Is one penile implant better than the other? - AMS vs Coloplast
AMS or Coloplast? If you’ve made it this far in your ED journey, it’s likely that you might be deciding between the two available inflatable penile implants available in the United States. Although some Urologist exclusively use one manufacturer or the other, I personally feel that there are certain nuanced differences between each that can be leverage to optimize YOUR outcome and satisfaction with the procedure. As I’ve mentioned before, it is extremely important to understand all your options before your first implant surgery and get it all right the first time.
From the patient perspective there are three unique considerations for the AMS 700 series vs. the Coloplast Titan that I have highlighted below.
1) Composition of the Implant Cylinders– although the implants look similar, they are quite different material. The AMS 700 cylinders have 3 layers – a synthetic fabric that is sandwiched between two layers of silicone. This design provides for a natural feel and appearance especially when the implant is completely deflated. In comparison, the Titan is made of a very strong polyurethane material. This makes a much more durable composition, although the trade-off is noticeable “dog-ear” when the implant is completely deflated. This is analogous to a plastic straw that is bent in half creating prominent corners. This is strictly a cosmetic issue related to the composition of the implant cylinder and does not increase the risk of any complication.
2) Length and Girth Expansion – One of the most important aspects of the conversation that you should have with your surgeon is expectations in terms of length and girth after the surgery. Most use a surrogate called stretch penile length to help estimate post-operative length with the implant fully inflated. This is to help with realistic expectations with the penile implant. Every patient will get custom sized at the time of surgery and experienced surgeons will “upsize” 1-2 cm if appropriate. The AMS 700 LGX device is designed for both length and girth expansion. The AMS 700 CX device is designed for controlled expansion and does not expand length wise. This is important in men that have penile curvature, as a CX device would be the preferred option, otherwise an LGX over time would actually worsen penile curvature. The Titan only has girth expansion. The Titan is a great option for men with severe fibrosis, penile curvature, or larger penile stretch length. It has slightly better axial rigidity in my opinion compared to AMS devices, especially at larger cylinder sizes.
3) The Pump – The pump is arguably the most important part of the implant since it is what you will interactive with to be able to use the device for sexual activity. The pump design is one of the key differences between the AMS 700 and Titan. The AMS 700 pump has two options – the Momentary Squeeze (MS) and the new Tenacio. I imagine the MS pump will probably be phased out at some point, but in terms of reliability it is still tried and true. The advantages of the AMS pumps is that they have a prominent deflation button – making it easier to identify the button through the scrotal skin and deflate it. With both it is a “quick-release” where once deflation is initiated the implant should continue to deflate to 0% (you don’t have to hold it down). On the flip side the MS pump is slightly hard to inflate, although the Tenacio has made some improvement in this regard. The AMS pumps are also slightly larger and bulkier compared to the Titan pumps. The Titan device has two pump options – the Titan One Touch Release (OTR) and the Genesis pump. Both are easier to inflate compared to the AMS pumps and are less bulky. The OTR deflation button is more subtle and patients may have a harder time initially identifying it. Similar to the AMS pumps, the OTR is a “quick-release.” The Genesis pump has the slimmest profile and large paddles for deflation, however it does not have the quick-release function and you have to hold down the paddles and squeeze the penis until the implant is deflated. I would generally say if there is any concern regarding dexterity or sensitivity in the dominant hand (for example patients with severe neuropathy from diabetes or patients with Parkinson’s tremor), I advocate for the AMS device or Coloplast with Genesis pump. Regardless of what option is chosen, all men have difficulties and frustrations with initially cycling the implant in the first few weeks after surgery.
There are other important considerations for the surgeon, (reservoir shape/size, antibiotic impregnated implant vs. tailored antibiotic coating, etc) but these are three important things you should consider when deciding between AMS 700 series vs Titan. Fortunately, both are excellent products and generally the implants are more or less the same than different. I have extensive experience with both implants and I am proud to be a Center of Excellence for BOTH the AMS 700 device and the Coloplast Titan penile implants. If you or your partner are looking to restore your erectile function, please contact me to develop an individualized approach to your surgery.
-Dr. Patel
