A team of doctors at Johns Hopkins University released a statement on Monday that they had successfully completed the world’s first total scrotum and penis transplant on a US military professional who was wounded in Afghanistan.
The penis transplant also replaced the scrotum, and took place on March 26 in a grueling 14-hour operation carried out by nine plastic surgeons and two urological surgeons. In a statement to reports on a conference call, Andrew Lee, professor and director of plastic and reconstructive surgery at the Johns Hopkins University School of Medicine, stated that “We are optimistic that he will regain near-normal urinary and sexual functions following a full recovery.”
When the patient was serving in Afghanistan, he was severely injured from a blast from an improvised explosive device in Afghanistan. The entire penis, scrotum, and partial abdominal wall all came from a deceased donor and may serve to drastically improve the quality of life of this injured serviceman.
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“It’s a real mind-boggling injury to suffer; it is not an easy one to accept…When I first woke up, I finally felt more normal,” said the serviceman, who asked reporters that he remain anonymous.
Around a month later, the recipient of the world’s first penis transplant is already up and walking around – expected to be discharged from the hospital later this week. According to doctors, the man lost his testicle in the explosion but they would not be restored as part of the penis transplant.
“The testicles were not transplanted because we had made a decision early in the program to not transplant germline tissue, that is to say not transplant tissue that generates sperm because this would raise a number of ethical questions,” said JHU plastic surgeon Damon Cooney. “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.”
This penis transplant surgery – formally known as vascularized composite allotransplantation, involves transplanting skin, muscles and tendons, nerves, bone, and blood vessels. It is a very complicated surgery – as evidenced by the 14-hour-long process with nearly a dozen doctors on staff. While it’s possible to create a penis of sorts using tissue from other parts of the bodies, only a penis transplant will restore near-complete function to a man – allowing him to achieve an erection due to the unique tissue construction. By opting to go with a reconstructive penis transplant rather than just using tissue from elsewhere on the body, the Johns Hopkins team may have significantly improved the life and functioning of this wounded veteran.
While the serviceman did retain his prostate gland in the blast, the fact that he lost his testicles precludes him from ejaculating. It won’t be known for about six months just how much sexual function will have been restored.
The Johns Hopkins team is no stranger to groundbreaking plastic and reconstructive surgery, however, with the first full scrotum and penis transplant just being the latest breakthrough in a collection of world firsts. The team became the first team to perform a double arm transplant, restoring function to soldier Brendan Marrocco, who lost both of his arms as well as his legs in the Iraq war when an armored vehicle he was driving ran over a bomb back in 2009. This reconstruction was also quite significant, as he was being the first soldier of the Iraq and Afghanistan wars to lose all four of his limbs in combat and survive.
While this is the first successful full scrotum and penis transplant in the world, the first actually took place back in 2006 for a man in China – but it was later removed due to “a severe psychological problem of the recipient and his wife.”
To this day, only four penis transplants have ever been done successfully – including the one that was announced on Monday. The first two penis transplants were carried out in South Africa, while the United States had a successful transplant in 2016.
It remains to be seen just how successful this penis transplant will be moving forward, but even if the serviceman is not to regain full sexual function, it will still be a massive improvement over being left without genitalia entirely. If this operation proves to be a success, it may finally become an option for those left without a penis in the future.