WASHINGTON — Doctors at Johns Hopkins University (JHU) on Monday announced that they had performed the world’s first total penis and scrotum transplant on a US war veteran who was wounded in Afghanistan.
The 14-hour operation, which took place on March 26, was performed by a team of nine plastic surgeons and two urologic surgeons.
“We are optimistic that he will regain near normal urinary and sexual functions following a full recovery,” W.P. Andrew Lee, professor and director of plastic and reconstructive surgery at the JHU School of Medicine, told reporters on a conference call.
The soldier was severely injured by a blast from an improvised explosive device in Afghanistan several years ago, Lee said.
‘Mind-boggling’
The entire penis, scrotum without testicles and partial abdominal wall came from a deceased donor.
“It’s a real mind-boggling injury to suffer; it is not an easy one to accept,” said a statement from the recipient, who asked to remain anonymous.
“When I first woke up, I felt finally more normal,” said the soldier, who is now up and walking around.
He is expected to be released from hospital this week.
The man lost his testicles in the explosion and did not get them restored as part of his transplant.
Ethical questions
“The testicles were not transplanted because we had made a decision early in the program to not transplant germ line 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,” Cooney added.
“And we just felt there were too many unanswered ethical questions with that.”
No ejaculation
Doctors said they were hopeful the soldier would be able to urinate with his penis in the coming weeks, and that he would eventually regain enough sensation to achieve an erection.
The patient retained his prostate gland in the blast. But because he lost his testicles, he would not be able to ejaculate.
The extent of his sexual function will not be known for about six months, doctors said.
Other penis transplants
The first penis transplant in the world took place in China in 2006, but it was later removed due to “a severe psychological problem of the recipient and his wife,” doctors said.
Only four penis transplants have been done successfully, including the one announced on Monday, doctors said.
Two of these transplants have been done in South Africa, the nation that achieved the first such successful surgery in 2015. The United States performed its first successful penis transplant in 2016.