A veteran
injured in a blast in Afghanistan receives the world's most extensive penis transplant and is expected to recover urinary and, eventually, sexual function.
WASHINGTON — A veteran who lost his genitals from a blast in Afghanistan has received the world’s most extensive penis transplant, and doctors said Monday he is recovering and expected to leave the hospital this week.
Johns Hopkins University surgeons, saying they wanted to address “an unspoken injury of war,” rebuilt the man’s pelvic region — transplanting a penis, scrotum and part of the abdominal wall from a deceased donor — in an experimental 14-hour operation last month.
Such transplants “can help those warriors with missing genitalia just as hand and arm transplant transformed the lives of amputees,” Dr. W.P. Andrew Lee, chairman of plastic and reconstructive surgery at Hopkins, told reporters Monday.
The patient, who asked to remain anonymous, is expected to recover urinary and, eventually, sexual function.
The scrotum transplant did not include the donor’s testicles, meaning reproduction won’t be possible. “We just felt there were too many unanswered ethical questions” with that extra step, said Hopkins’ Dr. Damon Cooney.
Three other successful penis transplants have been reported, two in South Africa and one in 2016 at Massachusetts General Hospital. Those transplants involved only the penis, not extensive surrounding tissue that made this transplant more complex.
The loss of a penis, whether from cancer, accident or war injury, is emotionally traumatic, affecting urination, sexual intimacy and the ability to conceive a child. Many patients suffer in silence because of the stigma their injuries sometimes carry.
For a functional penis transplant, surgeons must connect tiny nerves and blood vessels. Candidates face some serious risks, including rejection of the tissue and side effects from anti-rejection drugs that must be taken for life.
But penis transplants have generated intense interest among veterans from Iraq and Afghanistan, and a few years ago Hopkins surgeons began planning and rehearsing how to perform such an operation in patients with widespread tissue damage. The Department of Defense Trauma Registry has recorded 1,367 male service members who survived with genitourinary injuries from 2001 to 2013.
Hopkins is screening additional veterans to see if they are good candidates for this type of reconstructive transplant.
In a statement from Hopkins, the patient was quoted as saying: “When I first woke up, I felt finally more normal.”