Surgeons at Johns Hopkins University in Baltimore are gearing up to perform the first ever penis transplant in the United States. The focus of the operation is on helping wounded veterans, with a young soldier who was injured in a bombing in Afghanistan stepping up as the first patient.
Only two other penis transplants have ever been recorded in medical journals: a failed 2006 procedure in China, and a successful one in South Africa last year. News of this upcoming surgery – which could be taking place in a few months to a year’s time – might be hard to take seriously at first glance, but it highlights an incredibly life-changing and equally embarrassing injury that hits soldiers every year.
“These genitourinary injuries are not things we hear about or read about very often,” says Dr. W. P. Andrew Lee, chairman of plastic and reconstructive surgery at Johns Hopkins. “I think one would agree it is as devastating as anything that our wounded warriors suffer, for a young man to come home in his early 20s with the pelvic area completely destroyed.”
In South Africa, the procedure is being developed for the purpose of fixing the genitals of men that were injured during ritual circumcisions, a common practice in the Xhosa tribe, but the need for this kind of operation is just as important in America. The Department of Defense Trauma Registry reports that 1,367 military servicemen sustained injuries to their genitals between 2011 and 2013 in Iraq and Afghanistan.
In the past, men with these wounds have had to rely on prosthetics or reconstructions that use skin from other body parts, but they didn’t restore natural function like a complete organ transferred from a deceased donor would.
The team has been given permission to perform a total of 60 transplants, with each instance being monitored to determine whether to make the procedure a standard treatment. However, the operation is no small feat, with doctors from Johns Hopkins estimating each one to be a 12-hour surgical endeavor.
The risks involved include bleeding, infection, and even the possibility that the medicine needed to prevent transplant rejection will increase the chances of cancer. The amount of urinary and sexual functions that need to be ‘just right’ can lead to debilitating psychological implications, and even if everything is working physically the trauma of having a foreign object where your genitalia used to be can be too much to handle.
In fact, that was effectively what happened to the Chinese patient who could have been the first successful case in 2006. Only 10 days after undergoing a physically successful surgery, the patient returned to ask doctors to remove his new organ.
The idea of a penis transplant has already been met with judgement by doctors and civilians alike. The most common piece of criticism being the fact that it’s not needed to save the patient’s life, like most other transplants are. However director of paediatric plastic and reconstructive surgery at Johns Hopkins, Dr. Richard J. Redett, assured critics, “If you meet these people, you see how important it is.”
“To be missing the penis and parts of the scrotum is devastating. That part of the body is so strongly associated with your sense of self and identity as a male. These guys have given everything they have.”
There are a lot of ways that this can go wrong, and the idea of waking up with a stranger’s genitals is still an unexplored concern for medical professionals.
“Our young male patients would rather lose both legs and an arm than have a urogenital injury,” Scott E. Skiles, the polytrauma social work supervisor at the Veterans Affairs Palo Alto Health Care System, told the New York Times.
However, it’s been very important to the doctors involved with this undertaking that the patients go in with realistic expectations. In the one case that this unconventional surgery has worked, the results were amazing. South African surgeons reported in June that their patient had impregnated his girlfriend only six months after the transplant.