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Implants

PENILE IMPLANTS​

  • The two most common implants are the semi-rigid penile implant and the inflatable 3-piece (rod, pump, reservoir) implant. There are also two-piece inflatable penile implants.  The two largest US companies that make semi-rigid and inflatable penile implants are AMS and Coloplast. 

  • The inflatable penile prosthesis (IPP) is composed of three components connected by tubing: the reservoir, the pump, and the rod/balloon

    • AMS 700 series: not used mainly because of the design with a large rectangular pump​ and small solid segment towards the back for anchoring to the pubic bone.

    • Coloplast Titan: this is the IPP of choice given its 5cm solid segment towards the back for anchoring to the pubic bone. It also has a hydrophilic coating which allows absorption of whatever solution the implant is placed in.

    • AMS Ambicor: a two-piece IPP; not used because of the small solid segment towards the back for anchoring to the pubic bone.

  • The semi-rigid or malleable penile prosthesis (MPP) is a rod made of metal and silicone.

    • AMS Spectra: no longer used unless patients specifically ask for this. It is mostly metal with a silicone envelope​.

    • AMS Tactra: mostly silicone with a metal core.

    • Coloplast Genesis: similar design to the Tactra; has a hydrophilic coating.

  • Penile implants are often inserted about 1 year after phalloplasty. Testis implants may be inserted at the same time.

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TESTICULAR IMPLANTS

  • The two most commonly used testis implants are the solid silicone carving implants and saline filled implants. 

  • The pump component of the IPP replaces one testicular implant. 

  • The testis implants may be inserted at time of penile implant insertion. For patients not interested in penile implants, testicular implants can be inserted around 6 months after scrotoplasty.

  • ​https://alphaaesthetics.com/silicone-carving-implants/

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ALTERNATIVES

  • No implants.

  • The Elator: an external erectile device that is sized to each phallus.

  • Zephyr implant: Jan 2019 study shows somewhat positive results, but followup only 8-9 months; non-FDA approved and not available in US for implantation.

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