A soldier wounded by an improvised explosive device in Afghanistan has received the world’s first complete penis and scrotum transplant, officials at Johns Hopkins Hospital in Baltimore said on Monday.
A team of nine plastic surgeons and two urological surgeons operated on the veteran, whose identity was not disclosed, for 14 hours on March 26.
The team transplanted an entire penis, a scrotum without testicles and a partial abdominal wall from a deceased donor. The wounded man, who requested anonymity, has recovered from the surgery and is expected to gain full function of his transplanted penis. He’s expected to be discharged from the hospital this week.
“Functional recovery however, can take time, both in terms of urinary function and sexual function. Nerves grow at a very deliberate speed, so it could be many months before some of those functions could return,” Dr. W.P. Andrew Lee, the head of plastic and reconstructive surgery at Johns Hopkins Medicine said.
But since the man’s testicles did not survive the IED blast, the penis transplant did not involve the donor’s testes, where sperm are produced. If doctors went ahead with a testicle transplant in this patient, it would raise all sorts of legal and ethical issues because the potential child could be from the donor’s genetic offspring, and may not be from the recipient’s.
A transplant in which a body part or tissue is transferred from one individual to another is called vascularized composite allotransplantation. The surgery involves transplanting skin, muscles and tendons, nerves, bone and blood vessels.
Lee said the procedure was particularly important due to the heavy psychological toll the loss of genitals takes on a patient.
“A lot of the injured veterans tell us that when they don’t have a portion of their external genitalia or lost all of it, they don’t feel whole,” Lee said. “So this is something that not only makes them feel whole physically and psychologically, we think it helps to restore a sense of identity, their manhood, their self-confidence. And I think that becomes apparent as we talk to this patient as well as other candidates.”
The same Johns Hopkins surgical team had performed the first U.S. double-arm transplant of two arms on a wounded service member in December.
There have been four previous penis transplants performed in the world, but this is the first time doctors have successfully performed the first total penis and scrotum transplant in the world. The first was in China in 2006 and was unsuccessful. The second was performed in South Africa in 2014 on a young man who had his penis amputated after a botched circumcision ritual. That operation was deemed a success with the recipient able to impregnate his partner shortly after the surgery. The third was a 64-year-old man in the U.S. who underwent a successful penis transplant in a procedure at Massachusetts General Hospital in 2016. And the fourth penis transplant was in South Africa in 2017 on a 40-year-old man who had lost his penis to a botched circumcision ritual.