A successful total penis and scrotum transplant, the first of its kind in the world, was performed by a Johns Hopkins' reconstructive surgery team. The team that performed the first bilateral arm transplant in US for a wounded warrior has now successfully performed the total penis and scrotum transplant in a war veteran who sustained injuries in Afghanistan.
Many soldiers returning from combat bear visible scars, or even lost limbs, caused by blasts from improvised explosive devices, or IEDs. However, some servicemen also return with debilitating hidden injuries -- the loss of all or part of their genitals.
"We are hopeful that this transplant will help restore near-normal urinary and sexual functions for this young man," says W.P. Andrew Lee, M.D., professor and director of plastic and reconstructive surgery at the Johns Hopkins University School of Medicine.
"It's a real mind-boggling injury to suffer, it is not an easy one to accept," says the recipient war veteran who wishes to remain anonymous. "When I first woke up, I felt finally more normal... [with] a level of confidence as well. Confidence... like finally I'm okay now," he says. He has recovered from the surgery and is expected to be discharged from the hospital this week.
While it's possible to reconstruct a penis using tissue from other parts of the body, says Lee, a prosthesis implant would be necessary to achieve an erection, and that comes with a much higher rate of infection. Additionally, due to other injuries, servicemen often don't have enough viable tissue from other parts of their bodies to work with.
This type of transplant, where 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. As with any transplant surgery, tissue rejection is a concern. The patient is put on a regimen of immunosuppressive drugs to prevent rejection. Lee's team has developed an immune modulation protocol aimed at minimizing the number of these drugs needed to prevent rejection.