CNN: Wounded Veteran Receives First Penis and Scrotum Transplant

World | April 25, 2018, Wednesday // 14:28|  views

Source: Johns Hopkins Medicine

(CNN) - The world's first successful total penis and scrotum transplant was completed at Johns Hopkins Hospital on March 26, according to a news release issued Monday.

The procedure lasted 14 hours and involved nine plastic surgeons, two urological surgeons and a team of anesthesiologists, nurses and surgical technicians, according to the release. The transplant recipient, who wished to remain anonymous, is a young US serviceman who sustained injuries to his lower pelvis, lower abdominal wall and lower extremities in an improvised explosive device blast while serving in Afghanistan.

"While war injuries cause great suffering, disfigurement and disability, they have also provided the impetus for medical discoveries," said Dr. W.P. Andrew Lee, chairman of the Department of Plastic and Reconstructive Surgery at Johns Hopkins University and one of the surgeons in the case, in a news briefing.

"While extremity amputations are visible and resultant disability obvious, some war injuries are hidden and their impact not widely appreciated by others," Lee added. "Genitourinary injury, where the male service members' external genitalia are lost or severely damaged, is one such 'unspoken injury of war.' "

In order to perform the transplant, the team had to obtain the necessary tissues -- consisting of a penis, scrotum and part of the lower abdominal wall -- from a deceased donor, according to Dr. Rick Redett, clinical director of the Johns Hopkins genitourinary transplant program and another surgeon on the case.

"To perform the transplant, we procured the necessary tissue from the donor to restore normal anatomy in the recipient," Redett said in a statement.

During the procedure, three arteries, four veins and two nerves were connected under microscopic guidance in order to provide adequate blood flow and sensation to the transplanted tissue, Redett said.

However, the donor's testicles and vas deferens -- which produce and transport sperm -- were not transplanted due to ethical concerns, according to Dr. Gerald Brandacher, scientific director of the Composite Tissue Allotransplantation Program at Johns Hopkins and a surgeon on the case.

"For ethical reasons, we would not want to transplant the germ line from the donor, because that would mean that, were the recipient to father a child, that actually the genetic background of the child would be from the donor and not from the recipient," Brandacher said. "But in a second step, the patient will receive testicle prostheses."

After the announcement of the surgery, the donor's family, which also was not mentioned by name, released a statement thanking the recipient for his service: "We are all very proud that our loved one was able to help a young man that served this country. We are so thankful to say that our loved one would be proud and honored to know he provided such a special gift to you. As a family, we are very supportive of all the men and women who serve our country and grateful for the job you did for this nation."

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Tags: penis, scrotum, transplant


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