Background
Penile prosthesis transforms an otherwise aesthetic organ into a functional sexual organ for a transgender man. Traditional erectile devices have been manufactured in accordance with the anatomy of the native penis. While this had favourable outcomes for the biological male with erectile dysfunction, it has been complicated by host of morbidities including protrusion, infection and malfunctioning, ultimately leading to high explantation rate post phalloplasty. ZSI 475 FTM is the first erectile device designed exclusively for the neophallus. It is still relatively unused in Australasia, though used in several large centres across Europe since 2016.
Method
This presentation will demonstrate the first use of this device in a transgender FTM patient in Oceania. A 21 patient underwent gender reassignment surgery with innervated radial artery forearm free flap to create neophallus in December 2021. With good healing and preserved clitoral (glans) sensation, he underwent implantation of ZSI 475 implant in May 2023. The inflatable penile implant was placed in the neophallus posterior to the urethra, the spherical testicle-shaped manual pump being implanted into the left hemiscrotum to create neo-testicle and the saline filled reservoir in the pelvis through groin crease incision.
Conclusion
ZSI 475 inflatable erectile device differs from previously used penile implants in being manufactured specifically for phalloplasty. Based on current literature, short-term cylinder protrusion, malpositioning, urinary retention and mechanical failure rates are low compared to traditional penile prostheses, though in some cases device infection remains a problem. This presentation explores the worldwide literature of its surgical outcomes and patient satisfaction to date and presents the first case with this device in our continent.