The first penis transplant to be carried out in the US has been hailed a success by surgeons. Thomas Manning, 64, underwent a 15-hour reconstructive operation at the Massachusetts General Hospital last month and "continues to recover well".
Manning had his penis amputated in 2012 after being diagnosed with penile cancer. Since the reconstructive surgery, he has shown no signs of bleeding, rejection or infection and blood flow has been established.
In the surgery, a donor penis was grafted onto the comparable structures of the patient. The aims of the procedure, called genitourinary vascularised composite allograft (GUVCA) transplant, were to reconstruct the external genitalia so it has a more natural appearance, to get urinary function back and potentially to re-establish sexual function.
Manning is currently in the early stages of recovery, but his doctors say they are "cautiously optimistic" he will regain lost function.
The surgery took more than three years of research and collaboration between departments across the hospital. Doctors had to practice on cadavers, carrying out a number of trial runs before the operation, while Manning was screened extensively to ensure he would be able to cope with the transplant psychologically.
"New chapter filled with personal hope"
Losing the penis can be devastating to affected men. It can happen as a result of injury, in combat, for example, and through disease − as in Manning's case. Surgeons wanted to find a way to provide a long-term solution to affected men.
Curtis L Cetrulo, one of the lead surgeons, said: "We are hopeful that these reconstructive techniques will allow us to alleviate the suffering and despair of those who have experienced devastating genitourinary injuries and are often so despondent they consider taking their own lives. The entire transplant team has worked tirelessly to ensure that our patient is on the path to recovery, thanks in part to the gift of organ donation."
In a statement, Manning said: "Today I begin a new chapter filled with personal hope and hope for others who have suffered genital injuries, particularly for our service members who put their lives on the line and suffer serious damage as a result. In sharing this success with all of you, it's my hope we can usher in a bright future for this type of transplantation."
Mixed success in past
Dicken S C Ko, who also led the surgery, said these "proof-of-principle cases" will allow surgeons to work out the best techniques for future transplants, which will help pave the way for more operations. "We are delighted to have taken the first steps to help those patients who have suffered silently for far too long," he said.
However, Cetrulo also told The New York Times it is still early days for the procedure and that they are still in "uncharted waters". Previously, penis transplants have been carried out with mixed success. In China, a 44-year-old man asked to have the transplanted organ removed (despite surgical success) because of the psychological trauma that resulted. However, a surgery carried out in 2014 was deemed a huge success. The 21-year-old man recovered function and a year after had successfully fathered a child.
Ko said the hospital has not planned any more transplants, but is evaluating candidates individually to decide whether to go ahead. He also said that, at present, it will only be provided to men who lost their penises through trauma or disease.