After implantations in Belgium, Germany, France, Iceland, and Sweden, Dr. Ignacio Moncada of the Zarzuela hospital in Madrid has implanted a ZSI FTM penile implant for the first time in Spain. It’s the opening of a new country for all our Spanish-speaking patients!
The surgical patient presented with a Coloplast malleable implant that had disinserted itself from the left ischiopubic ramus where it had been affixed. The implant was actually loose, causing perineal pain and threatening the skin area — which had grown thinner as a consequence. The patient had also had an inflatable implant on the right side, which had been removed due to mechanic failure. There was fibrosis abundant in both the left perineal area and the right pubic area.
The removal of the Coloplast malleable prosthesis was performed quickly and easily with a direct incision. The incision was fully disinfected and then carefully closed, as there is always a risk of contamination of a new prosthesis. Dr. Moncada then performed the traditional incision to the right side of the phalloplasty. It has to be said that Dr. Moncada handles this type of surgery perfectly, so getting to the pubic bone was quite quick and easy as well, in spite of the patient’s surgical history. Dr Moncada was then able to clear a 2- by 2.5-centimeter area to receive the base of the ZSI 100 FTM malleable prosthesis, without causing any significant bleeding.
He then dilated the phalloplasty in order to insert the distal part of the prosthesis inside it. The total estimated length of the phalloplasty and its implantation base was 15 centimeters. The ZSI 100 FTM prosthesis was recut accordingly, and the glans was fitted. Then the ZSI 100 FTM prosthesis was positioned inside the phalloplasty and attached to the pubic bone. Six stitches were made to ensure the proper seating of the malleable prosthesis. (The fixing to the pubic bone of the ZSI 100 FTM is actually more challenging than that of the ZSI 475 FTM inflatable prosthesis, the inflatable part of the latter absorbing some of the stress exerted on the pubic bone during fixation.)
After a thorough cleaning with a mixture of saline solution and antibiotics, Dr. Moncada closed the surgical site in several planes.
To ensure good healing, the penis will have to be maintained on the stomach area for a month, with a minimum of stress put on the pubic bone. In combination with scar fibrosis, an adequate fixation — made with six distinct stitches — does limit the dislocation risks linked to intensive use of the prosthesis.
ZSI is the only European manufacturer of artificial urinary sphincters and of malleable and inflatable penile implants, as solutions for male urological problems (incontinence), sexual complications (Erectile Dysfunction), and gender identity procedures (prostheses for trans men and women).
