Surgeons from the United States for the first time transplanted a man who lost his genitals in the war, penis and scrotum. They expect that such transplantation will heal hundreds of other servicemen with similar injuries.
Many soldiers return from combat zones with injuries resulting from the explosion of improvised explosive devices. Among these injuries — partial or complete loss of genitals. Yet to restore the damaged organs was only possible through the reconstruction of tissues of the patient and prosthesis. However, surgeons at Johns Hopkins University conducted the world's first penile and scrotal surgery from a donor. The work done is described on the website of the University.
"We hope that the transplant will restore the urogenital and sexual function in this young man," says Professor Andrew Lee, a specialist in reconstructive surgery.
The operation took place on March 26. For 14 hours, a team of nine plastic surgeons and two urologists transplanted the war-affected male penis, testicular scrotum and part of the abdominal wall of the deceased donor. The doctors connected the arteries, nerves, restored the urethra. Although in recent years, several penis transplants have been performed, this has become the largest — the explosion damaged not only the genitals, but other tissues in the pelvis.
"This is a terrible trauma that is not easy to take," says the patient, who wished to remain anonymous veteran of Afghanistan. - When I woke up after anesthesia, I finally felt more... normal. I felt confident that I was OK now."
Due to the explosion, the man lost both legs, but the damage to the genitals, oppressed him more than anything.
"This trauma as if closed to me the way to the relations. I felt like I was left alone for the rest of my life. It was hard for me to even look at myself as a man," he says.
When the wounded man regained consciousness in the hospital, I was happy that he was still alive. But then came the realization of the injuries. The doctor told him that he would not be able to restore the genitals.
"When he left, I thought he was just a short-term doctor. You have all these technologies, and you're telling me it's forever? There must be something," the man recalls.
It was even visited by thoughts of suicide. But each time he asked himself a question:
"Am I going to kill myself because of dick?»
The young man received a higher education, was going to enter a medical College. But the personal life was complicated — he was afraid of the moment when he would have to tell someone about his injur.
In 2012, doctors offered him a reconstructive surgery in which the penis would be reconstructed from his own tissues, for example, a flap of skin from the forearm. They also told him about the possibility of transplantation. Reconstruction could be carried out in the near future, but the man decided to wait for the transplant.
Although it is possible to reconstruct the penis using tissue taken from other parts of the patient's body, explains Whether, to achieve an erection, you will need a prosthesis, the presence of which is associated with an increased risk of infection. In addition, due to other injuries, military personnel may not have enough of their own tissue for reconstruction of the member.
The donor was from another state, so the doctors had to go there urgently to separate the future transplant from the body of the deceased man. They also took several vertebrae to get stem cells — their use minimizes the risk of transplant rejection.
The donor's family sent a letter to the patient:
"We are all very proud that our loved one was able to help the man who served this country. We are pleased to say that our loved one could be proud to have made you a special gift. As a family, we very much support all the men and women who serve our country and are grateful for The work you have done for this nation.
Please know that these are really sincere words-there are several veterans in our family. We hope You will feel better and wish you a speedy recovery."
According to the patient, at first he doubted that he would be able to treat the new part of the body as his own.
"I thought if I can look at this member as his? But when I after the surgery he looked at it, I realized that nothing else I did not perceive. It's mine."
In the future, the man plans to finish training and be a doctor. To arrange personal life, he is no longer afraid.
This operation is called vascularized composite allotransplantation — organ transplantation from one person to another. Since the man did not transplant the donor's testicles, he will have to receive testosterone injections. So far, the patient feels well.
Surgeons developed the technique of such an operation for five years. They expect to continue to use it to wounded veterans. According to research, 2001-2013 1367 of military men received injuries of the genital organs, the penis was affected in a third of cases. Now the affected men have the opportunity to restore the genitals, if it is possible to find a suitable donor. However, the obstacle may be the high cost of the operation — evaluates Whether its in the $300-400 thousand At this time the surgeons received payment from University funds, and urologists agreed to work for free. Lee expects that the cost of future operations will be covered by Pentagon grants and insurance.