Within a year, maybe in just a few months, a young soldier with a horrific injury from a bomb blast in Afghanistan will have an operation that has never been performed in the United States: a penis transplant.
The organ will come from a deceased donor, and the surgeons, from Johns Hopkins University School of Medicine in Baltimore, say they expect it to start working in a matter of months, developing urinary function, 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. Nearly all were under 35 and were hurt by homemade bombs, commonly called improvised explosive devices, or I.E.D.s. Some lost all or part of their penises or testicles — what doctors call genitourinary injuries.
Missing limbs have become a well-known symbol of these wars, but genital damage is a hidden wound — and, to many, a far worse one — cloaked in shame, stigma and embarrassment.
“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.”
Only two other penis transplants have been reported in medical journals: a failed one in China in 2006 and a successful one in South Africa last year. The surgery is considered experimental, and Johns Hopkins has given the doctors permission to perform 60 transplants. The university will monitor the results and decide whether to make the operation a standard treatment. The risks, like those of any major transplant operation, include bleeding, infection and the possibility that the medicine needed to prevent transplant rejection will increase the odds of cancer.
Dr. Lee cautioned that patients should be realistic and not “think they can regain it all.” But doctors can give the recipients a range of what to expect.
SOURCE: DENISE GRADY
The New York Times