Penile prosthesis implantation is essential for sexual functionality after phalloplasty. However, standard prostheses often fail to meet the unique demands of these surgically constructed phalluses, leading to high complication rates [1]. This abstract presents the surgical replacement of a malleable penile prosthesis with the Zephyr ZSI 100 FTM, a device specifically designed for transgender men after phalloplasty, adapted for use in a patient with micropenis.

This video presentation details the surgical case of a 37-year-old male with micropenis undergoing the replacement of a failed malleable penile prosthesis with a Zephyr ZSI 100 FTM implant. The operation included comprehensive preoperative planning with Doppler ultrasound to confirm vascular integrity and detailed intraoperative techniques to accommodate the patient’s unique anatomical challenges.

Postoperative outcomes demonstrated improved structural stability and functional results. There was a significant enhancement in rigidity and patient satisfaction, devoid of the typical complications associated with standard implants in similar complex cases

The use of the Zephyr ZSI 100 FTM implant in a non-transgender patient with micropenis showed promising results, suggesting that devices designed for transgender individuals after phalloplasty might offer viable solutions for other patients with similar anatomical challenges. [2]

Cohen AJ, Bhanvadia RR, Pariser JJ, et al. Novel technique for proximal bone anchoring of penile prosthesis after radial forearm free flap neophallus. Urology. 2017;105:2-5.
Pigot GLS, Sigurjónsson H, Massie JP, et al. Surgical experience and outcomes of implantation of the ZSI 100 FtM malleable penile implant in transgender men after phalloplasty. J Sex Med. 2020;17(1):152-158