Johns Hopkins School of Medicine's Department of Plastic and Reconstructive Surgery Director W.P. Andrew Lee (C) speaks after performing a double arm transplant on a veteran. © Jose Luis Magaua

Arms and legs aren't the only appendages that American servicemen lose to IEDs but, thanks to a pioneering surgical technique, injured soldiers will soon have the option of replacing their war-damaged wedding tackle. A team of surgeons from Johns Hopkins University School of Medicine announced on Sunday that within a year (more likely, just a few months) their facility will begin performing penis transplants. American veterans will be their first patients.

 Doctors in Baltimore, Maryland will perform up to 60 penis transplants on injured veterans who lost their genitals in Iraq and Afghanistan. It will be the first time the procedure is performed in the United States.

Nearly 1,400 military servicemen sustained injuries to the genitals between 2011 and 2013 in Iraq and Afghanistan alone, according to the Department of Defense Trauma Registry. The vast majority of the 1,367 injured troops was under 35 and had lost all or part of their penises or testicles on account of improvised explosive devices (IEDs). Approximately 7 percent of male military personnel under the age of 40 sustained genital injuries during their military service, a 2014 report in the Journal of Sexual Medicine found.


“These genitourinary injuries are not things we hear about or read about very often,” Dr. W. P. Andrew Lee, the chairman of plastic and reconstructive surgery at Johns Hopkins, told the New York Times. “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.”

 


When men are injured in combat, the first thing they ask about after surgery is their genitals, doctors told the NY Times.

“Our young male patients would rather lose both legs and an arm than have a urogenital injury,” Scott E. Skiles, the polytrauma social work supervisor at the Veterans Affairs Palo Alto Health Care System, said.


Johns Hopkins has restricted the transplant surgery to those, like Causey, who suffered genitourinary injuries in combat.
“Once this becomes public and there’s some sense that this is successful and a good therapy, there will be all sorts of questions about whether you will do it for gender reassignment,” Dr. Jeffrey Kahn, a bioethicist at the Baltimore school, told the NY Times. “What do you say to the donor? A 23-year-old wounded in the line of duty has a very different sound than somebody who is seeking gender reassignment.”
 
 
​‘He’s smiling big’: First penis transplant recipient impregnates girlfriend
After the transplant is completed, the penis will begin working in a matter of months, allowing the recipient to develop urinary function, sensation and even the ability to have sex.

“Some hope to father children,” Dr. Lee said. “I think that is a realistic goal.”

In fact, the 21-year-old recipient of the first successful penile transplant, performed in South Africa last December, was able to impregnate his partner just five weeks later. Doctors in South Africa are hoping to perfect the procedure to help the more than 250 young South Africans who are annually forced to undergo penile amputation due to complications following traditional circumcision ceremonies, mostly performed by Xhosa tribal populations away from urban areas.

Prior to that surgery, doctors had to fashion a penis out of the donor’s abdominal skin so that he could be buried with a penis-shaped organ. Johns Hopkins will ask permission to specifically use the penis from the families of donors, just as doctors would for hands and face transplants, Kahn said.

If the transplant recipients do impregnate their partners, it will be with their own ‒ not the donors’ ‒ sperm, as the testes will not be a part of the procedure, the NY Times reported. Those men who have completely lost their testicles and receive transplants will not be able to have biological children.


 Source: NY Times
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