Zenflow said four US centers have now completed commercial procedures with the Spring implant. Sijo Parekattil did the first on July 29, 2026 at Avant Concierge Urology in Winter Garden, Florida. FDA approved the South San Francisco company's PMA in December 2025.

The other three: Bilal Chughtai at the Smith Institute of Urology at Northwell Health's Plainview Hospital, Mohamed Bidair at Alvarado La Mesa Urology, and Austen Slade at Dr. Slade Urology in Boise. The Spring goes in through a single-use flexible cystoscope, comes in three sizes, needs no catheter afterward and can be removed.

Seven months from approval to first commercial case is a deliberate pace, and four sites in six weeks after that is a controlled launch rather than a ramp. For a first-line BPH device that has to win office urologists, which four proctors go first will matter more than the count does.