PENILE IMPLANTS​

• The two most common implants are the semi-rigid penile implant (aka malleable penile prosthesis or MPP) and the inflatable 3-piece (rod, pump, reservoir) implant (aka inflatable penile prosthesis IPP). There are also two-piece inflatable penile implants. Two large US companies make MPPs and IPPs. 

  • Boston Scientific (previously AMS)​

  • Coloplast

• The 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 rectangular upper pump design. Coating also has antibiotic but it won't soak up newer antiseptic irrigants as it is not hydrophilic. 

  • 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. Also, this has been recently discontinued (2023-2024).

• The semi-rigid or MPP is a rod made of metal and silicone.

  • AMS Spectra: discontinued 

  • AMS Tactra: mostly silicone with a metal core; no hydrophilic coating

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

  • Rigicon: newer company; mostly silicone with metal core; no hydrophilic coating.

• Penile implants are often inserted about 1 year after phalloplasty. Testis implants may be inserted at the same time if the scrotum can accommodate it.

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TESTICULAR IMPLANTS

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

  • AART or alpha aesthetics solid silicone implants: comes in set sizes that can be shaved to accommodate a patient individually​

  • Coloplast Torosa saline filled implants: comes in multiple sizes

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

• The testis implants may be inserted at time of penile implant insertion if the scrotum is large enough for the pump and testis. 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 short; not available in US for implantation.

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