AMS 700™ CX

What Is the AMS 700 CX?

The AMS 700 CX is a 3-piece inflatable penile prosthesis manufactured by Boston Scientific.

It is designed for men with erectile dysfunction who have selected penile prosthesis surgery after appropriate evaluation and counselling.

The system consists of two inflatable cylinders implanted inside the corpora cavernosa, a pump positioned within the scrotum and a separate hydraulic fluid reservoir positioned within the pelvis or lower abdomen.

The patient controls the erection manually.

Inflation transfers fluid from the reservoir into the cylinders, creating rigidity.

Deflation returns fluid to the reservoir, allowing the penis to become softer and easier to conceal.

What Does CX Mean?

CX identifies the AMS 700 cylinder configuration designed primarily for controlled girth expansion and strong axial rigidity.

It should be distinguished from AMS 700 LGX, which is specifically designed for controlled expansion in both length and girth.

CX is also different from AMS 700 CXR, which uses a narrower cylinder profile for selected restricted or fibrotic corporal anatomies.

How the AMS 700 CX Works

The AMS 700 CX creates an erection through a closed hydraulic system.

When the patient repeatedly compresses the scrotal pump, fluid moves from the separate reservoir into the paired intracavernosal cylinders.

As the cylinders fill, their diameter increases and they become progressively more rigid.

This mechanical rigidity provides the support necessary for penetrative sexual activity.

After intercourse, the patient activates the deflation mechanism.

Fluid returns to the reservoir and the cylinders become softer.

The implant therefore bypasses the vascular mechanism responsible for a natural erection.

Three-Component Design

The AMS 700 CX contains three principal components.

The first is a pair of inflatable cylinders placed within the corpora cavernosa.

The second is the scrotal pump used for inflation and deflation.

The third is the separate fluid reservoir.

Tubing connects these components to form a closed hydraulic circuit.

This architecture gives a 3-piece prosthesis a substantial difference between the inflated and deflated states.

CX Cylinder Expansion

The CX cylinder is designed primarily for controlled circumferential expansion.

When inflated, the cylinder expands in girth and develops strong axial rigidity.

Unlike AMS 700 LGX, CX is not specifically designed to provide longitudinal cylinder expansion.

That distinction is important for both patient counselling and device comparison.

CX should therefore not be marketed as a length-expanding implant.

Rigidity

Axial rigidity is one of the principal characteristics of the CX platform.

The cylinders are designed to provide enough structural support for penetration while remaining deflatable after intercourse.

This rigidity has also made CX an established choice in patients with Peyronie’s disease who require prosthesis implantation.

However, clinical rigidity depends on more than the cylinder model alone.

Cylinder size, corporal anatomy, fibrosis, surgical positioning and inflation technique also influence the result.

AMS 700 CX and Peyronie’s Disease

The AMS 700 CX has been extensively used in men with erectile dysfunction associated with Peyronie’s disease.

Cylinder inflation itself can improve some curvature by providing internal structural support.

When residual curvature remains, the surgeon may perform penile modeling over the inflated cylinders.

More severe deformity may require additional plication, tunical incision or grafting.

Published comparative evidence suggests that AMS 700 CX and Coloplast Titan can both provide effective penile straightening with similar satisfaction and no statistically significant difference in device survival.

AMS 700 CX vs Coloplast Titan

CX and Titan are two of the most established 3-piece inflatable penile prosthesis platforms.

Both provide strong rigidity and circumferential expansion.

A published comparative study in men with Peyronie’s disease reported estimated 5-year mechanical survival of approximately 91% for AMS 700 CX and 87% for Titan, although the difference was not statistically significant.

The same study found comparable penile straightening and patient satisfaction.

A later comparative satisfaction study also found no significant difference in long-term EDITS satisfaction scores between the two devices.

Therefore, neither should be described as universally superior.

Selection depends on anatomy, surgeon experience, cylinder characteristics, pump preference, coating strategy and patient priorities.

AMS 700 CX vs AMS 700 LGX

The main distinction is expansion behavior.

AMS 700 CX is designed primarily for girth expansion and rigidity.

AMS 700 LGX is designed to provide controlled expansion in both length and girth.

This does not mean LGX is automatically better.

Patients with significant Peyronie’s disease, corporal fibrosis or a need for greater axial rigidity may be better suited to CX depending on anatomy and surgeon judgment.

Likewise, patients prioritizing controlled longitudinal expansion may be considered for LGX when anatomically appropriate.

AMS 700 CX vs AMS 700 CXR

CXR is a narrower-cylinder version within the AMS 700 family.

It is intended for selected patients whose corpora cannot safely accommodate standard CX or LGX cylinders.

This can occur in severe corporal fibrosis, after priapism, after previous prosthesis infection or removal, or after complex reconstructive surgery.

CX remains the standard-diameter controlled-girth-expansion configuration.

CXR should therefore be treated as a separate device record in the CMS.

Current Cylinder Lengths

Boston Scientific currently lists AMS 700 CX cylinders in:

12 cm

15 cm

18 cm

21 cm

A 24 cm CX cylinder is listed as available by special order.

Rear-tip extenders can also be used to achieve appropriate total corporal length.

The final cylinder configuration is selected according to intraoperative corporal measurements.

Rear-Tip Extenders

Rear-tip extenders allow the surgeon to fine-tune prosthetic length.

They are placed proximally on the cylinder to achieve an appropriate fit within the measured corporal space.

They should not be used to artificially increase penile length.

Correct sizing is critical because excessive length can increase the risk of pain, deformity, erosion and tissue injury.

AMS 700 Pump

The AMS 700 system uses a scrotally positioned pump.

After healing, the patient locates the pump through the scrotal skin and repeatedly compresses it to inflate the cylinders.

Deflation returns fluid to the separate reservoir.

Successful use requires adequate manual dexterity and appropriate postoperative training.

Patients with severe hand weakness, arthritis or neurological impairment may find a malleable implant easier to operate.

Reservoir

AMS 700 CX uses a separate fluid reservoir.

The reservoir is commonly placed within the pelvis or lower abdominal region.

In patients with previous pelvic surgery, alternative reservoir positions can be used when traditional placement is difficult or undesirable.

This is particularly relevant after radical prostatectomy, cystectomy, urinary diversion or some complex hernia repairs.

InhibiZone™ Antibiotic Treatment

Current Boston Scientific product listings include AMS 700 CX configurations with InhibiZone antibiotic treatment.

InhibiZone incorporates rifampin and minocycline into the device surface.

The purpose is to reduce bacterial colonization of the prosthesis during and after implantation.

This differs from hydrophilic-coated devices such as Coloplast Titan or Rigicon Infla10, where the surgeon selects an aqueous solution during device preparation.

InhibiZone should be viewed as one element of infection prevention rather than a guarantee against infection.

Infection

Prosthetic infection remains one of the most serious potential complications of penile implant surgery.

Possible symptoms include increasing pain, erythema, swelling, drainage, fever, erosion or abnormal fixation of components.

Deep infection may require device removal or specialist salvage surgery.

Risk is influenced by factors including revision surgery, previous infection, diabetes control, tissue quality and operative technique.

Mechanical Reliability

AMS 700 CX has one of the stronger long-term evidence bases among inflatable penile prostheses.

A large long-term study of AMS 700 CX/CXM recipients reported mechanical survival of approximately 97.6% at 3 years, 93.2% at 5 years and 78.2% at 10 years.

Another long-term series reported approximately 81.3% mechanical survival at 10 years.

These data show that many implants function for a decade or longer, but no mechanical penile prosthesis can be guaranteed to last for life.

Earlier Multicenter Reliability Evidence

An earlier multicenter study of 372 AMS 700 CX recipients reported approximately 92.1% mechanical reliability at 3 years and 86.2% at 5 years.

The study also reported that 88.2% of interviewed patients would recommend penile implantation to a relative or friend.

These results are useful historically but reflect an earlier generation of the implant and surgical practice.

For a modern device page, the later long-term survival data provide a stronger headline durability signal.

What Happens If the CX Fails?

Mechanical failure can involve the cylinders, pump, reservoir, tubing or valve system.

Symptoms may include inability to fully inflate the prosthesis, loss of rigidity after inflation, difficulty pumping or inability to deflate.

Clinically significant malfunction generally requires assessment by a prosthetic urologist.

Revision surgery may involve replacing one component or the entire system depending on prosthesis age, compatibility and operative findings.

Concealability

Because AMS 700 CX has a separate reservoir, fluid can move out of the cylinders during deflation.

This allows the penis to become substantially softer than with a malleable prosthesis.

The resting appearance is generally easier to conceal beneath clothing.

Exact flaccidity depends on cylinder size, corporal anatomy, fibrosis and surgical outcome.

Does AMS 700 CX Increase Penile Length?

AMS 700 CX should not be marketed as a penile-lengthening implant.

The surgeon chooses cylinder size according to the measured corporal anatomy.

CX does not have the dedicated longitudinal expansion characteristic of AMS 700 LGX.

Patients may perceive changes in dimensions after surgery, but no specific length increase should be guaranteed.

Oversizing the cylinders to create additional length can lead to excessive pressure, pain, erosion and deformity.

Does AMS 700 CX Increase Girth?

CX cylinders expand circumferentially during inflation.

This increases the diameter and rigidity of the prosthetically supported penis compared with the deflated state.

However, the amount of visible girth depends on the patient’s corporal dimensions, tissue characteristics and selected cylinder size.

The device should not be described as a cosmetic girth-enlargement procedure.

CX After Radical Prostatectomy

Men with persistent erectile dysfunction after radical prostatectomy are common candidates for inflatable penile prosthesis implantation.

AMS 700 CX can provide reliable mechanical rigidity independently of cavernous nerve recovery.

Previous pelvic surgery may influence reservoir placement but does not automatically prevent 3-piece implantation.

Alternative reservoir-placement techniques can be used when necessary.

CX in Diabetes

Diabetes can cause severe vascular, neurological and cavernosal damage leading to treatment-resistant erectile dysfunction.

AMS 700 CX can provide mechanical rigidity even when oral medication or injection therapy is ineffective.

Diabetes is also relevant to perioperative infection risk.

Appropriate medical optimization and glycemic assessment are therefore important before surgery.

CX in Corporal Fibrosis

Moderate corporal fibrosis does not automatically exclude CX implantation.

However, extensive fibrosis can restrict corporal diameter and make standard cylinders difficult to place.

In such cases, specialized dilation or reconstructive techniques may be required.

A narrower device such as AMS 700 CXR may be more appropriate when the corporal lumen cannot safely accommodate standard CX cylinders.

Patient Satisfaction

AMS 700 CX has consistently demonstrated high patient satisfaction in published studies.

In one direct comparison with Coloplast Titan, overall patient satisfaction was similar between devices.

Another long-term comparative study using the Erectile Dysfunction Inventory of Treatment Satisfaction found almost identical scores between AMS 700 CX and Titan.

This supports the view that successful counselling, surgical technique and matching the device to patient anatomy may be more important than brand preference alone.

Sensation and Orgasm

The AMS 700 CX primarily restores mechanical rigidity.

It does not normally remove penile sensory nerves.

Patients who were capable of orgasm before implantation generally remain capable of orgasm unless another medical or neurological condition interferes.

The prosthesis does not restore ejaculation when ejaculation has been lost for another reason.

For example, men after radical prostatectomy typically remain unable to ejaculate semen despite potentially retaining orgasm.

Revision Surgery

AMS 700 CX can be surgically replaced when mechanical failure, infection, erosion or another significant complication occurs.

Revision surgery is generally more complex than first-time implantation because scar tissue develops around prosthetic components.

Repeated revision can also progressively alter corporal anatomy.

Patients should therefore understand that penile implantation is a long-term prosthetic treatment that may eventually require additional surgery.

Who May Be a Good Candidate for AMS 700 CX?

AMS 700 CX may be particularly suitable for men with treatment-resistant erectile dysfunction who want a 3-piece inflatable prosthesis with strong rigidity and controlled girth expansion.

It can be especially useful in selected men with Peyronie’s disease and erectile dysfunction.

It may also suit patients who prioritize an established device with substantial long-term clinical follow-up.

Candidates must have adequate manual dexterity to operate the pump and should understand that the device is intended to restore rigidity rather than guarantee increased penile length.

What Should Patients Weigh Before Choosing AMS 700 CX?

The principal strengths of CX include its long clinical history, strong rigidity, controlled girth expansion and extensive published durability data.

The trade-offs are those associated with a conventional 3-piece hydraulic prosthesis.

It requires a scrotal pump and separate reservoir.

Mechanical failure can occur over time.

Infection, erosion, pain, reservoir problems and revision surgery remain possible.

CX also does not provide the dedicated longitudinal expansion of AMS 700 LGX.

The best device therefore depends on anatomy, disease characteristics, patient priorities and surgeon expertise.