Abstract Background Mechanical malfunction remains one of the most common causes of inflatable penile prosthesis failure, yet long-term data on the specific causes, failure locations, and timing remain limited. Aim We aim to elucidate the mechanism, location, and timing of mechanical breakdown of the Coloplast Titan Touch implants. Methods This is a retrospective review of all patients at a single surgical center performed by a high-volume single surgeon between January 2013 and December 2025. Only Coloplast Titan implants with Touch pumps were included in this study. Sites of mechanical failure were categorized into location of tubing fracture, cylinder, or reservoir leak or pump malfunction. Outcomes The primary outcome was the incidence and etiology of mechanical failure requiring surgical revision, and secondary outcomes included anatomic location of failure and time to mechanical failure requiring reoperation. Results A total of 3197 penile prostheses were implanted using the no-touch technique. In the Coloplast Touch group (n = 1907), 214 patients (7.6%) required reoperation or replacement, with 149 cases (69.6%) due to mechanical failure. Median time to reoperation was 59.1 months. Kink-resistant tubing (KRT) malfunction was the leading cause. Most tubing fractures (77%) occurred at the connection between the KRT and strain relief boot near the scrotal pump. Other fracture sites included the cylinder junction (13.7%), reservoir junction (5%), and KRT–KRT connections (2.9%). Additionally, 34% of failures involved sidewall erosion of the KRT without complete fracture. Clinical implications Identification of recurrent anatomic failure points may inform surgical technique modifications and device design improvements aimed at reducing mechanical failure rates and extending implant longevity. Strengths and limitations Strengths include a large single-institution cohort with long-term follow-up and uniform surgical technique. Limitations include the retrospective design and single-surgeon experience, which may limit generalizability. Conclusion Characterizing the timing and anatomic site of failure enables us to generate hypotheses regarding the underlying mechanisms of malfunction to target modifications to our surgical technique with the goal of extending the durability and overall longevity of the Coloplast Titan multicomponent penile prosthesis.
Feng et al. (Fri,) studied this question.