Doctors in the United States have performed the World’s first full penis and scrotum transplant, on a soldier who was wounded while fighting in a war in Afghanistan.
The surgery went on for 14 hours and surgeons connected tiny nerves, blood vessels, skin, muscles, and tendons to rebuild both, the man’s penis and its extensive surrounding tissue.
While a handful of successful penis transplants have been reported in recent years, this was the first to reconstruct the scrotum as well — making it far more complex and expensive than the previous procedures.
The recipient, who wishes to remain anonymous, said, “he felt finally more normal,” on waking up after the surgery.
The extent of injuries of the patient was such that – he had lost his penis, scrotum, and much of his abdominal wall – it meant taking an exact replica of what was missing which was the most sensible option for the surgeons.
“We’ve really replaced like with like,” surgeon Dr Richard Redett said. “We looked at the defect our patient had and procured the exact same graft from our donor.”
The full transplant is radically different to current the procedures – often used in transgender surgery or is used to treat congenital abnormalities – that use a patient’s own skin to construct a penis.
Such operations require patients to use an implant to achieve an erection, which brings a higher risk of infection than the highly experimental full transplant.
But while they avoid such problems, transplants present new ethical problems in penis surgery.
The families of deceased donors need to give explicit permission for a penis – as parts of the face or hands – to be given for transplant, for example.
It was also decided in this operation that a scrotum transplant should not extend to the donor’s testicles, which would bring the possibility of having children. “We just felt there were too many unanswered ethical questions,” said surgeon Damon Cooney.
The surgeons at John Hopkins described lost penises as “an unspoken injury of war”, suffered in silence by patients who face stigma as well as a loss of sexual intimacy and urinary function.