Doctors in America have completed the world’s first successful total penis and scrotum transplant.
Surgeons at John Hopkins University in Maryland took 14 hours to complete the operation on a military serviceman who was wounded in Afghanistan.
A total of nine plastic surgeons and two urologic surgeons took part in the procedure, which saw an entire penis, scrotum (minus tecticles) and abdominal wall transplanted from a deceased donor onto the patient.
“We are hopeful that this transplant will help restore near-normal urinary and sexual functions for this young man,” WP Andrew Lee, professor and director of plastic and reconstructive surgery at the Johns Hopkins University School of Medicine, said.
The unnamed recipient was injured by a blast from an improvised explosive several years ago, and issued a statement in the wake of the surgery.
“It’s a real mind-boggling injury to suffer, it is not an easy one to accept,” he said. “When I first woke up, I felt finally more normal … [with] a level of confidence as well … like finally I’m okay now.”
The man, who wishes to remain anonymous, also lost his testicles in the explosion but did not have them restored as part of the surgery.
“The testicles were not transplanted because we had made a decision early in the programme to not transplant germline tissue … tissue that generates sperm, because this would raise a number of ethical questions,” plastic surgeon Damon Cooney said.
“In particular, the ability of the recipient of the transplant to have children would result in genetic material being transmitted from the donor of the transplanted tissue to the recipient’s offspring.”
Though he will be able to pass urine, it’s unclear whether sexual function will be an option.
The patient retained his prostate gland in the blast but, as he lost his testicles, he will not be able to ejaculate. The extent of his sexual function will not be known for about six months, doctors said.
While it is possible to reconstruct a penis using tissue from other parts of the body a prosthesis implant would be necessary to achieve an erection, and that comes with a much higher rate of infection.
Just four penis transplants have been successfully completed. Two were done in South Africa back in 2014, while the first occurred in the US in 2016.
The first man to undergo a penis transplant was in China, but in that instance, it was ultimately removed due “a severe psychological problem of the recipient and his wife”.