BALTIMORE — Genitourinary injuries were one of the signal wounds from the wars in Iraq and Afghanistan. Among the worst for servicemembers injured by improvised explosive devices was the loss of all or part of their genitals.
Now, a reconstructive surgery team at Johns Hopkins University has performed the first total penis and scrotum transplant in the world.
“We are hopeful that this transplant will help restore near-normal urinary and sexual functions for this young man,” said W.P. Andrew Lee, MD, professor and director of plastic and reconstructive surgery at the Johns Hopkins University School of Medicine.
In the 14-hour surgery involving nine plastic surgeons and two urological surgeons in March, the entire penis, scrotum (without testicles) and partial abdominal wall was transplanted from a deceased donor.
The patient was a veteran who sustained injuries in Afghanistan who has opted to remain anonymous.
The surgeons pointed out that vascularized composite allotransplantation involves transplanting skin, muscles and tendons, nerves, bone and blood vessels. Because of concerns about tissue rejection, patients are put on a regimen of immunosuppressive drugs.
Lee’s team has developed an immune modulation protocol aimed at minimizing the number of these drugs needed to prevent rejection, according to a Johns Hopkins press release.
Most people looking at a hospital room will see an environment specifically designed to keep human beings alive through even the most traumatic circumstances.
A facility-specific survey found that 138 of 140 VA facilities reported shortages of medical officers, with psychiatry and primary care positions being the most frequently listed.