Other Types of Penile Implants

I. Rod-type penile implants: Over the years there have been many rod-type penile implants devised, and many have fallen by the wayside and are no longer manufactured. They consist of a pair of rods, one placed in each of the penile erection chambers (corpora cavernosa). Rod-type implants frequently provide inadequate penile rigidity, patient discomfort, and difficulty with concealment. In addition, they make any urologic endoscopic procedures (e.g., prostate laser therapy, TURP, ureteroscopy) difficult.

Figure A
Schematic of rod-type penile implant.
Figure B
These are rod-type penile implants, with spiral wire inside. This type of device has a lot of "spring-back," and often won't stay in position.
Figure C
Flexi-Rod penile implant, with a "hinge" area. This device often provided inadequate rigidity due to the hinge area, which would buckle and not maintain its position.
Figure D
Rod-type penile implant, showing 2 different diameter cylinders, with tail caps.
Figure E
Another rod-type penile implant. You can see the coiled wire, which provides some malleability to that section of the device. Each penile implant cylinder is cut to length, and a tail cap applied. Two different diameter cylinders are shown.
Figure F
Figure G
These rod-type penile implants have many articulating ball and socket joints inside them. They allow better positioning of the device, and less spring-back. However, they make the penis behave like a gooseneck lamp!
II. Self-contained inflatable penile implants: These penile implants consisted of 2 cylinders with a trimmable tail section, and a pump in the distal 2-3 cm. of the device. To inflate it, the patient would have to pump both of the cylinder tips. This proved to be painful (since the tips are in the glans), and these devices proved to be unreliable and provided inadequate rigidity. They are not sold in the US any more.
Figure H
Self-contained inflatable penile implant with trimmable tail section (only one cylinder is shown).
III. Two-component inflatable penile implants: These penile implants consist of two inflatable penile cylinders, and a scrotal pump mechanism. The only model sold in the U.S.at this time is the AMS Ambicor (shown on the Penile Implant Surgical Procedure page of this website.)
Figure I
This figure shows an early version of the two-component inflatable penile implant. The cylinder tail sections are trimmable. A combined pump-reservoir was placed into the scrotum. However, this particular device proved to be quite unreliable, and is no longer manufactured.
Figure J
Figure K
These figures show another type of two-component inflatable penile implant. A combined pump-reservoir was placed into the scrotum, and two inflatable cylinders were placed into the penile erection chambers. Rear tip extenders were used as needed. These devices are filled with sterile saline solution by placing a needle into the injection port at the bottom of the pump-reservoir, allowing precise fluid volume adjustment. This type of inflatable penile implant is sold overseas, but not in the U.S. The fill volume must be exactly right, or the device will provide inadequate rigidity or flaccidity.
IV. Fully-inflatable, three-component penile implants: These penile implants consist of two intracorporal inflatable cylinders, a scrotal pump, and a fluid reservoir. This type of device is the most complex, but provides unequivocally the best flaccidity, and the best quality erection (i.e., the best penile girth and rigidity). There are only two manufacturers in the U.S.: American Medical Systems (AMS), and Coloplast (formerly Mentor) Corp.
Figure L
This photo shows an earlier version of the AMS inflatable penile implant. The reservoir is round, the cylinders only expand in girth, and the original pump configuration is shown. AMS continually strives to improve their devices, and they have released many versions over the years.
Figure M
This diagram shows the current AMS inflatable penile implant cylinder construction. There is an inner cylinder made of silicone. However, silicone is not very strong, and it requires reinforcement. AMS then applies a woven Dacron fabric cylinder around the inner cylinder. To prevent tissue ingrowth, they then apply an outer silicone cylinder. A Parylene coating is applied to the non-patient contact surfaces of the cylinders, to decrease friction between the cylinder layers. Finally, to decrease the chance of infection, they impregnate the outer cylinder surface with antibiotics (rifampin and minocycline).
Figure N
This photo shows the two AMS reservoir configurations, round and flattened. The urologist can choose which reservoir configuration is best for each patient. Both are impregnated with antibiotics.
Figure O
This diagram shows an AMS penile implant with length and girth expanding (LGX) cylinders, a Momentary Squeeze pump, and a round reservoir. The LGX cylinders may provide inadequate rigidity in some patients.
Figure P
This diagram shows an AMS penile implant with a Tactile pump. This pump was larger than other models, and some patients found it to be uncomfortable.
Figure Q
This photo show a Coloplast Titan inflatable penile implant with a Genesis pump, standard reservoir, standard input tubing exit angle, and regular cylinder tips. Coloplast likewise continually strives to improve their device, and this implant has been replaced with the model shown below.
Figure R
Figure S
This photo shows a Coloplast Titan inflatable penile implant with One Touch Release (OTR) pump, zero-degree input tubing, Cloverleaf reservoir, and soft silicone cylinder tips. Coloplast cylinders are made of a single layer of Bioflex® polyurethane, which is much stronger than silicone. A new smaller Touch pump was released in 2014. Click here to read about the features and advantages of this implant.
Bruce B. Garber, MD, FACS 525 Jamestown Street Suite 108 Philadelphia, PA 19128 Phone: 610-613-9251