In New Clinical Trial, Surgeons Plan First Penis Transplant in the U.S.

Surgeons at Johns Hopkins University School of Medicine are getting ready to perform the first penis transplant in the United States.

The University has approved 60 surgeries for this investigational program, which is expected to begin within months.

Patients will be soldiers who have sustained genital injuries in combat.

“To be missing the penis and parts of the scrotum is devastating,” Dr. Richard Redett, the director of pediatric plastic and reconstructive surgery at Johns Hopkins, told The New York Times. “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.”

The penises will come from deceased donors, with special permission from their families. Blood type, age, and skin tone are considered when making a match.

Patients will undergo psychiatric evaluations before surgery. A man’s partner, if he has one, will also be involved.

It’s important for patients and partners to understand the unknowns. “We can’t guarantee the outcome of the extent of urinary function, erection, and ability to have sexual intercourse or have children,” said Carisa Cooney, a clinical research manager, in a Johns Hopkins interview.

Regaining urinary and sexual function could take between six and twelve months. Nerves grow at a rate of one inch per month, Dr. Redett told Johns Hopkins. If the patient still has his testes, he may be able to father children eventually.

Rejection of the donor penis is a concern. Patients will take an immunosuppressive drug for the first 10 to 14 days after the transplant. At that point, bone marrow from the donor will be infused to reduce the amount of anti-rejection medications needed. However, patients will need to take such medications for the rest of their lives.

Worldwide, only two penis transplants have been attempted so far.

The first, performed in China in 2006, was physically successful. However, the patient and his wife had psychological distress and the transplanted penis was removed after two weeks.

The second was conducted in December 2014 in South Africa, three years after the 21-year-old patient had had his penis amputated because of circumcision complications. Earlier this year, the man reportedly impregnated his girlfriend.

At Johns Hopkins, scientists will monitor the patients’ progress before deciding whether to offer penis transplants as standard treatment.

Resources

CNN

Pearson, Michael and Debra Goldschmidt
“First penis transplant patient's girlfriend is pregnant, doctor says”
(June 12, 2015)
http://www.cnn.com/2015/06/12/health/penis-transplant-south-africa-pregnancy/

The Guardian

Sample, Ian
“Man rejects first penis transplant”
(September 17, 2006)
http://www.theguardian.com/science/2006/sep/18/medicineandhealth.china

International Society for Sexual Medicine

“South African Surgeons Perform World’s First Penile Transplant”
http://www.issm.info/news/sex-health-headlines/south-african-surgeons-perform-worlds-first-penile-transplant/

Johns Hopkins Medicine

“Q & A: Penile Transplantation”
http://www.hopkinsmedicine.org/transplant/news_events/penis_transplant_qa.html

The New York Times

Grady, Denise
“Penis Transplants Being Planned to Help Wounded Troops”
(December 6, 2015)
http://www.nytimes.com/2015/12/07/health/penis-transplants-being-planned-to-heal-troops-hidden-wounds.html?_r=1

The Washington Post

Feltman, Rachel
(December 8, 2015)
https://www.washingtonpost.com/news/speaking-of-science/wp/2015/12/07/the-first-penis-transplants-in-the-u-s-will-soon-help-heal-wounded-veterans/