The Story Behind the First Successful Penis Transplantation

As our membership becomes more and more diverse, it’s increasingly important that this blog cover a range of topics that interest a wide spectrum of those involved in transplantation. With this in mind, I’ve invited my colleagues Drs. Cetrulo and Ko to provide some insight on the first penis transplant in the United States and what this means for the future of VCA. 


Curtis Cetrulo, Jr., MD, FACS, FAAP Massachusetts General Hospital, Department of Surgery
Dicken S. C. Ko, MD, FRCSC, FACS, Massachusetts General Hospital, Department of Urology

We recently had the privilege and the responsibility of performing the first penis transplant in the U.S. this past May. The recipient, Thomas Manning, had undergone a penectomy (amputation of the penis) after being diagnosed with penile cancer. He continues to do well, now three months after his surgery.

I (Dr. Cetrulo) had been presenting the results of a hand transplant when Dr. Ko, a transplant urologist, approached me and asked, "We have so many desperate patients missing genitourinary tissue. Can we transplant penile tissue?"

That was three years ago, when we started working on our protocol. We had further inspiration from our military surgical colleagues. These hardened surgeons were distraught over lack of adequate treatments for the many coming back from Iraq and Afghanistan with devastating genitourinary injuries. The suicide rate in this population may be as high as 25 to 50 percent.

It’s a real problem among male combat vets. We’ve estimated something on the order of 1,500 blast injuries to the groin that have resulted in the loss of genitourinary tissue. You can imagine these wounded warriors coming back from Iraq and Afghanistan with their hopes for intimacy in their lives being destroyed. It’s an incredibly difficult thing to talk about among men, so it’s a very insulating kind of injury. A lot of these patients have suffered in silence for years.

Mr. Manning contributed to bringing penile cancer patients and those with genitourinary injuries out of these shadows after his transplant. An unusually forthcoming patient, he spoke freely in public about his hopes and fears and urged others to follow his public example.

We feel that it is important to discuss this case publicly, so that patients and physicians understand that there is hope.  One of the most remarkable phenomena, after having done this procedure, is that people came out of the woodwork to talk about a subject that was not discussed very commonly beforehand.

At Massachusetts General Hospital, we set three goals for this transplant procedure: first, to restore normal appearing external genitalia; second, to restore urinary function; and third, to restore sexual function.

The first goal was accomplished soon after it was clear that the allograft would survive, and the second goal was achieved at about three weeks postoperatively, when the Foley catheter was removed and the patient’s ability to urinate normally was restored. The third goal – restoration of erectile function – will require at least 6-8 months for nerves to regenerate, but we are hopeful on that front as well.

 

 

 

Comments

Congratulations to the transplant team in Boston for pushing the envelope. We wish you and your patient success and best of lucks in this endeavor.

Congratulation both to the team and the patient. Wishing you all the best.

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