Penis transplant
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Penis transplantation is a surgical transplant procedure in which a
penis A penis (plural ''penises'' or ''penes'' () is the primary sexual organ that male animals use to inseminate females (or hermaphrodites) during copulation. Such organs occur in many animals, both vertebrate and invertebrate, but males d ...
is transplanted to a patient. The penis may be an
allograft Allotransplant (''allo-'' meaning "other" in Greek) is the transplantation of cells, tissues, or organs to a recipient from a genetically non-identical donor of the same species. The transplant is called an allograft, allogeneic transplant, o ...
from a human donor, or it may be grown artificially, though the latter has not yet been transplanted onto a human.


Cases


2006 allotransplant procedure

The first such procedure was performed in September 2006 at a military hospital in
Guangzhou Guangzhou (, ; ; or ; ), also known as Canton () and Chinese postal romanization, alternatively romanized as Kwongchow or Kwangchow, is the Capital city, capital and largest city of Guangdong Provinces of China, province in South China, sou ...
, China. The patient, a 44-year-old male, had sustained the loss of most of his penis in an accident. The transplanted penis came from a
brain-dead Brain death is the permanent, irreversible, and complete loss of brain function which may include cessation of involuntary activity necessary to sustain life. It differs from persistent vegetative state, in which the person is alive and some au ...
22-year-old male. Although a surgical success, the patient and his wife developed
psychological trauma Psychological trauma, mental trauma or psychotrauma is an emotional response to a distressing event or series of events, such as accidents, rape, or natural disasters. Reactions such as psychological shock and psychological denial are typical ...
as a result of the procedure, and had the surgery reversed 15 days later. Following this, Jean-Michel Dubernard, who performed the world's first
face transplant A face transplant is a medical procedure to replace all or part of a person's face using tissue from a donor. Part of a field called "Vascularized Composite Tissue Allotransplantation" (VCA) it involves the transplantation of facial skin, the ...
, wrote that the case "raises many questions and has some critics". He alluded to a double standard, writing: An example of a critic is Piet Hoebeke, a reconstructive
urologist Urology (from Greek οὖρον ''ouron'' "urine" and '' -logia'' "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary-tract system and the reproductive org ...
in Belgium, who wrote a letter that raised the question of whether or not ethics committees were involved, and criticized the group for the follow-up time of only 15 days. Hoebeke asserted that successful voiding at two weeks is not predictive of long-term outcomes, and even that inadequate arterial
anastomoses An anastomosis (, plural anastomoses) is a connection or opening between two things (especially cavities or passages) that are normally diverging or branching, such as between blood vessels, leaf veins, or streams. Such a connection may be norm ...
might not manifest themselves in this time. The hospital that performed the first transplantation later issued a set of guidelines which, among other considerations, "recommended that the procedure be restricted to individuals with severe injuries who are unwilling to undergo traditional reconstructive surgery", according to a mini-review of the ethical issues surrounding penis transplantation published in the ''
Asian Journal of Andrology The ''Asian Journal of Andrology'' is a quarterly peer-reviewed medical journal covering andrology. It was established in 1999 and is the official journal of the Asian Society of Andrology. An open access journal, it is published by the Shanghai ...
''.


2014 procedure in South Africa

In December 2014, the first successful penis transplant was performed on a 21-year-old man by specialists led by urologist André van der Merwe from the
University of Stellenbosch Stellenbosch University ( af, Universiteit Stellenbosch) is a public research university situated in Stellenbosch, a town in the Western Cape province of South Africa. Stellenbosch is the oldest university in South Africa and the oldest ext ...
in South Africa. The surgical team consisted of urologist Andre van der Merwe and plastic surgeon Frank Graewe. The immunosuppression was conducted by Rafique Moosa. The nine-hour procedure used
microsurgery Microsurgery is a general term for surgery requiring an operating microscope. The most obvious developments have been procedures developed to allow anastomosis of successively smaller blood vessels and nerves (typically 1 mm in diameter) whic ...
to connect blood vessels and nerves. The patient had lost his penis as a result of a botched circumcision procedure he underwent aged 18. As of 13 March 2015, the recipient was reported to have recovered function in the organ, including
urination Urination, also known as micturition, is the release of urine from the urinary bladder through the urethra to the outside of the body. It is the urinary system's form of excretion. It is also known medically as micturition, voiding, uresis, ...
,
erection An erection (clinically: penile erection or penile tumescence) is a physiological phenomenon in which the penis becomes firm, engorged, and enlarged. Penile erection is the result of a complex interaction of psychological, neural, vascular, a ...
,
orgasm Orgasm (from Greek , ; "excitement, swelling") or sexual climax is the sudden discharge of accumulated sexual excitement during the sexual response cycle, resulting in rhythmic, involuntary muscular contractions in the pelvic region chara ...
and
ejaculation Ejaculation is the discharge of semen (the ''ejaculate''; normally containing sperm) from the male reproductory tract as a result of an orgasm. It is the final stage and natural objective of male sexual stimulation, and an essential compo ...
, but sensation is expected to take two years to return fully. The doctors who performed the transplant were surprised by this, as they had not expected the patient to recover fully until about December 2016. Given that circumcisions are performed frequently in parts of South Africa to mark a boy's transition to adulthood, and these are often unsanitary procedures, frequently carried out by uncertified amateurs, doctors have said that South Africa has some of the greatest need for penis transplantations in the world. In 2015, the recipient announced that he had successfully conceived a child.


2016 Massachusetts General Hospital procedure

In May 2016 surgeons, co-led by Curtis L. Cetrulo Jr. and Dicken S. C. Ko at
Massachusetts General Hospital Massachusetts General Hospital (Mass General or MGH) is the original and largest teaching hospital of Harvard Medical School located in the West End neighborhood of Boston, Massachusetts. It is the third oldest general hospital in the United Stat ...
,
Harvard Medical School Harvard Medical School (HMS) is the graduate medical school of Harvard University and is located in the Longwood Medical Area of Boston, Massachusetts. Founded in 1782, HMS is one of the oldest medical schools in the United States and is cons ...
performed a transplant on a 64-year-old man from
Halifax, Massachusetts Halifax is a town in Plymouth County, Massachusetts, United States. The population was 7,518 at the 2010 census. History Halifax was first settled by Europeans, most notably the Bosworth family from Bosworth Fields in England, in 1669, growing ...
. The surgeons demonstrated that it was possible to perform penile transplantation using a new technique of genitourinary vascularized composite allografts (GUVCA) to replace lost tissue under conventional immunosuppressive medication. The clinical results of this pioneering procedure in reconstructive transplantation in the United States was published in Annals of Surgery, May 2017. In October 2020 doctors from Massachusetts General Hospital debates penis transplant in transgender patient.


2017 procedure in South Africa

A surgical team from Stellenbosch University and the Tygerberg Academic Hospital performed a second penis transplant on 21 April 2017. In a nine and a half hour procedure, André van der Merwe and his team successfully transplanted a penis onto a 40-year-old male who had lost his penis 17 years prior, in a botched traditional circumcision. The patient is set to receive medical skin darkening tattoos in order to correct skin tone differences, as the donor was white and the recipient black. Stellenbosch University is the only medical center in the world to have successfully completed two penile transplants.


Johns Hopkins program

In December 2015, ''The New York Times'' reported that surgeons from
Johns Hopkins School of Medicine The Johns Hopkins University School of Medicine (JHUSOM) is the medical school of Johns Hopkins University, a private research university in Baltimore, Maryland. Founded in 1893, the School of Medicine shares a campus with the Johns Hopkins Hospi ...
in
Baltimore Baltimore ( , locally: or ) is the most populous city in the U.S. state of Maryland, fourth most populous city in the Mid-Atlantic, and the 30th most populous city in the United States with a population of 585,708 in 2020. Baltimore was ...
would soon be performing experimental penis transplantation surgeries on injured veterans, and were optimistic that such surgeries could result in sexual and reproductive function. In April 2018, ''The New York Times'' reported that surgeons from Johns Hopkins, led by W. P. Andrew Lee, had performed the first penis transplant performed on a combat survivor and the third successful penis transplant so far. This transplant also included the scrotum, but not the testicles, for ethical reasons. The patient's identity was not disclosed.


Laboratory-grown penises

In 2009,
Anthony Atala Anthony Atala, M.D., (born July 14, 1958) is an American bioengineer, urologist, and pediatric surgeon. He is the W.H. Boyce professor of urology, the founding director of the Wake Forest Institute for Regenerative Medicine, and the chair of th ...
and colleagues at the
Wake Forest Institute for Regenerative Medicine The Wake Forest Institute for Regenerative Medicine (WFIRM) is a research institute affiliated with Wake Forest School of Medicine and located in Winston-Salem, North Carolina, United States WFIRM's goal is to apply the principles of regenerative ...
in
North Carolina North Carolina () is a U.S. state, state in the Southeastern United States, Southeastern region of the United States. The state is the List of U.S. states and territories by area, 28th largest and List of states and territories of the United ...
transplanted
bioengineered Biological engineering or bioengineering is the application of principles of biology and the tools of engineering to create usable, tangible, economically-viable products. Biological engineering employs knowledge and expertise from a number o ...
penises onto 12 rabbits. All of them mated and four produced offspring. It was a test for a concept he had been working on since 1992, with the aim of making human penises for transplant. He has since produced test versions of bioengineered human penises. While there have been multiple successful transplants of other bioengineered organs, including the
urethra The urethra (from Greek οὐρήθρα – ''ourḗthrā'') is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra ...
, transplantation of a complete bioengineered penis has not yet been attempted in humans.


In fiction

The
British British may refer to: Peoples, culture, and language * British people, nationals or natives of the United Kingdom, British Overseas Territories, and Crown Dependencies. ** Britishness, the British identity and common culture * British English, ...
science fiction Science fiction (sometimes shortened to Sci-Fi or SF) is a genre of speculative fiction which typically deals with imaginative and futuristic concepts such as advanced science and technology, space exploration, time travel, parallel uni ...
comedies, ''
Percy The English surname Percy is of Norman origin, coming from Normandy to England, United Kingdom. It was from the House of Percy, Norman lords of Northumberland, derives from the village of Percy-en-Auge in Normandy. From there, it came into use ...
'' (1971) and ''
Percy's Progress ''Percy's Progress'' is a 1974 British comedy film directed by Ralph Thomas. It was written by Sid Colin, Harry H. Corbett and Ian La Frenais. It was released in the United States under the title ''It's Not the Size That Counts''. The US ...
'', also known as ''It's Not the Size That Counts'' (1974) depict the world's first penis transplant.
Ralph Thomas Ralph Philip Thomas MC (10 August 1915 – 17 March 2001) was an English film director. He is perhaps best remembered for directing the ''Doctor'' series of films. His brother, Gerald Thomas, was also a film director, probably best remembere ...
directed both films, and the first was co-written by
Michael Palin Sir Michael Edward Palin (; born 5 May 1943) is an English actor, comedian, writer, television presenter, and public speaker. He was a member of the Monty Python comedy group. Since 1980, he has made a number of travel documentaries. Palin w ...
and featured music by
The Kinks The Kinks were an English rock band formed in Muswell Hill, north London, in 1963 by brothers Ray and Dave Davies. They are regarded as one of the most influential rock bands of the 1960s. The band emerged during the height of British rhyt ...
.


See also

* Penectomy, surgical amputation of the penis *
Phalloplasty Phalloplasty is the construction or reconstruction of a penis or the artificial modification of the penis by surgery. The term is also occasionally used to refer to penis enlargement. History Russian surgeon Nikolaj Bogoraz performed the fir ...
, surgical reconstruction of the penis


References

{{Male genital procedures Transplantation Organ transplantation Tissue transplants