Cololovin wrote:GoodWood wrote:I think the real question in this discussion is what level of concern is reasonable when it comes to IPPs.
Couldn't agree more on what you said prior and yes that's the whole point of the disucssion.GoodWood wrote:I may be misunderstanding your point, but are you suggesting that all IPPs fail within a few years, with a large number failing within 1–2 years? If that’s what you mean, I’d be interested in seeing documentation supporting that claim.
Fair enough. I have several points to support this claim:
1) MAUDE Report Statistics: Data posted monthly by Lasthope shows an average of 350 failures per month. Over 60% of these are due to mechanical issues. The average lifespan is 5 years for the Titan and 4 years for the AMS (though the range is wide, spanning from a few months to 7 years). These figures remain remarkably consistent month-over-month. In statistics, this consistency is a hallmark of reliability, which refers to the degree to which a measuring tool produces stable and consistent results by controlling for random error.
One might argue that because MAUDE does not capture every single failure, it isn’t a perfect representation of the total population. My counter-argument is that because MAUDE does not selectively report early failures—but rather collects reports randomly as they occur—it serves as a statistically valid sample.
Furthermore, last September, after Lasthope persistently presented this data on FT and I joined in calling it out, industry leaders like Steven Wilson, Perito, and Tobias Kohler published the first paper in the 50-year history of IPPs to discuss MAUDE data in Nature. While some have downplayed this milestone, the timing is undeniable. It is unlikely to be a coincidence that the first-ever MAUDE-focused paper appeared just as we were relentlessly highlighting these numbers. My point isn't just to take credit; it’s to show that the biggest names in the industry now acknowledge MAUDE as a legitimate sample—ironically, even while some patients continue to argue against its relevance.
2) Social Media and FrankTalk Anecdotes:
Many often argue that 'only those with complaints appear online, while the satisfied majority are busy enjoying their results.' While it may be true that many are satisfied, those users often eventually become the ones posting about failures—and here is why.
The vast majority of FrankTalk members join the forum as 'virgin' cases—men who are either about to get an implant or have just received one. Their journey is documented from day one through their signatures and post history. When a significant portion of this same group returns a few years later reporting revisions or failures, it invalidates the 'selection bias' argument. What we are witnessing is an anterospective (prospective) sample rather than a retrospective one. These aren't just random people showing up only to complain; these are users whose entire surgical journeys we have followed from the beginning. Just this week, for example, three members we’ve known since their initial surgeries reported broken IPPs after only 1–2 years.
Furthermore, I have rarely seen a community so dedicated to 'cultish positivity.' I understand this as a mental defense mechanism, but it is damaging. Even a respected figure like Rodsmen, when facing a failure just two years post-op, felt the need to say, 'As much as I want to bury the lead, I’m sorry to tell you guys my implant failed.' That specific phrase—'bury the lead'—speaks volumes about the community’s creed. This pressure to maintain a positive front ironically harms the community more than it preserves its mental state, as it obscures the clinical reality of device longevity.
3) The 15-20 year hoax study: The '15-20 year study' is a complete hoax for three reasons. First, there is a glaring, declared conflict of interest. Second, even renowned experts in the field have called it a 'stretch,' refusing to back such an obvious exaggeration. Most importantly, the study is riddled with at least six fatal statistical errors. I’m happy to break those down in a separate post if you're interested.
4) Engineered Narratives and Demographic Shifts:
The current narrative, including most major studies, is largely published by beneficiaries—a point I can break down in more detail in a future post. To put it simply: if I buy a phone charger from Samsung, I cannot blindly trust a study they published claiming it endured a billion bending cycles or has a 1% annual failure rate. Independent verification is essential.
Even if we accept the current published data at face value, these numbers rarely reflect the experience of a younger man. The mean age in these studies is typically between 60 and 65. The activity of a 70-year-old prostate cancer survivor iss likely very different from that of a 20-year-old with a venous leak.
Furthermore, the demographics are shifting. Erectile dysfunction is becoming increasingly prominent in younger men, yet the industry continues to rely on data derived from an older population with different lifestyle demands and longevity requirements. A device that 'lasts' for a 70-year-old may be woefully inadequate for a young man with decades of life ahead of him.GoodWood wrote:My understanding is that the risk increases with the first revision but then tends to level off rather than continually climbing with each subsequent procedure.
A systematic review published by Tobias Kohler confirms an exponential increase in risk with each subsequent revision. This is common sense: if you were undergoing a fifth knee replacement, the infection risk would be sky-high due to altered anatomy, tissue changes, compromised perfusion, and the presence of inactivated biofilms established during the first surgery. It should go without saying.
Even if one were to argue against the 'exponential' nature of the risk, we should certainly not be celebrating revisions with the 'easier recovery and longer-lasting implant' mantra. This is a 'death cult' narrative—and kudos to Perito for engineering it. To frame a surgical failure and subsequent re-operation as a benefit to the patient is a complete reversal of clinical logic.GoodWood wrote:Infection is a risk, but it’s certainly not inevitable.
With the kind of inevitability we’re discussing, for a young man with a life expectancy of another 50 or 60 years? Oh yeah, I bet it is.
I also completely disagree with the comparison to internal defibrillators. A defibrillator battery has a predictable lifespan, and its replacement is nowhere near as nuanced as surgery in a delicate, active, and sensitive mechanical region like the penis. We are talking about an organ that is subject to physical movement, sweat, and high-use activity. To compare a static battery swap in the chest to a revision in the complex, vascularized tissue of the penis is a gross oversimplification of the surgical and biological stakes involved.GoodWood wrote:I try to assume good intent from everyone who posts.
I couldn't agree more and I respect that.GoodWood wrote:When the term “troll” gets used, it’s usually not simply because someone disagrees. It’s typically because the tone of a post comes across as mocking, belittling, or intentionally provocative. For example, the opening of your reply to powerdaddy reads that way to me.
Believe me, that shift in tone only happened after I was labeled. For instance, I was using this exact same tone during my debate with PowerliftingDad earlier in this thread. When he disagreed, his response was, 'I won't be responding to your negativity.' In my view, labeling someone as 'negative' just to avoid a difficult conversation is the very definition of toxic positivity.
Even if we assume for a moment that I’m just one big asshole, sociopathic 'mofo'—does that kill my argument? Doesn't the data I'm presenting concern the entire community? In fact, isn't it the primary concern?
You don’t have to like Winston Churchill’s or Truman’s attitude to agree with the facts they state. This is an anonymous forum—it is the perfect niche to be as brutally honest as possible. I truly don't understand why taking things personally is so common here when we should be focused on the evidence.GoodWood wrote:I do believe the manufacturers are trying to improve the devices, but progress takes time.
In a capitalist world, let's be realistic: companies won't spend a dime on durability R&D unless the feedback is overwhelmingly negative and sales take a hit. And don't get me wrong—I'm not a socialist either.Under socialism, the implant probably wouldn't even exist in the first place.
All I am asking is that we speak our minds and remain honest about our fears and what we are actually witnessing. 'Burying the lead' helps no one. If we want better technology and longer-lasting devices, we have to stop sugarcoating the failures and start demanding accountability through honest data.GoodWood wrote:Stronger tubing would be welcome,
the most important priority I believe.GoodWood wrote:and I also think having more cylinder diameter options would help. I ultimately chose a Titan largely to avoid losing girth. I might have preferred the more natural flaccid state of the LGX, but the diameter options didn’t work as well for me. If LGX cylinders were available in larger diameters, I might have seriously considered them.
very constructive ideas and thoughts ( and you know meGoodWood wrote:get the revision done so I can get back to enjoying life.
Some men believe that dismantling this morbid narrative—one engineered by figures like Perito and Wilson—is the first essential step toward reducing the frequency of revisions. And let's be clear: replacement is a medical necessity. My criticism doesn't mean I won't replace my own implant when it eventually goes 'kaput.' It simply means I intend to have the courtesy of being angry about it when it happens, rather than 'ass-kissing' the perpetrator.
If your defibrillator lasted only 1–2 years before failing unexpectedly, you would obviously replace it to stay alive—but I’m certain you wouldn’t be thanking the cardiology community every few days for the 'great invention.' You paid for that device. You are a taxpayer. You work and innovate in your own job, you get paid, and you don’t expect society to thank you day in and day out for simply doing what you were hired to do. We should expect the same level of professional accountability from the medical device industry.
Hey guys, I suggest adding trolls to your 'foe' list. It’s the best way to starve them of attention. Just go to their profile and click 'Add Foe'.
