosion listed on each product as a possible issue needs clarification.
Erosion with a multi-piece inflatable implant is less than a fraction of 1%.  The incidence of erosion with a malleable implant exceeds 15% in some studies. When there can be 5000 times more risk with a malleable, then that needs serious consideration. Both are equal that they have risk. Multiple times the risk breaks the equality. Trying to link the page and cannot get the URL to copy. Too long to copy and paste the entire study.  The undersizing mindset of implants came directly from rigid implants eroding. The concept is if the implant was smaller than the space it went into, then there was less risk of erosion. That concept of though carried over to inflatables which results in people losing dick size even though a deflated penis is not under tension. Hope this makes sense.   In this study : Satisfaction with the semirigid penile prosthesis among couples from a Semiurban Indian population Patil AY, Nerli R B, Dixit NS, Hiremath MB - J Sci Soc
The decision to use the semirigid prosthesis was made by the patient himself based on his social/financial status so cost is the main reason a rigid is chosen.  The most serious postoperative complications were infection (8%) and erosion (5%),  Patient satisfaction in the three-piece inflatable prosthesis group was higher than in the malleable prosthesis group (P < 0.05). Similarly, Salama[19] thought that it would be of interest to investigate satisfaction rates with malleable penile prostheses among couples from the Middle East. A total of 50 patients who underwent the insertion of AMS 650 and Acu-Form penile prostheses and their partners were evaluated. In all, 70% of the patients and 57% of the partners were satisfied with the prosthesis. There was an increase in frequency of intercourse, sexual desire, and ability to achieve orgasm. Dislike for the device was the most common cause for nonsatisfaction of patients with the device.  https://www.nature.com/articles/3900349.pdf?origin=ppub  Rigid implants break too.   List of malleable implants:
Malleable   Small-Carrion prosthesis   USA
AMS 600 Spectra   USA
Coloplast Genesis   USA
ESKA Jonas prosthesis   Germany
Virilis I and II prosthesis   Italy
HR penile prosthesis   Brazil
Silimed prosthesis   Brazil
Shah prosthesis   India
Promedon Tube prosthesis   Argentina
Zephyr ZSI 100   Switzerland
One article I read says there are few studies in the past 20 years between rigid and inflatable implants because insurances in many countries now cover both. Due to increased satisfaction with inflatable, semi rigid is rarely used. Additionally, it stated erosion is not as common with the semi rigid now as doctors are more aware of it's commonality and allow for that when measuring, trimming and selecting the device allowing extra room to prevent penile tension.  

[james1947]

Tank you for the detailed answer Alibaba
Two of the urologists here that treated me for other urology problems, both have more than 100 implants done (I know the number is not so big but most man here over 60 think they are at "end of life" and are not sexually active).
Both stated that they had no cases of infection following implant.
Both stated that some 15% are complaining that the implant is somewhat cold compared to the body temperature.
Most complains were with made in India implants, much cheaper than AMS.
From the Indian study you mentioned:

The satisfaction of patients and partners...was 80.66 ± 4.49 and 75.66 ± 6.57, respectively, at 12 months after surgery and 71.73 ± 8.10 and 65.6 ± 6.49, respectively, at 24 months after surgery

James

[Hawk]

James, I am not here to tell you or anyone to never get a mailable implant.  If I could have sex no other way I would possibly get one but I would have to be certain I could not have intercourse without surgery and I would have to be certain that a 3 piece implant was out of the question because of dexterity or completely impossible cost.  

Everyone has to decide and live with the decision.  The one point I had not even considered is that an inflatable implant is filled with body temperature fluid no different than blood.  The mailable is not.  I guess you could soak in warm water.

[Pfract]

@hawk: ''cost too high' sometimes it's just people trying to save some money.. AKA false economy?  

[Hawk]

So I guess there is not socialized medicine where you live and you have to pay for these costs on your own?

[james1947]

Hawk

Yes, I will have to pay for an implant if I will decide to do. Same with any other health expenses.

Pfract

Not to be blunt, I will just say that at age 71 I learned already how to manage my "economy".
Not going in details too much, I have a 9 year old daughter and I am sure even you can understand where my priorities are.

James

[Pfract]

Understood James. I didn't mean to upset you in any. Just really voicing it out on the differences between both devices. Good luck on your future choice, whatever it may be!

[james1947]

Thank you for the wishes Pfract

James