Introduction: Despite advances in design, inflatable penile prostheses (IPPs) remain susceptible to mechanical degradation with repeated use. We sought to characterize IPP component failure at time of device revision and stratify by manufacturer [American Medical Systems (AMS) and Coloplast (CP)]. Methods: Retrospective review of our penile prosthesis database between July 2007 – May 2022 was conducted, identifying men who underwent revision surgery. Mechanical indications for surgery were categorized by location (e.g. tubing, cylinder, or reservoir leak and pump malfunction). Non-mechanical revisions (e.g. component herniation, erosion, or crossover) and patient satisfaction were not analyzed. AMS™ 700 (silicone reservoir and cylinders) component failure rates were compared to those of Coloplast Titan® (Bioflex® reservoir and cylinders) components. Categorical variables were assessed with Fisher’s Exact or Chi-square analysis; Student’s t-test and Mann Whitney U were used for continuous variables. Results: Among 1105 IPP procedures performed at our center over the 15-year study period, we identified 276 revision procedures, 76 of which were due to mechanical failure (53 AMS and 23 CP). Coloplast devices failed most often due to tubing fracture (19/23, 83%), and rarely elsewhere. AMS devices showed no predominant site of failure. When comparing manufacturers, tubing failure was more common in CP devices (19/23 vs 15/53 for AMS, p < .01), while pump failure was more common among AMS devices (15/53 versus CP 1/23, p = .02, Figure). Revised Coloplast cylinders were longer than AMS cylinders (median length 20cm vs. 18cm, p < .01). Median time to revision was longer for Coloplast devices (55.2 months versus AMS: 27.8 months, p < .01). Mechanical failure rate for virgin cases was similar between brands (26/581 AMS, 10/165 CP, p = .500). Conclusions: Coloplast devices commonly failed at the tubing and rarely elsewhere. Pump malfunction was more common among AMS devices. Time to failure was significantly longer for Coloplast devices. SOURCE OF Funding: N/A
