“I feel whole again:” Wounded vet receives first penis-scrotum combo transplant

A young military veteran severely maimed by an improvised explosive device (IED) received a transplant of a large section of tissue, including the penis, scrotum, and a portion of the abdominal wall, from a deceased organ donor, according to The New York Times.

The 14-hour operation took place at Johns Hopkins Hospital last month. It marks the third successful penis transplant and the first complex penis transplant, which is to say it involved the scrotum and surrounding tissue as well as the penis. For ethical reasons, surgeons removed the testicles prior to the transplantation to prevent the possibility that the recipient could father children genetically belonging to the donor.

Though doctors expect his recovery and nerve regrowth to take some time, they’re hopeful that the patient will eventually recover the ability to urinate and have spontaneous erections and orgasms. In fact, they expect urination to be possible within a few months.

The patient, who wished to remain anonymous due to the stigma, told the Times: “I feel whole again.” The IED took both of his legs above the knee and destroyed his genitals. But it was the genital injury that hit him hardest, he said. “That injury, I felt like it banished me from a relationship. Like, that’s it, you’re done, you’re by yourself for the rest of your life. I struggled with even viewing myself as a man for a long time.”

He now has plans to go to medical school, settle down, and meet someone. “Just that normal stuff,” he said.

Prior to his operation, the experimental transplantation procedure involved only the penis. The first successful such transplant took place in 2014 in South Africa, and in 2016, a Boston man became the second penis transplant recipient—the first in the US—after he lost his penis to cancer.

But for years, a group of doctors at Johns Hopkins has been working to provide the life-changing transplant to young military veterans returning from war with devastating injuries.

“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,” Dr. W.P. Andrew Lee, the chairman of plastic and reconstructive surgery at Johns Hopkins, said in 2015.

It’s unclear how many veterans are in need of such a transplant. From 2001 to 2013, 1,367 men, nearly all under the age of 35, returned home from Iraq and Afghanistan with genital injuries, according to the Department of Defense Trauma registry. Of those, 31 percent involved injuries to the penis and 20 percent of those penile injuries were categorized as severe, according to the Times. Back in 2015, Johns Hopkins had given its doctors permission to pursue 60 transplants.

For this first transplant at Johns Hopkins, which Lee estimated to cost $300,000 to $400,000, the team of surgeons and urologists worked for free. They hope that the Department of Defense will pick up the tab for future transplants.

https://arstechnica.com/?p=1297631