There are varying degrees of erectile dysfunction severity, ranging from cases that respond to medication to those that do not respond to it. More than 40% of cases of erectile dysfunction do not respond to medication.

Penile implants are considered the optimal solution for cases that do not respond to medication, cases with partial response to drug treatment, or men experiencing side effects of medication who desire natural erections at any time without relying on a specific treatment.

However, previous techniques for penile implants involved the destruction of natural tissues, which affected the appearance of the penis after the procedure and reduced the natural sensation for both partners during intercourse.

Therefore, Dr. Adham Zaazaa, Professor of Andrology and fertility surgery expert at Cairo University, has been continuously engaged in scientific research to innovate and develop several techniques known as Zaazaa Advanced Implantation Techniques. These techniques aim to increase safety during the penile implantation procedure and enhance postoperative satisfaction.

Thanks to Dr. Adham Zaazaa’s new techniques, penile implantation has become safer, allowing men to return quickly to their normal lives. Some of these techniques include:

● Zaazaa Cavesonal Sparing Technique.
● Zaazaa Tumescent Stretching Measurement Technique (TSMT).
● PIIMP Charting.
● Zaazaa Pre-Set Monofilament Needle-less Air Sutures

Zaazaa Caversonal Sparing Technique

Professor Dr. Adham Zaazaa, a pioneer in prosthetic urology in Egypt and the Middle East, has developed a new technique that represents a new era in penile prosthesis implantation. It addresses one of the most significant concerns among those considering penile prosthesis implant surgery, which is the potential loss of natural erections.

Younger men are also concerned that the implant may deprive them of benefiting from future alternative treatments.

With Professor Dr. Adham Zaazaa’s technique for sparing the cavernous tissue and arteries during penile prosthesis implantation, the cavernous tissue remains intact; its function around the penile prosthesis implant is preserved.

Complications related to penile shrinkage, due to implantation, have diminished, and instead, the penile prosthesis implant improves the length and girth of the penis compared to its dimensions before implantation,

Details of Dr. Adham Zaazaa’s technique for sparing the cavernous tissue during implantation of the penile prosthesis:
Dr. Adham Zaazaa’s technique for sparing cavernous tissue during implantation of male prostheses aims to avoid most of the disadvantages of traditional techniques used in the process of implanting a penile prosthesis to treat cases of erectile dysfunction and impotence.

Dr. Adham Zaazaa’s technique preserves the cavernous tissue, the surrounding nourishing artery known as the cavernous artery, and the nerves in the penile region during implantation procedures. This technique provides several benefits that were not available with traditional implantation methods.

This unique technology relies on precise steps during implantation of the penile prosthesis to allow implantation in the center of the cavernous tissue without removing the surrounding tissue or arteries.

What is cavernous tissue, and why is it important?
Cavernous tissue is the tissue responsible for erections in men. It is called cavernous because it resembles caves filled with blood. This adequate blood filling is necessary for an erection as well as healthy surrounding nerves, arteries, and veins. The veins have to retain blood within the penis to achieve a sufficient erection. Therefore, the challenge was to implant prosthesis within cavernous tissue while preserving it.

History of attempts to spare cavernous tissue:
In 2003, the German doctor Manning developed a technique for sparing natural tissues. Then, in 2010, Spanish doctor Moncada developed his own. However, both previous techniques only preserved 50%.

Later, Professor Adham Zaazaa, a professor of male genital and fertility surgeries at Cairo University, developed a new surgical technique called “Professor Zaazaa’s Technique for Sparing Cavernous Tissue during Penile Prosthesis Implantation” He first published its details in 2018 during a united conference between the European Society for Sexual Medicine (ESSM) and International Society for Sexual Medicine (ISSM), held in Lisbon, the capital of Portugal, under the title “The World Meeting on Sexual Medicine (WMSM)”

Mastery and Excellence of Dr. Adham Zaazaa in Sparing Cavernous Tissue with Expertise in Microscopic Surgeries:
Dr. Adham Zaazaa was able to preserve natural tissues in more than 90% of cases, whether with malleable or inflatable implants. Consequently, he introduced a new surgical technique that preserves cavernous tissue during penile prosthesis implantation, ensuring natural erectile function, vitality of penile tissues, and warmth during erection, and maintaining its shape and texture.

These advantages were not previously available due to the destruction of the cavernous tissue when implanting the penile prosthesis.

Advantages of Dr. Adham Zaazaa’s Technique for Sparing Cavernous Tissue During Penile Implantation:
Cavernous Tissue Preservation: The technique developed by Dr. Adham significantly preserves the cavernous tissue around the implants to a much greater thickness compared to traditional surgeries. After the new technique of Dr. Adham for sparing the cavernous tissue, the tissue thickness around the implant exceeds 5.5 millimeters, compared to only 1.8 millimeters without the sparing technique.

The integrity of the cavernous tissue allows for the following:
1. Support of natural erection and sexual performance, not solely relying on the mechanical movement of the penile implant to achieve an erection.
2. Maintenance of natural penile tumescence, as 88% of patients feel natural tumescence upon arousal after implantation.
3. Preservation of the maximum length and girth of the penis.
4. Maintenance of the natural sensation of warmth in the penis and swelling of the glans during arousal.
5. Increased satisfaction for both the husband and wife, as this technique has achieved high levels of satisfaction with post-operative sensations.
6. It enables men, especially young men, to benefit from future treatments when they become available as it keeps the cavernous tissue’s ability to respond to any emerging treatments in the future.

Maintaining the integrity of the cavernous artery: Maintaining the integrity of the cavernous with its natural pulses allows the following:
1. Delivering medications and antibiotics around the implant; hence ensuring a complete response to medications and preventing infections and complications that may occur with traditional penile prosthesis procedures.
2. Preservation of blood circulation to penile tissues, preventing their shrinkage and reducing shortening of the penis over time.
3. Maintenance of the natural shape and texture of the penis and the vitality of its tissues.

The new surgical technique developed by Dr. Adham Zaazaa has avoided many complications associated with traditional penile implant surgeries, such as:
• Complete and irreversible destruction of cavernous tissue.
• Shortening and shrinking of the penis.
• Sole reliance on the implant for achieving an erection, resulting in the loss of any natural tumescence, that may have been present, even in cases with spontaneous penile tumescence but require implants for erectile dysfunction.
• Inability to deliver necessary post-operative medications to the penile tissues around the prosthesis, leading to a higher risk of infections and post-operative complications. This also exposes the patient to increased risks due to the lack of sparing of the cavernous tissue or the cavernous artery in traditional implantation methods.
• Coldness of the penis during erection and reduced natural sensation.
• The transformation of intimacy into a mechanical process that does not satisfy the desires of both partners.
• There is a lack of hope for benefiting from future treatments that may emerge due to the destruction of the cavernous tissue.

Dr. Adham Zaazaa’s technique for sparing cavernous tissue during penile implantation gained recognition through various avenues:

Publication in “The Journal of Sexual Medicine” in 2019:

In 2019, the most important scientific journal in andrology surgeries and sexual medicine, “The Journal of Sexual Medicine,” published a research paper by Dr. Adham Zaazaa, detailing his surgical technique for sparing cavernous tissue during penile prosthesis implantation.

European Society for Sexual Medicine Conference (ESSM) in January 2020 in Prague:

Dr. Adham Zaazaa has become one of the key participants in international scientific conferences in the field of andrology surgeries. He was highly regarded at the European Society for Sexual Medicine Conference held in January 2020 in Prague, Czech Republic. Many international experts in the field of andrology praised the advantages of his technique for sparing cavernous tissue during penile prosthesis implantation and avoiding the associated complications. Several researchers cited Dr. Adham Zaazaa’s technique in their studies.

Leadership Award in Prosthetic Urology:

In November 2021, Professor Dr. Adham Zaazaa received the International Leadership Award in Penile Prosthetic Urology. He was personally honored by Professor Steve Wilson, the world’s leading expert in penile implant surgeries, who presented him with the award in recognition of his outstanding contributions to the field of sexual medicine and prosthetic urology.

This honor took place during the International Conference of the Urology Society in its forty-first session in Dubai, where Coloplast, the global company in penile prosthesis implants, gathered the experts in the field and honored Egyptian surgeon Adham Zaazaa, Professor of Andrology at Cairo University, with the Leadership Award in Prosthetic Urology for achieving the highest success rates in penile prosthesis implant surgeries in Egypt, Africa, and the Middle East.

Techniques of Dr. Adham Zaazaa in the latest 2022 reference for penile prosthesis surgeons in the world:

One year after he was honored as one of the best surgeons for penile prosthesis, Dr. Adham Zaazaa’s techniques for sparing cavernous tissue, maintaining blood flow, and increasing the size of the penis. His techniques were adopted as among the most important new techniques in penile prosthetic implantation by a group of the best prosthetic implantation experts in the world and is included in the latest edition of the “Penile Implant Surgery 2022 Edition” book, which is currently the most important and most up-to-date reference for men’s prosthetic surgeons worldwide.

Dr. Adham Zaazaa’s technique for sparing cavernous tissue during penile prosthesis implantation is considered a major scientific achievement, as penile prosthesis implantation surgery has become a safer surgery for the patient, and sexual satisfaction rates have increased for both partners, which has been praised by many urological surgical scientists worldwide.

Zaazaa TSMT “Tumescent Stretching Measurement Technique” and PIIMP Charting:
In March 2023, Professor Dr. Adham Zaazaa presented his latest surgical techniques that measure the ideal depth, length, and girth of the penis during penile implant surgeries at the European Society for Sexual Medicine Conference in Rotterdam, the Netherlands. This technique offers a new and highly accurate method for taking measurements during the procedure.

This technology provides a new way to take measurements within the process with extreme accuracy and in a much better way than before.

It is possible to achieve optimal measurements and dimensions applicable to both malleable and inflatable implants by combining this technique with the cavernous tissue-sparing technique.

Zaazaa Pre-Set Monofilament Needle-less Air Sutures:
The Pre-Set Monofilament Needle-less Air Sutures technique resists bacteria and ensures complete safety during implanting penile prosthesis. It prevents scratching the external wall of the prosthesis, providing maximum sterilization and safety.

When using traditional sutures, some surgeons may scratch or puncture the outside layer of the implant, allowing bacteria, blood, or fluids to infiltrate the penile implant.

The efficiency and skill of Dr. Adham Zaazaa and his medical team contribute to the exceptional success rates in erectile prosthesis implantation surgeries by Dr. Adham Zaazaa along with applying these innovative techniques. This achievement led him to receive the Leadership Award in Penile Implant Surgeries, becoming one of the most distinguished surgeons in penile implant surgeries worldwide.