The story behind world’s first total penis and scrotum transplant

By Prarthana Mitra

A wounded war veteran who’d sustained severe injuries in Afghanistan became the world’s first recipient of a total reconstructive surgery of the male genitalia.

Although similar transplants involving the penis had been attempted by doctors in Massachusetts, South Africa and China before, this surgery marks a milestone for total penile and scrotal transplants and is a historic achievement for the surgeons at Johns Hopkins University.

Here’s what happened

As a result of an IED blast in Afghanistan, the wounded soldier underwent a fourteen-hour long procedure on March 26, that entailed an allotransplantation of a deceased donor’s penis, scrotum and partial abdominal wall. To ensure blood flow and sensation, surgeons also connected three arteries, four veins and two nerves during the operation. However, the testicles were not transplanted.

A week after the complex procedure, the veteran was reported to be recovering quickly and was discharged. It will take about six months before the patient can feel sensation and experience an erection.

W.P. Andrew Lee, M.D., professor and director of plastic and reconstructive surgery at the Johns Hopkins University School of Medicine who led the team of nine plastic surgeons and two urological surgeons, was optimistic and said, “We are hopeful that this transplant will help restore near-normal urinary and sexual functions for this young man.”

In a statement released by Johns Hopkins, the patient said, “It’s a real mind-boggling injury to suffer, it is not an easy one to accept.” He was reported as brimming with a newfound confidence post-surgery.

Why you should care

The young veteran is only one of the innumerable victims who suffer from debilitating war injuries and total or partial loss of their organs in war zones across the world.

As the nature of war has changed, so has the nature of injuries suffered during the war. According to the Baltimore Sun, some soldiers who lose lower limbs from mines and improvised explosive devices also experience hidden genitourinary injuries.

In her book on post-traumatic stress,  intimacy and injury, Dr. Elspeth Cameron Ritchie, a retired Army psychiatrist talks about how one of the first questions that a soldier after regaining consciousness from a severe injury is whether their genitals are intact. Genital injuries often spawn into castration complex and disrupt a soldier’s domestic and conjugal life. “For many men, a lot of their sense of identity is also wound up in their sense of manhood,” she said.

Despite this, such injuries were stigmatized and not talked about much until recently. Doctors at Johns Hopkins took an interest in penile transplants and formed a team about five years ago to study and prepare for a penile transplantation, studying the blood flow to the penis and practising on cadavers. This medical victory will hopefully pave the way for more of such valuable research and success stories.

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