Inflatable Penile Prosthesis
Coloplast Titan vs Boston Scientific AMS 700; Malleable Implants
Evidence grade 5 of 5, Settled. Read how the Atlas grades evidence.
The written rationale for this grade is still being prepared.
- FDA
- FDA approved (inflatable penile prostheses; long-established class)
Reference only. Not medical advice.
What can go wrong
Device infection is the feared complication, historically ~2-3% and lower with antibiotic-coated devices and no-touch technique, but higher in diabetics, revisions, and spinal-cord-injury patients; infected devices generally require removal and salvage or staged reimplantation. Other issues: mechanical malfunction (revision ~6% in some series), erosion, glans cooling/sensory change, auto-inflation, reservoir herniation, and a small risk of penile shortening. It does not increase native penile size.
This is something to take to a clinician. The Atlas can tell you what is known about inflatable penile prosthesis in general. It cannot tell you what is happening in your body, and the difference matters most for exactly the symptoms that bring people to this page.
The inflatable penile prosthesis (IPP) is a surgically implanted erectile device for ED that fails or cannot use other therapies. The two dominant three-piece systems are the Boston Scientific AMS 700 (originally American Medical Systems) and the Coloplast Titan; malleable (semi-rigid, non-inflatable) rods are a simpler lower-cost alternative. These are among the most satisfying treatments in sexual medicine: roughly 79-86% of patients and partners report high satisfaction in pooled series, and a large majority would choose the operation again. The principal serious complication is device infection; modern antibiotic-coated devices and technique have reduced rates to low single digits.
The definitive end-stage treatment for refractory ED, not a cosmetic enlarger.
What people take it for
What it is taken for. Approval, where it exists, covers only some of these.
How it works
A three-piece IPP places paired cylinders in the corpora cavernosa, a fluid reservoir behind the abdominal wall, and a scrotal pump. Squeezing the pump moves saline from reservoir to cylinders to produce rigidity; a release valve returns fluid for flaccidity. Malleable implants are bendable rods giving permanent semi-rigidity without a pump.
Safety in detail
Implantation is a definitive, irreversible surgery: the native erectile tissue is permanently altered, precluding later use of pills, injections, or vacuum erections. It carries operative and infection risk and should follow failure or contraindication of less invasive ED therapy.
What people get wrong
Often saidA prosthesis makes the penis bigger
ActuallyIPPs restore rigidity; many patients note slight shortening versus pre-ED erections, not enlargement.
Often saidInfection means it always must come out forever
ActuallyInfections usually require removal, but salvage washout or staged reimplantation can restore function in many cases.
Who profits, and who pushes back
Nobody is named here yet, because we have not done that work on this entry. Read that as unfinished. Somebody almost certainly sells this, and somebody almost certainly disputes it. Assume both until we have checked.
How we got here
American Medical Systems pioneered the inflatable prosthesis in the 1970s; the AMS 700 line evolved over decades and was acquired by Boston Scientific. Coloplast acquired the Mentor/Titan line. Antibiotic coatings (InhibiZone, hydrophilic dipping) in the 2000s drove infection rates down substantially.
- 1973First inflatable penile prosthesis (Scott/AMS)
- 2000sAntibiotic-impregnated and hydrophilic coatings introduced
- 2010sBoston Scientific acquires AMS urology; Coloplast holds Titan
- 2020Systematic review finds device durability broadly comparable
Set against the alternatives
AMS 700 uses a parylene-coated, layered cylinder design and InhibiZone (minocycline/rifampin) antibiotic coating; the Titan uses a Bioflex polyurethane cylinder with a hydrophilic coating the surgeon dips in antibiotic, and its pump/girth expansion differ. Systematic review finds 5-year mechanical survival around 91% (AMS 700 CX) vs 87% (Titan), not statistically different, and the literature is inconclusive on overall superiority; choice is largely surgeon preference and anatomy.
| Boston Scientific AMS 700 | InhibiZone (minocycline/rifampin) coating, layered cylinder | ~91% 5-yr mechanical survival (CX) | FDA approved, market leader |
|---|---|---|---|
| Coloplast Titan | Hydrophilic coating dipped by surgeon, Bioflex cylinder | ~87% 5-yr mechanical survival | FDA approved |
| Malleable/semi-rigid rod | No pump, permanently semi-rigid, lower cost | High durability, lower satisfaction vs IPP | FDA approved |
| Coating infection data | Rifampin/gentamicin dipping associated with low rates | Vanc/gent and standard coatings higher in one comparison | - |
What we do not know
- Do newer coatings further lower infection in high-risk diabetics?
- Head-to-head long-term satisfaction by device in matched cohorts?
At a glance
- Major brands
- AMS 700 (Boston Scientific), Titan (Coloplast)
- Simpler option
- Malleable/semi-rigid rods
- Satisfaction
- ~79-86% high satisfaction (pooled)
- Primary serious risk
- Device infection
What this entry does not yet cover
What follows is unfinished work on our side, not a finding about Inflatable Penile Prosthesis. A short entry is not a safe entry.
- Cost and market. We have not documented what it sells for or who sells it.
- Supply chain. We have not mapped where it is made.
- Who uses it. We have not documented the user groups.
- What could change. No forward-looking summary yet.
- Children and teenagers. We have not checked what is known about younger people.
Sources
The studies below are named and described, but not linked. You cannot open them from here and check our reading against them, which means this page is our summary of the literature rather than a document you can verify. Weigh it accordingly until the links exist.
The studies that matter
Chung et al., AMS 700 CX vs Titan for Peyronie's, J Sex Med2013
138-patient comparison: ~6% revision for malfunction, ~2% explant for infection; similar satisfaction between devices
Systematic review: AMS 700 vs Coloplast Titan, Cureus / PMC2020
5-yr mechanical survival ~91% (AMS) vs ~87% (Titan), not significantly different; literature inconclusive on superiority
Pooled satisfaction literaturevarious
~79-86% high patient satisfaction; ~82% would undergo the same operation again