When the penile implants fail they are easily replaced and because the space in the shaft of the penis is already shaped around the cylinders, post-operative pain and discomfort of replacement surgery is much less than for the original surgery. Replacement penile implant surgery is slightly more difficult and time consuming compared to the initial surgery and carries with it a greater risk of infection. For this reason, it is recommended that replacement surgery is performed by a penile implant specialist rather than a general urologist. The initial penile implant is in the majority of cases the easiest surgery.
There is no appreciable difference between the life expectancies of the different manufacturers. The AMS silicone cylinders are more fragile than the Bioflex Coloplast cylinders and are the most likely cause of failure of this brand of implant. Failure occurs because of repeated bending of the deflated cylinders at the location of folds and not at the point where the cylinders are connected to the non-inflatable proximal portion. The Coloplast tubing that connects the cylinders to the pump is the Achilles heel of this penile device brand. The tubing is outsourced and not manufactured in-house, is not as good as the AMS tubing and is prone to fracture after 10 to 15 years of use.
Penile pump malfunction is rare. Both AMS MS (momentary squeeze) pump and the Coloplast “Touch” pump are extremely reliable and on rare occasion, the pumps will jam in the deflation mode and will require a very, very forceful squeeze to activate the device. This has occurred more often with the Coloplast pump than with the AMS pump. The reservoirs almost never fail. The Coloplast reservoir has a built-in lockout valve which prevents backflow into the cylinders preventing auto inflation.
Both brands of IPPs have their advantages and disadvantages. It is likely that perfection will never be achieved and also likely that improvements will continue to occur.