If you are looking for a malleable penile implant in India, you will probably come across Promedon TUBE, Rigicon Rigi10, Boston Scientific Tactra and Coloplast Genesis.
Promedon TUBE is promoted quite strongly in India, particularly around two points: rigidity and its long history as an international implant.
As a penile implant surgeon, however, I would ask four different questions before putting any permanent implant inside a patient.
My Four Questions About Promedon TUBE
- Why does it still use a twisted silver-wire core when silver-wire fracture has such a long history in penile implants?
- Where is the independent evidence that Promedon is more rigid than modern alternatives?
- Why is its current American and major European footprint so limited compared with other international prosthetic platforms?
- For an implant promoted so heavily in India, why is there so little international surgeon discussion and long-term published evidence about it?
The first question is the most important.
1. The Silver-Wire Problem Is Not New
Promedon TUBE contains a twisted silver-wire core covered with PTFE and silicone.
That basic idea is actually quite old.
In 1980, the famous Jonas penile prosthesis was introduced. It also used silicone around a central structure made from silver wires. The advantage was simple: the implant could be bent down inside clothing and straightened for intercourse.
Initially it looked like an excellent solution.
Then the fracture reports started appearing.
What Happened To The Old Silver-Wire Implants?
A 1984 Journal of Urology paper examined five consecutive silicone–silver-wire implants that had to be removed within two years.
When the implants were examined, the investigators found multiple fractures in all the strands of the silver-wire cores in both cylinders.
Another study subsequently reviewed 27 men with the Jonas prosthesis.
Patients developed:
- decreasing rigidity,
- palpable or audible “crackling,”
- abnormal X-rays,
- and complete multiple wire fractures discovered during revision surgery.
This became important enough to influence implant design in the United States.
A modern review of the history of malleable implants explains that the Jonas silver strands tended to fracture, leaving the prosthesis mechanically ineffective. In American practice, the Jonas subsequently lost popularity to the AMS 600, which used a braided stainless-steel core instead.
So this is not a new theoretical argument about metals.
Penile implant surgeons already encountered this problem approximately 40 years ago.
Why Does This Matter For Promedon?
Because a 2026 Brazilian study makes the connection directly.
The authors describe Promedon TUBE as having a PTFE-coated twisted silver-wire core.
They then specifically point out that its architecture resembles earlier-generation implants such as the Jonas device and state that the Jonas prosthesis was replaced in the American market after its silver strands tended to fracture and cause device failure.
That statement does not come from a competitor advertisement.
It comes from a contemporary peer-reviewed paper examining malleable prosthesis fractures.
And Promedon itself has modern fracture reports.
A recent series involving patients with fractured TUBE implants documented bilateral silver-wire fractures. In some cylinders the broken metallic core had actually damaged or penetrated the surrounding material.
The resulting instability was associated with weakening and disruption of the tunica albuginea, requiring implant replacement and reconstructive surgery.
That is why fracture is my number-one question with TUBE.
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Think of It Like Repeatedly Bending A Paper Clip
Patients often get confused between rigidity and durability.
They are not the same thing.
Take a metal paper clip.
Push directly against it and it can withstand considerable force.
But repeatedly bend the same point backwards and forwards and eventually the metal develops fatigue and breaks.
A malleable penile implant undergoes something similar:
down for concealment → up for intercourse → down again → up again.
Potentially thousands of times.
So I am less interested in:
“How many kilograms can I push against this implant once?”
and more interested in:
“How many years and bending cycles can this internal core survive?”
For a permanent prosthesis, that is arguably the more important question.
Important Clarification: Does Every Silver-Containing Implant Fracture?
No.
That would be an exaggeration.
For example, Coloplast Genesis has also used a silver-based internal coil, and modern device construction differs significantly between manufacturers.
Therefore my concern is not simply the word “silver.”
My concern is:
twisted/braided silver strands + repeated bending + documented historical fractures + documented modern Promedon fractures.
That combination deserves proper explanation to a patient.
2. Is Promedon Really The Most Rigid Implant?
Promedon quotes an axial-load figure of approximately 1.5 kg or more.
This demonstrates that the implant can provide adequate rigidity.
It does not demonstrate that Promedon is the most rigid malleable prosthesis available.
Boston Scientific, for example, publishes substantial column-strength and fatigue-testing data for Tactra.
Different manufacturers, however, use different implant diameters and different testing methods.
So comparing one number from one company’s brochure with another number from another company is not scientifically clean.
If somebody tells you:
“Promedon is the strongest malleable implant”
ask one simple question:
“Show me the independent study where Promedon, Tactra and Rigi10 were tested side-by-side using exactly the same protocol.”
I have not found such evidence proving Promedon’s superiority.
So adequate rigidity? Yes.
Proven highest rigidity? That is a very different claim.
3. Where Is The American And European Footprint?
Promedon is an international company.
TUBE is genuinely used outside India, particularly in Latin America.
But Indian patients should distinguish between:
“internationally available”
and
“widely used in major American and European penile-implant centres.”
These are not the same thing.
The old Jonas silver-wire device actually entered the US market and received FDA clearance decades ago. FDA records document silicone-silver penile prostheses in the American market during that era.
Yet US practice subsequently moved toward other designs, including stainless-steel-core malleables and eventually newer-generation prostheses.
For the current Promedon TUBE, I still cannot identify the kind of mainstream contemporary US footprint that one sees around major American prosthetic platforms.
That doesn’t prove the implant is bad.
But if I were choosing a permanent implant for myself, I would certainly want to know:
“Where are thousands of American and European patients using this particular model?”
4. Where Is The International Surgeon Conversation?
This is perhaps the easiest question for a patient to investigate personally.
Search:
Promedon TUBE implant USA
Promedon TUBE European surgeon
Promedon TUBE long-term results
Promedon TUBE fracture
Promedon TUBE YouTube
For an implant with a long commercial history, the amount of contemporary independent international discussion is surprisingly small.
There are certainly publications and international users.
But compared with how prominently TUBE is marketed to Indian patients, the amount of:
- international surgeon education,
- large multicentre evidence,
- long-term survival data,
- independent device comparisons,
- and American/European patient discussion
is surprisingly limited.
That mismatch is what concerns me.
So Would I Call Promedon TUBE A Bad Implant?
That isn’t the useful question.
Promedon TUBE can obviously produce sufficient rigidity for intercourse.
The question is whether the claims being made about it are supported by equally strong evidence.
For me, four questions remain:
1. Silver-Wire Fracture
The historical precedent is well established, and contemporary Promedon fractures are published.
2. “Superior Rigidity”
I have not seen independent head-to-head evidence establishing that Promedon is the strongest contemporary malleable implant.
3. US And European Adoption
Its contemporary international footprint appears much more concentrated outside mainstream American practice than the word “international” might suggest.
4. International Chatter And Long-Term Evidence
For a device promoted so aggressively in India, the independent international discussion remains surprisingly limited.
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My Advice To An Indian Patient
If you are comparing Promedon TUBE, Rigi10, Tactra, Genesis or another malleable penile implant, don’t ask only:
“Which one feels hardest?”
Ask:
What is inside it?
What breaks when it fails?
How often has that failure been reported?
What happens to my corpora if it fractures?
How extensively is the implant used internationally?
Where are its 5-, 10- and 15-year data?
A penile implant may remain inside your body for a decade or longer.
For me, the most important question about a malleable implant is therefore not:
“How hard is it today?”
It is:
“What happens after thousands of bends and ten years inside the body?”
That is the question every patient deserves to have answered before surgery.
Key References
Tawil EA, Gregory JG. Failure of the Jonas prosthesis. Journal of Urology. 1986.
