Within the next year, soldiers with gruesome injuries from war will get the opportunity to have an operation never before performed in the United States: a penis transplant.
The surgeons planning the operations, from Johns Hopkins University School of Medicine in Baltimore, say they expect the already-donated organs to work in a matter of months. These transplanted parts will develop urinary functions, sensation and, eventually, the ability to have sex.
From 2001 to 2013, 1,367 men in military service suffered wounds to the genitals in Iraq or Afghanistan, according to the Department of Defense Trauma Registry.
While missing limbs are a known scar of battle, genital damage is a hidden wound thanks to the shame, stigma and embarrassment of losing one’s ‘manhood’.
“These genitourinary injuries are not things we hear about or read about very often,” said Dr. W. P. Andrew Lee, the chairman of plastic and reconstructive surgery at Johns Hopkins.
“I think one would agree it is as devastating as anything that our wounded warriors suffer, for a young man to come home in his early 20s with the pelvic area completely destroyed.”
There’ve only been two documented penis transplants in medical records: a failed attempt in China back in 2006, and a successful one in South Africa last year (he’s even gone on to have a child). The procedure is experimental, but doctors at John Hopkins have the go-ahead to perform 60 transplants. Bleeding, infection and the chance the transplant medicine making the patient susceptible to cancer are the risks attached to these operations.
Patients who’ve had the transplant may still be able to have children, too. The operation is the penis only – no testes – so if a transplant recipient does have a child, it’s genetically their own offspring.
Sgt. First Class Aaron Causey lost both legs, one testicle and part of the other from a homemade bomb in Afghanistan four years ago. Of his wounds, his testicular damage bothers him the most.
“I don’t care who you are — military, civilian, anything — you have an injury like this, it’s more than just a physical injury,” Sergeant Causey said.
There’s some criticism to the experimental procedure. Some physicians argue this isn’t a life-saving operation, so it’s not as crucial as other problems doctors could be solving.
“If you meet these people, you see how important it is,” argued Dr. Richard J. Redett, director of pediatric plastic and reconstructive surgery at Johns Hopkins. “To be missing the penis and parts of the scrotum is devastating. That part of the body is so strongly associated with your sense of self and identify as a male. These guys have given everything they have.”
The operation will take roughly 12 hours where surgeons will connect two to six nerves, and six or seven veins and arteries, stitching them together under a microscope.
The ultimate goal, besides the psychological benefits, is to restore function, not just appearance.
“They say, ‘I want to feel whole again,’ ” said Dr. Brandacher, one of the surgeons at John Hopkins. “It’s very hard to imagine what it means if you don’t feel whole. There are very subtle things that we take for granted that this transplant is able to give back.”