Coloplast v AMS

[newbie443]

I never understood the length and girth expansion of the LGX. Expanding from what, to what? If you are sized with the maximum possible length at the time of surgery, how is there room for the implant to expand length-wise?

Some of us have size loss pre surgery. Some of this may be returned after surgery. The Titan, CX, and LGX all expand but the LGX will expand more in length if there is room. The Tunica will loose elasticity when erections stop. Over time with cycling an implant some of that may be return. This is not enlargement. This is only for lost size that can be regained. If you do not have length regainable size loss greater than that of the limits of the other devices you will have the same results with the LGX. Scroll down on this link to table 1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654325/ It shows the amount of expansion of the LGX and the Titan. So you are restricted to what your body will permit up to the limits of the device.

[merrix]

Merrix, we agree on one thing in that the first link you posted purpose is NOT reliably. So it is NOT for the purpose of such references. So that is why I did not see as such. And why I disagree with your post telling other members that they will need nearly twice the revisions with a LGX as a Titan. Using the information in that report for other than was intended goes extremely beyond reading with an open mind. The purpose was tissue expansion over time and it seems to me this does have a bearing on the study. It is true that if you take the differences just between the Titan and the CX and the between the CX and the LGX that those differences are low. But it should be noted that both the CX and LGX gave more length expansion than the Titan. And if you compare the LGX(1.2) to the Titan(0.9), the LGX had 1/3 again as much gain as the Titan in just over 1/2 the time. So this is far from debunking the LGX tissue expanding.

I am not for or against any of the devices. I do believe that we are different and this is why there are different devices. Again if you have any information that shows that the the LGX has poor reliability I would like to see it. My information shows this is not so. This is a current (November 2020) study that is in line with what research has shown in that there is no significant difference in longevity in the current available devices. https://www.cureus.com/articles/36922-a ... ure-review

Well, I respect if you choose not to see those different MTBF for different types in that study as relevant. I do however. And that's probably as far as you and me will come on that point. Fine.

Regarding the length gain, yes there was a difference. As you put it, 33% more from LGX than Titan. But to prove my point, 2 mm is 100% more than 1 mm. And that 1 mm difference is still completely meaningless, no matter the 100%. I think the numbers above are in the same ballpark. Nice percentage, but useless in absolute numbers. Nobody will notice a 3 mm difference... And to market something as revolutionary length gaining, I think a difference of 3 mm to one type and 1 mm to the other, makes it borderline fraudulent to market it as such.
1 mm more length gain than their own CX... And one is marketed as length gaining and the other is not. Seriously?

[newbie443]

But I do see them as relevant for the purpose the study was intended. That study did not included all failures. That study was done to look at differences in tissue expansion over a set number of years. Those cases were selected for that purpose. Those MTBF numbers only have relevance to that study group of selected cases.

That study was not done to determine failure rates of the different types of implants. To be able to claim that, all failures for those years would need to be included. They were not. That is why other published information that studied failures for the purpose of device longevity do not even come close to being as low as in that study.

That is why the last link I posted found no noticeable difference in longevity between the different devices. It used data from publications that studied failure rates.

[Masonjames]

My surgeon told me that the Titan was what I needed because of my large girth. He said the AMS was out of the question. I still lost some girth, even with the Titan Xlarge. Hoping to gain that back.

[merrix]

But I do see them as relevant for the purpose the study was intended. That study did not included all failures. That study was done to look at differences in tissue expansion over a set number of years. Those cases were selected for that purpose. Those MTBF numbers only have relevance to that study group of selected cases.

That study was not done to determine failure rates of the different types of implants. To be able to claim that, all failures for those years would need to be included. They were not. That is why other published information that studied failures for the purpose of device longevity do not even come close to being as low as in that study.

That is why the last link I posted found no noticeable difference in longevity between the different devices. It used data from publications that studied failure rates.

This is getting more philosphical now than maybe relevant for this thread.
And an interesting discussion not only for the purpose of establishing a possible lower MTBF for the LGX.
This is still a random sample. They took a random sample of guys who did revisions. Of course some of them will be for other reasons than implant failure. But our experience tell us that an absolute majority of revisions are because of implant failure.
And if one type is overrepresented in revisions for other reasons than implant failure (let us say infection), then this is just as relevant anyway. What we want to avoid is a revision. No matter if the reason is implant failure or infection. As a matter of fact, this is a strength in this study. They looked at revisions for whatever reason. Not only for implant failure. What we care about is what implant gives us the longest Mean Time Between Revisions. Not Mean Time Between Implant Failure.
And when they took this random sample of guys who had done a revision, they asked them how long they had their implant.
Voila, we have a reliability study.
Not the main target of the study, but with great validity and reliability nonetheless.
Random sample from the same population that would be used for a reliability study. I.e. people who needed to replace their implant.

Another example:
A researcher want to see if the second knee prosthesis surgery requires more cutting of the bones or if it can just be inserted where the first prosthesis was.
So he finds 1000 randomly selected patients who did their second knee prosthesis surgery.
He thinks one relevant variable in his study is how long time the prosthesis had been in there. He suspects that maybe those who had it there for long time would have a larger chance of requiring more bone sawing to mount the second prosthesis.
As a control question, he also checks what brand the first prosthesis was. Maybe that makes a difference for the bone sawing required.
If he then would find that the average time to second prosthesis by those operated with brand A was only half vs those with brand B, wouldn't that say something about the reliability of prosthesis brands A and B?
Of course it would.
Random sample from the same population that would be used for a reliability study. I.e. people who needed to replace their knee prosthesis.

[newbie443]

My surgeon told me that the Titan was what I needed because of my large girth. He said the AMS was out of the question. I still lost some girth, even with the Titan Xlarge. Hoping to gain that back.

The column strength is the general rule and reason for the Titan being available in larger sizes and the choice for the smaller number of really large men. The stiffness is also better for men with greater curvature for straightening. And in men with really large girth. For most men with average size and under or even a little above or with mild curvature the AMS has equal results and has more comfort. There are of course overlap's between the models. And the LGX does have the ability to expand in length more. That does not mean it will, only that it can. So there are many things that can determine which device is best for each of us. And for some in the overlapping areas it can be a toss up and doctor or patient choice. There are other factors that I'm sure I do not know about and some doctors are brand specific so they only use one manufacture.

[MK1965]

I gained 1 inch of lost length due to radical prostatectomy with my first implant which was Titan.
A few days ago, I had revision and was implemented with AMS 700 CX with 2 cm longer cylinders.
I hated my flaccid look and angle which never looked flaccid.
I I still od opinion than any length shorted then 20 cm Titan is not good choice.
MK

[Masonjames]

My surgeon told me that the Titan was what I needed because of my large girth. He said the AMS was out of the question. I still lost some girth, even with the Titan Xlarge. Hoping to gain that back.

The column strength is the general rule and reason for the Titan being available in larger sizes and the choice for the smaller number of really large men. The stiffness is also better for men with greater curvature for straightening. And in men with really large girth. For most men with average size and under or even a little above or with mild curvature the AMS has equal results and has more comfort. There are of course overlap's between the models. And the LGX does have the ability to expand in length more. That does not mean it will, only that it can. So there are many things that can determine which device is best for each of us. And for some in the overlapping areas it can be a toss up and doctor or patient choice. There are other factors that I'm sure I do not know about and some doctors are brand specific so they only use one manufacture.

You are right about that. It depends on our anatomy which device is best for us. The important thing is that we are functional again. I love mine.

[newbie443]

Merrix,

You make an assumption that the samples were random. And another assumption that they are an accurate reflection of the life span of penile implants. And you use that to say there is a huge difference in between the LGX and the Titan in life span. Even though the study makes no claim for any of that nor have I found a publication to concur with your point of view.

I have found publications that refute your point of view. Your surgeon actually says you are wrong. "There is no appreciable difference between the life expectancies of the different manufacturers." https://www.urologicalcare.com/contents ... 15%20years. At the bottom you can ask him a question and see if you can convince him the LGX will need nearly twice the revisions over time as the Titan. He also lists the life expectantly between 5-20 years. That seems to be what I find at other sources showing around 60% survival at 10 years and around 90% at 5 years. You might see if he will concede that his and all the other published information is faulty as it is so much higher what you persist.

If anyone believes what you are saying, then that means that all the information above by your surgeon and all the other publications listing life expectancy of implants is wrong. Your doctor and all the other high volume implant doctors in the world would clearly see a nearly 2-1 ratio. And yet you are over 5 years on your Titan well past that 48 months. And I am 33 months on my LGX well past the 29 month. So we are both on borrowed time now. So for your point of view to be right all those doctors would be wrong.

Just suppose for a second that you are somehow less than accurate in your reasoning. Let us suppose that the cases selected for that study either by accident (random) or intentionally (being for the intended purpose and not for a longevity study) or both greatly skewed the MT for an implant longevity study. Implant longevity was not the purpose of the study so there was no reason to correct for it. The MT data was displayed to only to be relevant to that study group for that study. That the MT data is not applicable to implant life expectancy studies. Then your doctor and all the other published data on implant life expectancy is now not wrong.

I just cannot see how Coloplast would not exploit this advantage if it really existed. And I surely do wish you, me and everyone else the 10-20 year life expectancy with our devices that is currently being predicted.

Take care .

[newbie443]

I gained 1 inch of lost length due to radical prostatectomy with my first implant which was Titan.
A few days ago, I had revision and was implemented with AMS 700 CX with 2 cm longer cylinders.
I hated my flaccid look and angle which never looked flaccid.
I I still od opinion than any length shorted then 20 cm Titan is not good choice.
MK

That is a common complaint with the Titan and I believe that one doctor uses 15cm as a cut off point. Studies have indicated that girth is more important than length. And in a study the 18cm Titan was king of girth over the 20cm Titan and the 18cm and 21cm LGX. Sorry no CX data for you. So some men do give up a bit of comfort to keep as much girth as they can.