US Soldier Gets First Total Penis and Scrotum Transplant

Breakthrough procedure treated a common and often ignored war wound.

When soldiers injured in battle wake from surgery, their first question is often about their sexual organs. Genitourinary injuries have been called the “hidden wounds” of war, seldom spoken about, yet bringing on devastating physical and psychological trauma.

However, advances in organ transplantation are giving wounded warriors new hope. This week, the pioneering medical staff at John Hopkins University in Baltimore, Maryland, announced the world’s first total penis and scrotum transplant.

The patient, a US soldier maimed by an improvised explosive device in Afghanistan, received the penis, scrotum, and partial abdominal wall from a deceased donor.

Although the first person on the planet to receive this full surgery, the soldier’s injury is far from uncommon.

According to a study based on the Department of Defense Trauma Registry, 1,376 male US service members suffered genital injuries in Afghanistan and Iraq between October 2001 and August 2013. Most such injuries involve the external genitals and are due to explosions from bomb blasts.

A new marvel of modern medicine

Although groundbreaking, the total transplant at John Hopkins isn’t the first successful penis transplant surgery. In 2014, surgeons in South Africa transplanted a penis on to a man injured during a traditional circumcision ceremony, and repeated the same feat again in 2017, also to treat a botched circumcision.

Meanwhile, in 2016, doctors at Massachusetts General Hospital in Boston mirrored their success. But the recent operation at John Hopkins is by far the most complex penis transplant performed to date.

In a grueling 14-hour operation, a team of two urological surgeons and nine plastic surgeons performed the transplant, meticulously connecting nerves, veins, and arteries between the donor tissue and patient. To practice for such a challenging procedure, the surgeons first rehearsed on cadavers.

Strange new world

The idea of having another man’s genitals might seem strange at first. Would a transplanted penis ever seem like it was really “yours”?

In fact, it’s been an issue for at least one patient. In an attempted penis transplant in China in 2006, the recipient decided to have the organ removed due to psychological distress.

On the other hand, the first patient in South Africa has since fathered a child. The second is a black man who received a white penis, but two years later, was reportedly doing “extremely well, both physically and mentally.”

D,. Brandacher, one of the surgeons who performed the transplant at John Hopkins, is optimistic. In hand transplants, he says, patients immediately refer to the graft as “my” hand. Theoretically, many patients will hopefully experience a new penis the same way.

Hope for the future

The success of the procedure at John Hopkins opens new possibilities in the world of organ transplants.

In this particular case, the donor’s testicles weren’t transplanted, due to ethical considerations. Instead, the patient will receive testicle prostheses. Although he won’t be able to father children, he should regain sensation, as well as both urinary and sexual function, Heis expected to fully recover in six months to a year.

The patient also reported feeling happy with the results: “When I first woke up,” he said, “I felt finally more normal . . . [with] a level of confidence as well. Confidence . . . like finally I’m okay now.”

Image sources: John Hopkins

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