BALTIMORE, April 23, 2018 /PRNewswire/AsiaNet-Pakistan -- Many soldiers returning from combat bear visible scars, or even lost limbs, caused by blasts from improvised explosive devices, or IEDs. However, some servicemen also return with debilitating hidden injuries — the loss of all or part of their genitals. Now, the Johns Hopkins reconstructive surgery team that performed the country's first bilateral arm transplant in a wounded warrior has successfully 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," says W.P. Andrew Lee, M.D., professor and director of plastic and reconstructive surgery at the Johns Hopkins University School of Medicine.
A team of nine plastic surgeons and two urological surgeons was involved in the 14-hour surgery on March 26. They transplanted from a deceased donor the entire penis, scrotum (without testicles) and partial abdominal wall.
"It's a real mind-boggling injury to suffer, it is not an easy one to accept," says the recipient who is a veteran who sustained injuries in Afghanistan and wishes to remain anonymous. "When I first woke up, I felt finally more normal… [with] a level of confidence as well. Confidence… like finally I'm okay now," he says. The recipient has recovered from the surgery and is expected to be discharged from the hospital this week.
While it's possible to reconstruct a penis using tissue from other parts of the body, says Lee, a prosthesis implant would be necessary to achieve an erection, and that comes with a much higher rate of infection. Additionally, due to other injuries, servicemen often don't have enough viable tissue from other parts of their bodies to work with.
This type of transplant, where a body part or tissue is transferred from one individual to another, is called vascularized composite allotransplantation. The surgery involves transplanting skin, muscles and tendons, nerves, bone and blood vessels. As with any transplant surgery, tissue rejection is a concern. The patient is put on a regimen of immunosuppressive drugs to prevent rejection. Lee's team has developed an immune modulation protocol aimed at minimizing the number of these drugs needed to prevent rejection.
On the web:
https://www.hopkinsmedicine.org/plastic_reconstructive_surgery/specialty_services/transplant_tissue_transfer.html
https://www.hopkinsmedicine.org/transplant/news_events/penis_transplant_qa.html
https://www.hopkinsmedicine.org/transplant/programs/reconstructive_transplant/immunommodulatory_protocol.html
Johns Hopkins Medicine (JHM), headquartered in Baltimore, Maryland, is an $8 billion integrated global health enterprise and one of the leading academic health care systems in the United States. JHM unites physicians and scientists of the Johns Hopkins University School of Medicine with the organizations, health professionals and facilities of The Johns Hopkins Hospital and Health System. JHM's vision, "Together, we will deliver the promise of medicine," is supported by its mission to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care. Diverse and inclusive, JHM educates medical students, scientists, health care professionals and the public; conducts biomedical research; and provides patient-centered medicine to prevent, diagnose and treat human illness. JHM operates six academic and community hospitals, four suburban health care and surgery centers, and 40 primary and specialty care outpatient sites under the umbrella of Johns Hopkins Community Physicians. JHM extends health care into the community and globally through Johns Hopkins Home Care Group, Johns Hopkins Medicine International and Johns Hopkins HealthCare. The Johns Hopkins Hospital, opened in 1889, has been ranked #1 in the nation by U.S. News & World Report for 22 years of the survey's 28-year history. For more information about Johns Hopkins Medicine; its research, education and clinical programs; and for the latest health, science and research news, visit www.hopkinsmedicine.org.
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