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Tuesday, April 24, 2018

Surgeons perform first penis and scrotum transplant in the world

Por Damian

A new benchmark has been reached by science! A veteran who lost his genitals during an explosion in Afghanistan has received the most expensive penile transplant in the world. Doctors reported last Monday that the patient is recovering well and is expected to be discharged from the hospital this week.

To correct the war injury, surgeons at John Hopkins University in Baltimore, Maryland, rebuilt the entire pelvic area of the man: transplant of penis, scrotum and part of the abdominal wall of a deceased donor, in an experimental procedure that lasted 14 hours.

These transplants "can help soldiers with missing genitals, in the same way that the transplant of a hand or arm transforms the lives of amputees", said Dr. Andrew Lee, president of plastic and reconstructive surgery in Hopkins. It is expected that the patient, who asked not to be identified, to recover his urinary function and, eventually, the sexual one.

Transplantation of the scrotum did not include the testicles of the donor, which rules out reproduction. "We just felt that there were too many unanswered ethical questions" with that additional step, said Dr. Damon Cooney. Three other successful penile transplants have been reported, two in South Africa and one at Massachusetts General Hospital in 2016. Those transplants only included the penis, not the surrounding tissue that made this transplant more complex.

The loss of the penis, whether due to cancer, accident or war injury, is emotionally traumatic, affects urination, sexual intimacy and the ability to father children. Many patients suffer in silence because of the stigma sometimes associated with their injuries.

Doctors sometimes reconstruct the shape of the penis with the skin of the patient, often to address congenital abnormalities or during sex reassignment surgery. That means using implants to achieve an erection.

For a functional penis transplant, surgeons must connect small nerves and blood vessels. Candidates face serious risks, including rejection of tissue and side effects from immunosuppressants that they must take for the rest of their lives.

But penile transplants have generated a strong interest among veterans of Iraq and Afghanistan. The Trauma Archives from the Department of Defense has registered 1,367 men in service who survived with genitourinary injuries between 2001 and 2013, although it is not clear how many victims have lost all or part of the penis.