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Scientists Explore Possibility of Penis Transplants in the United States

Jan 05, 2016

Penis transplants may eventually become an option for American men who have had severe injuries to their genitals.

In an investigational program, scientists at Johns Hopkins University School of Medicine are preparing for the first penis transplants in the United States. Overall, the university has approved 60 transplants for this trial.

The first patients will be soldiers who have lost part or all of their genitals in combat.

In an interview with The New York Times, Dr. Richard Redett, the director of pediatric plastic and reconstructive surgery at Johns Hopkins, compared losing a penis to losing masculine identity.

“To be missing the penis and parts of the scrotum is devastating,” he said. “These guys have given everything they have.”ontinued...

So far, only two penis transplants have been conducted in the world. Only one was successful.

The first occurred in China in 2006. The operation was successful on a physical level. After ten days, the new penis had a healthy blood supply and the recipient could urinate on his own. However, the new penis was soon removed because the man and his wife had trouble with it psychologically.

The second transplant took place just over a year ago in South Africa. The 21-year-old patient had had his penis amputated after he developed complications from a botched circumcision. (In the Xhosa culture, it is customary for males to be circumcised as teenagers or young adults.)

That transplant was a success and in 2015, the man impregnated his girlfriend.

Psychological readiness is important. Men in the Johns Hopkins program will receive psychiatric evaluations. Patients and partners will be counseled on what to expect, as there are no guarantees that urinary and sexual function will be completely restored.

The operation is intricate. Surgeons must connect tiny blood vessels and nerves under a microscope. Nerves should eventually grow at a rate of one inch per month. Experts believe it will take six to twelve months to regain urinary and sexual function. If men still have their testes, they may be able to father children eventually.

There is a risk that a patient’s body will reject the new penis. With that in mind, men will receive a bone marrow infusion from the donor and take anti-rejection drugs for the rest of their lives.

Finding donors for such a delicate surgery could be a challenge. Transplant penises will come from deceased men with family permission. Surgeons will consider blood type, age, and skin tone when making matches.

“Unlike with donation of the heart, kidneys, liver, or lungs, a request for donation of the hands, arms, face, or penis is made separately. The family has to specifically consent to such a donation.” Dr. Redett explained in an interview with Johns Hopkins.

The first transplant could take place in a few months. After monitoring the results, the university will decide whether penis transplant will become a standard treatment at Johns Hopkins.


Resources

CNN

Pearson, Michael and Debra Goldschmidt

“First penis transplant patient's girlfriend is pregnant, doctor says”

(June 12, 2015)

http://www.cnn.com/2015/06/12/health/penis-transplant-south-africa-pregnancy/

The Guardian

Sample, Ian

“Man rejects first penis transplant”

(September 17, 2006)

http://www.theguardian.com/science/2006/sep/18/medicineandhealth.china

International Society for Sexual Medicine

“South African Surgeons Perform World’s First Penile Transplant”

http://www.issm.info/news/sex-health-headlines/south-african-surgeons-perform-worlds-first-penile-transplant/

Johns Hopkins Medicine

“Q & A: Penile Transplantation”

http://www.hopkinsmedicine.org/transplant/news_events/penis_transplant_qa.html

The New York Times

Grady, Denise

“Penis Transplants Being Planned to Help Wounded Troops”

(December 6, 2015)

http://www.nytimes.com/2015/12/07/health/penis-transplants-being-planned-to-heal-troops-hidden-wounds.html?_r=1

The Washington Post

Feltman, Rachel

(December 8, 2015)

https://www.washingtonpost.com/news/speaking-of-science/wp/2015/12/07/the-first-penis-transplants-in-the-u-s-will-soon-help-heal-wounded-veterans/