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The ergoflo extra anal douche comes with a medical grade contoured bulb featuring air valve technology. This industry-first reduces messy back-flow requiring fewer refills. Extra comes with a premium 5″? (13 cm) ABS plastic tip and a 3″ (20 cm) stowaway tip. Perfect Fit Brand Products are sold and intended for use strictly as adult novelty toys for entertainment. They are not intended for medical use and have not been clinically tested. No medical claims are warranted or implied by the use of these products. This enema kit is an FDA ““ registered medical device. Materials: made of medical grade PVC and ABS plastic in China. Meets EN71-3 standards.