First U.S. Penis Transplant to Take Place in 2016 on Vet
The first penis transplant in the United States is set to take place within the next year.
Surgeons from Johns Hopkins School of Medicine -- which has an active hand andface transplant program -- say the recipient will be a young soldier injured in a bomb blast in Afghanistan.
"We want to continue to expand the field into areas that are not easy to reconstruct using conventional methods," Dr. Damon Cooney, assistant professor of plastic and reconstructive surgery and co-clinical director of the penile transplant program at Johns Hopkins, told CBS News. "The more and more interactions we've had with the military, the more we came to find out that although people aren't talking about it much, genital injuries are a much bigger problem for a lot of people."
The organ for the procedure will come from a deceased donor. Doctors say they expect it to start functioning in matter of months -- meaning the development of urinary function, sensation, and eventually the ability to have sex. Plans for the surgery were first reported in The New York Times.
Only two penis transplants in the world have ever been documented in medical journals -- one failed attempt in China in 2006 and a successful one last year in South Africa. In June 2015, the recipient of the successful transplant -- who lost his penis after a botched circumcision -- announced that his girlfriend was pregnant.
The area of research is particularly important for young U.S. veterans, doctors say, as they've seen an increase in this type of trauma in troops wounded overseas. According to the Department of Defense Trauma Registry, an estimated 1,367 men in military service suffered wounds to the genitals in Iraq or Afghanistan from 2001 to 2013.
"Veterans returning from Iraq and Afghanistan have a disproportionate amount of what we call urogenital trauma -- trauma to the penis or testicles -- which is an unfortunate byproduct of the nature of the injuries they sustain because of things like IED explosions," Dr. Joseph Alukal, a urologist and director of male reproductive health at NYU Langone Medical Center and an assistant professor of Urology and Obstetrics and Gynecology at NYU School of Medicine, told CBS News. "It's been far more of an issue with this engagement than what we've ever seen before."
The procedure is considered experimental and Johns Hopkins has given doctors permission to perform 60 transplants, for which they are currently screening patients. The university will closely watch the results and decide whether to make it a standard treatment.
The surgery takes place under a very powerful microscope where doctors repair and connect the nerves, arteries, veins, and the urethra that all need to be working properly in order for the penis to be functional.
Like any other organ transplant, there are risks, including bleeding, infection, and other complications that would require further surgery. The patients must also take medication for the rest of his life to prevent transplant rejection, which can weaken the immune system and may increase the risk of cancer.
While the success seen in South Africa certainly offers much hope, experts warn that expectations should be managed. "If we were going to attempt this at NYU, I would warn patients that while we can make guarantees regarding the idea that the operation should work in terms of the new organ surviving, but in terms of its functionality during sex, we'll do everything we can to make it work but we can't guarantee that," Alukal said.
The procedure involves the transplant of a penis, not the testicles, so there is the possibility that recipients can have their own children. Men who have lost testicles completely may still qualify for the transplant surgery but would not be able to have biological children.
The program at Johns Hopkins is not limited to those who have been injured during war, but doctors say it is an important population to serve.
"These are young men who have been serving their country overseas," Cooney said. "They may not have a family. They may have been putting that off for when they come home. And typically they're proud of their body and their masculinity and if that's destroyed, it can be psychologically devastating."
Similarly, Alukal said it's "hugely important" that veterans get this medical attention. "Here are people who are putting themselves in harm's way on behalf of our nation and they've come back with this truly devastating injury in terms of their quality of life and psychological health," he said. "We need to do what we can to help them."
Cooney said the surgery may also soon be used for other patients in the U.S., including those with birth defects who were born without fully formed genitalia or patients who had their penis removed for surgical reasons. Transgender patientsseeking patient reassignment surgery could also potentially benefit from such a procedure.
"For now, since is this is a brand new technique, the simplest population to treat are those with traumatic injuries so that's where we're starting," Cooney said. "But certainly if it looks like this is successful then we would hope to open it up to other patients in the future."