In a world first, a US veteran now has a new penis and scrotum

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After 14 hours of surgery, a veteran of the US Armed Forces has a new, transplanted penis and scrotum. The world’s most comprehensive penis transplant yet took place at Johns Hopkins Hospital at the end of March, the hospital announced today — and so far, it looks like a success. The unnamed patient is walking around and should be able to leave the hospital this week.

This is the fourth successful penis transplant in the world so far, Richard Redett, clinical director of the Johns Hopkins genitourinary transplant program, said in a news briefing today. But it’s the first time doctors have transplanted such a large area of the body — including part of the lower abdomen, the entire penis, and the scrotum — from a deceased donor. The doctors will soon know whether the patient can urinate through his penis, but regaining sensation will take longer, possibly about six months.

The Johns Hopkins patient’s legs, penis, scrotum, and lower abdomen were blown up by an improvised explosive device in Afghanistan, according to The New York Times. He found the genital injuries especially difficult to recover from, the Times reports. These injuries can have devastating effects on servicemembers’ plans to have children, their intimate relationships, and their physical and mental health. The victims are usually young — just 24 years old on average, according to a report published by the Bob Woodruff Foundation, called “Intimacy after Injury.” And there are lot of them: at least 1,378 men in the armed forces came home with injuries to their genitals and urinary organs between 2001 and 2013, the report says.

One treatment is to reconstruct the penis with a prosthetic and tissue cut from other parts of the body. But servicemembers can be so injured that sometimes there just isn’t enough tissue to do that, according to a news release from Johns Hopkins Medicine. Penis transplants might offer a solution — but the procedure is still experimental, for now.

The March surgery on the US veteran had been in the making since 2013. That’s in part because of the lengthy technical preparation, which included dissections and mock surgeries on cadavers. Matching the donor and the recipient was also a little more complicated than for a solid organ like a kidney, according to the news briefing: In addition to matching the donor and recipients’ tissue and blood types, the doctors also matched their age and skin tone. And since the recipient had a rare blood type, there were fewer potential donors.

The team decided early on not to transplant the testicles, which could still make the donor’s sperm, Damon Cooney, a professor of plastic and reconstructive surgery at Johns Hopkins University School of Medicine, said during the news briefing. With the testicles, the transplant recipient could have fathered a child who had the donor’s DNA. “We just felt that there were too many unanswered ethical questions for that kind of transplant,” Cooney said.

The entire surgery took 11 surgeons 14 hours to complete on March 26th, and so far, the patient is healing well. After the surgery, “I felt finally more normal,” he said in a news release. “Like finally I’m okay now.”

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