Veteran receives world's first total penis and scrotum transplant at Johns Hopkins

Wednesday, 25 Apr, 2018

JOHNS HOPKINS MEDICINEAn Afghanistan War veteran whose legs and genitals were blown off in a roadside bomb explosion received a transplanted penis, scrotum without testicles, and partial abdominal wall in a 14-hour surgery on March 26 at Johns Hopkins Hospital.

The innovative operation was performed on a soldier who had been badly wounded during service in Afghanistan.

The chief of plastic surgery at John Hopkins, professor W.P. Andrew Lee, M.D., expressed his hope that the successful procedure will give his patient a new quality of life.

The soldier called his injury from an improvised explosive device "mind-boggling" and hard to accept. Details of the incident were not released.

"When I first woke up, I felt finally more normal...with a level of confidence as well". As if I were ok again, "said the patient". The doctors who performed the surgery said that it was a conscious decision on their part to exclude the testicles, since they produce sperms.

The transplant is an example of a type of procedure called vascularized composite allotransplantation, or VCA. It is a very complicated surgery - as evidenced by the 14-hour-long process with almost a dozen doctors on staff.

Disturbing yet oddly intriguing footage released by the John Hopkins Hospital in Baltimore, Maryland, where the operation took place, shows exactly how it happened. The first in China in 2006 was unsuccessful, while the second in South Africa in 2014 was a success. However, those transplants involved only the penis, not extensive surrounding tissue that made this transplant much more complex, said a report in The Sydney Morning Herald. This is said to be different from earlier penis transplants. This would have raised an ethical controversy, which the team wanted to avoid. He is now recovering and taking immunosuppressive therapy to prevent rejection.

The patient, who has chosen to remain anonymous, was a young United States soldier who trod on a hidden bomb while serving in Afghanistan.

They think the soldier should regain his full sexual potential, which wouldn't have been possible with just a penis reconstruction. "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", the family said. Genital injuries are rare outside of combat, and even then they are not common: according to Mary Roach, the author of Grunt: The Curious Science of Humans at War, there are about 300 genital injuries per 18,000 lower-limb injuries. In the future, they hope the DoD will cover the expenses for their veterans. Ars Technica reports that According to the Department of Defense, 1,367 men, almost all under the age of 35, returned to the US from Iraq and Afghanistan with genital injuries between 2001 and 2013.