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There are two broad categories of penile implants in Brooklyn – malleable implants and inflatable implants.
The inflatable 3 piece-penile implant is a moderately complex device that becomes firm during intercourse and flaccid after sex is completed. The implant works by transferring water from a reservoir into two cylinders located within the penis.
- Malleable implants, however, are far simpler devices. You simply bend the implant up during sex and you bend it down after sex is over.
The inflatable implant is superior to the malleable implant in terms of function and patient satisfaction. The malleable implant is well-suited for a patient with limited manual dexterity who cannot operate the inflatable implant.
When you wish to have sex with a 3 piece inflatable penile implant, you squeeze the pump that is located in the scrotum. Water is then transferred from a reservoir, located behind the abdominal wall, to a pair of cylinders, located in the penis. Your penis becomes erect. After sex is over, you squeeze the release valve also located in the scrotum, and water returns from the cylinders back to the reservoir. Your penis becomes flaccid.
All of the parts of the inflatable implant are located beneath the skin and so your sex partner need not know that you have the implant. The components are inserted through a small 2-inch scrotal incision.
The two main brands of the 3 piece-penile implant are the AMS 700, manufactured by American Medical Systems – Boston Scientific Corporation, and the Titan manufactured by the Coloplast Corporation. The two brands are equivalent in all outcome categories.
The AMS 700 is composed of three layers – an inner silicone layer, a middle Dacron fabric layer, and an outer silicone layer. The middle Dacron layer provides strength and helps prevent aneurysms or bubble formation. In addition, the inner layers are coated with a polymer called Parylene. This substance provides additional strength and helps prevent leakage of water from the device.
AMS 700 Illustration
To help prevent infection, Brooklyn Urologist Dr. Lazare coats the surface of the AMS 700 with two antibiotics – Minocycline and Rifampin (2). The proprietary name for this coating is “InhibiZone”.
Finally, the device comes in three models. The AMS 700 – CX increases in width after inflation, the AMS 700 LGX increases in length and width after inflation, and the AMS 700 – CXR is designed for a narrow penis or a penis that has become scarred and fibrotic.
The Coloplast Titan does not contain silicone. Instead, it is composed of a polymer called Bioflex. This substance confers strength and longevity to the device. The Titan has a low incidence of aneurysm formation and a low incidence of water leakage from the device (3).
To help prevent infections, the Titan is coated with a substance that prevents bacteria from sticking to the surface. This surface coating is also designed to absorb antibiotics. Most surgeons dip the device into a solution containing two antibiotics – Gentamycin and Rifampin – right before the operation begin. The results in terms of preventing infection have been excellent (4).
- The Coloplast Titan OTR stands for “One Touch Release”. This refers to the release button that you squeeze to make the penis flaccid. You need to compress the button only once and all the water returns from the cylinders to the reservoir.
The 3 piece-penile implant was introduced in 1973. Over the ensuing four decades, it has undergone continuous refinements and improvements. The improvements include stronger construction materials, infection-resistant coating, kink-resistant tubing, and a lock-out valve to prevent auto-inflation.
The 3 piece-penile implant has gradually evolved into what is arguably the most mechanically reliable device ever implanted into humans. In some reports, over 70% of the devices are working properly 15 years after they have been implanted into the patient (5). This statistic is expected to improve even further over the next several years due to recent advances in design.
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