Evan, age 35, lives in Montpellier, France, and it has been 2 years (January 2016) that he has lived with his ZSI 475 FTM prosthesis. At the conference “Les Trans, parlons-en” (trans, let’s talk about it), organized by the organization Fierté Montpellier-Tignes Pride, Evan told us about his experience with his phalloplasty and the prosthesis implantation by Dr. Morel-Journel (Lyon, France).
“I began the formalities and procedures for the antebrachial phalloplasty three years ago. It’s what I wanted since I began my transition, although in reality I was not very aware of the different types of prostheses available then. I’d heard about a number of operations, but I didn’t think there would be so many. I’ve had six so far. I had an unexpected operation because they had to reposition my scrotum. I had several postoperative complications, but they weren’t related to the prosthesis, which worked without a single problem. On the other hand, I’m now experiencing a significant urinary problem. They’re going to operate on me in January to resolve that.
“As to the choice of a prosthesis, I preferred the hydraulic device, which seemed more natural to me. Dr. Morel-Journel showed me two ZSI FTM models, pointing out that the malleable model would be a little more prominent and uncomfortable in day-to-day situations, as when sitting for example. I didn’t want the device to be too noticeable, so I confirmed my choice of the ZSI 475 FTM.
“Almost two years passed between the phalloplasty and the placement of the prosthesis. I was the second patient in Lyon, France, to be implanted with a ZSI FTM prosthesis. The first had postoperative problems, which was a little worrisome. But someone had to show the way, right? Fortunately everything went well. During my operation with epidural anesthesia, I could hear everything, but nothing was disturbing. It lasted less than two hours, and I was able to go home the next day. They implanted the penile and scrotal prostheses at the same time. I had pain for approximately a month and a half when standing, in the scrotum region. I had a gloomy feeling, as if something were pulling me down.
“To place the prosthesis, they had to undo my glanuloplasty so that now I’m trying to find ways to give the glans a natural appearance, probably via skin pigmentation with the Bordeaux team. Unfortunately, because that’s considered an aesthetic surgery, insurance doesn’t cover it.
“I waited a month for the activation and all went well. They taught me how to inflate and deflate the device, and I rapidly accustomed myself to it. You can hear a little noise from the pump, during inflation only. Nothing really disagreeable. You have to get used to deflating, because the pump can turn in the scrotum. I find it easier to deflate while I’m standing, but perhaps this depends on each person’s anatomy. It seems to be the prosthesis was set with screws. It’s length is perfectly adapted to my phalloplasty, although in my opinion it’s a little narrow … It’s the same as with biological men! But this is what I’ve got, and I’m not going to beat myself up over a matter of size! I know it’s a topic discussed a lot on the internet forums—size and especially width. This surely depends on the techniques of the surgeon doing the phalloplasty, the donor area, etc.
“I’m very happy with the result and with the prosthesis itself. My girlfriend too! It’s always me who inflates the prosthesis. Perhaps out of fear about my urinary problem … I’m not very comfortable with the leaks, although they don’t occur in intimate moments. Having a prosthesis has changed my self-image in daily life. I always wanted a phalloplasty and not a metoidioplasty, which would not have given me the sensation of being “complete.” It didn’t have to do with sexuality but rather with the image I have of myself. Now, aside from this aesthetic problem with the glans, which is hopefully reparable, I am satisfied.
“It’s important to learn about the surgeons one wants to work with. Dr. Morel-Journel and his team fulfilled my expectations in the best way possible in terms of the surgery. These days the average waiting period for the operation is three years. In my case I was very lucky, it was only eight months. Each surgeon has his or her own techniques for phalloplasty, incision, attachment, etc. We’re all very demanding and particular, but we have to remember that whatever happens, we’ll never have exactly what a biological man has. And each organism reacts differently to the operations. We’re all unique in the transition.
“Compared to other countries, we’re lucky in France because we can receive assistance for all kinds of operations. There are not many options at the moment, but there are good surgeons. Sometimes the wait times are so long that some people travel abroad, although this adds costs at the patient’s own expense. It presents other problems as well, like language, the proximity of the surgeon, postoperative follow-up. Many people who’ve gone abroad return to France to get corrections or even the prosthesis itself.
“In general it’s very satisfying. My life and the image I have of myself have improved. I feel more legitimate today. For me the prosthesis was part of the normal sequence. It was not my intention to have a penis without a prosthesis. Some are happy to use sleeves for the phalloplasty, but for me the prosthesis was essential.
In the forums we talk a lot about ZSI. We exchange information about prostheses and doctors. I hope that soon there will be more operations, with shorter wait times.”
ZSI is the only European manufacturer of artificial urinary sphincters and of malleable and hydraulic penile implants, as solutions for male urological problems (incontinence), sexual complications (Erectile Dysfunction), and gender identity procedures (prostheses for trans men and women).