Nadia Angelova
Oct 29, 2025
I have never been treated better in any other institution. Highest level of professionalism, combined with innovation and empathy for the patient. Thank you Dr. Valtuena and team!
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Spain, Madrid
Bottom surgery in Hospital Ruber Internacional
2 accreditations & 1 licence
hospital certificates of quality
About the clinic
FTM phalloplasty is a gender-affirming bottom surgery available at Hospital Ruber Internacional in Madrid, Spain. The procedure may cost around 30,000 EUR and is performed by Dr. César Casado, a plastic surgeon specializing in complex genital reconstruction. The hospital is JCI-accredited and part of Quirónsalud, Europe's largest hospital group.
About the Procedure
FTM phalloplasty creates male genitalia using tissue grafts. Dr. Casado offers two surgical approaches: radial forearm flap or anterolateral thigh flap. The method depends on individual anatomy and patient preferences. Urethral lengthening and penile prosthesis can be included if needed.
Treatment Process
The surgery follows WPATH standards for gender-affirming care. Patients need psychiatric evaluation and hormone therapy verification beforehand. The process includes:
- Personalized surgical plan
- Choice of flap type
- Optional urethral lengthening
- Optional penile prosthesis
Doctor's Expertise
Dr. Casado has 8 years of experience in plastic and reconstructive surgery. He specializes in microsurgery and gender-affirmation procedures. His expertise includes complex genital reconstruction cases.
Patient Support
The hospital provides full international patient assistance. This includes visa invitation letters and travel guidance. Continuous communication is maintained throughout the treatment process.
Contact the clinic for a personalized consultation and detailed cost breakdown based on your specific needs.
Highlights
1942
Year of foundation
800 doctors
25000 patients per year
Get a free consultation
Hospital Ruber Internacional
Individual treatment program and cost estimate
Average answering time – 5 minutes
Accepted payment methods
No payment is needed now. You will be charged directly at the clinic when you arrive.
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Treatments prices in the clinic
Last price update — 29.03.2025. Prices can be changed depending on the medical case and doctor's recommendations.
Plastic Surgery
| treatment | Price | |
|---|---|---|
| Bottom surgery | Price on request | |
| Reconstructive surgery | Price on request | |
| Breast reconstruction surgery | Price on request | |
| Penis enlargement | Price on request | |
| Male to female (MTF) surgery | Price on request | |
| Phalloplasty | Price on request | |
| Cleft Lip or Palate Repair | Price on request | |
| Sex reassignment surgery | Price on request | |
| Penile implant surgery | Price on request | |
| Vaginoplasty | Price on request |
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Licences
hospital accreditations of quality
Joint Commission International
US,
Joint Commission International certificate for Hospital Ruber Internacional
International Organization for Standardization
CH,
International Organization for Standardization certificate for Hospital Ruber Internacional
Hospital Ruber Internacional: more details about the clinic
Spain, Madrid
Additional services
Transfer
Airport to clinic
$100 -
$200
Clinic to airport
$100 -
$200
Language assistance
Available
free
Accommodation
Hotel (apartments) near the clinic, billed daily
Requirements for admission
Payment methods
Cash
Credit cards
Age
0 -
100
Patient reviews
5 Google
reviews
Ayali A
May 21, 2025
I would advise people to avoid the gynecology service. I went there for a hysteroscopy and got myself an infection because the procedure was done in a non-sterile way. The doctor did not use a speculum to open the area to visualize, clean the inside with iodine/chlorhexidine and advance the hysteroscope by avoiding picking up bacteria from the vaginal canal. By the time I realized what had happened, it was too late.
This kind of hysteroscopy is not uncommon but it was contraindicated in my case according to all guidelines because I had a history of uterine infection from prior uterine instrumentation and should have either been offered the sterile procedure or told about the details so I could opt out and I would have 100% not agreed if I knew. I specifically asked the doctor about the sterilization of the instruments and told him that I had such severe consequences from antibiotics previously from another procedure that I had barely recovered after months
(after losing 20% of my body weight in a matter of months) Instead of being informed of the risks given my history or choosing the safer version of the procedure, I was just prescribed more antibiotics at the end of the procedure.
And here I am 1 week later with an acute endometritis.
I needed to have the hysteroscopy because I was planning to have an embryo transfer for IVF to check the health of my uterus not because of some emergency and could have easily been given other options.
But it didn't even occur to me that someone could put my health at risk. I paid close to 500 euro and possibly weeks of antibiotics and months of gastrointestinal issues. I guess my money was more important so they chose to put me at significant risk instead of telling me that the way they do hysteroscopy is not appropriate for my medical history. Or taking 5 more minutes to clean the area before inserting the hysteroscope.
I chose Ruber because I had had a surgical hysteroscopy with them many years ago and was satisfied. They have a good reputation. I wish they invested their money into patient care instead of PR. The quality of patient care has significantly declined.
The sad thing is that I had really liked my doctor and the nurse at the appointment, I just wish they had cared for my health more. I am so utterly disappointed.
I would recommend to avoid this service. Your doctor may have great bedside manner but at the same time put your health at risk.
Idalia
Nov 18, 2024
I cannot express enough gratitude for Dr. Alvaro Martinez and his team. While traveling, I experienced a medical emergency due to a severe hemorrhage. After only trusting to leave Morocco for Europe, I ended up in Spain because it was the only flight I could get. From the moment I arrived, Dr. Martinez took exceptional care of me.
He acted quickly to admit me, provided a thorough explanation of my condition, and made me feel safe and reassured during a terrifying time. When he saw the initial treatment wasn’t working, he promptly decided surgery was necessary, and his expertise and quick action made all the difference.
I am so grateful for his professionalism, empathy, and dedication to my recovery. I highly recommend Dr. Martinez to anyone in need of exceptional medical care.
T. Lozovschi
Mar 24, 2025
The reception guy attitude unacceptable. We waited with kid who had a bleeding wound for more than 1 hour while there was no one except us He used the fact that we didn’t speak Spanish and deliberately didn’t want to talk to our insurance to get an authorization pressing the matter so we would pay for the service. He just kept asking them to get someone speaking English, despite me endless times asking him to ask just for what we need as we have emergency. ( I understand Spanish just can’t speak). So at the end as I was very stressed I paid so my kid would get necessary care , they even charged bigger amount and send invoice for less. The doctors and nurses were fast and professional. But the experience at this hospital emergency at night was awful, I wouldn’t wish anyone to go through such experience with their kid. Never Ruber Again!
Maya SONKALA
Dec 4, 2024
I had extremely bad experience. I have Adelesa comprehensive insurance, however, they are going giving doctors appointment. They are charging 250 euro for consultation so what is the use of buying insurance? Not recommended
40, 416114,-3.714781, Centro, 28013 Madrid, Испания
updated 2/5/2026
Get a free consultation
Hospital Ruber Internacional
Individual treatment program and cost estimate
Average answering time – 5 minutes
How it works:
- We find a medical coordinator familiar with the matter
- You get a personal offer with a step-by-step guide and the cost estimate
- We arrange your travel including appointment scheduling and flights booking
- You arrive at the hospital, we support you 24/7