After a 15-hour transplant operation that lasted from May 8 and 9th, 2016, a 64 year-old man, Thomas Manning whose penis was removed because of cancer has received the first penis transplant at Massachusetts General Hospital in Boston, in the United States.
A plastic and reconstructive surgeon and a leader of the surgical team, Dr. Curtis L. Cetrulo, which achieved this medical breakthrough, said that the organ came from a dead donor.
According to Cetrulo; “If all goes as planned, normal urination should be possible for Mr. Manning within a few weeks and sexual function in weeks. We’re cautiously optimistic as it is uncharted waters for us.”
In an interview with the New York Times in his hospital room, Manning said he wanted to speak out publicly to help dispel the shame and stigma associated with genital cancers and injuries, and to let other men know there was hope of having normal anatomy restored.
The surgeon said the penis transplant is experimental and part of a research programme with the ultimate goal of helping combat veterans with severe pelvic injuries, as well as cancer patients and accident victims.
Cetrulo noted that Manning will have to take several anti-rejection drugs for the rest of his life. One of them, tacrolimus, seems to speed nerve regeneration and may help restore function to the transplant.
He stated that another patient, whose penis was destroyed by burns in a car accident, will receive a transplant as soon as a matching donor becomes available.
Surgeons at the Johns Hopkins University School of Medicine are also planning to perform penis transplants, and have had a combat veteran, injured in Afghanistan, on the waiting list for several months.
Cetrulo estimated the cost at $50,000 to $75,000. Both hospitals are paying for the procedures, and the doctors are donating their time.
Worldwide, only two other penis transplants have been reported: a failed one in China in 2006 and a successful one in South Africa in 2014.
The Massachusetts General team spent three years preparing for the penis transplants. The team did meticulous dissections in a cadaver lab to map out anatomy, and operated on five or six dead donors to practice removing the tissue needed for the transplants. Mr. Manning’s operation involved about a dozen surgeons and 30 other health care workers.
An accident at work in 2012 brought Mr. Manning to the hospital, and ultimately to the transplant team. Heavy equipment had fallen on him, causing severe injuries. The doctors treating him saw an abnormal growth on his penis that he had not noticed.
Tests revealed an aggressive and potentially fatal cancer. Penile cancer is rare, with about 2,030 new cases and 340 deaths expected in the United States this year.
If not for the accident, Mr. Manning said, “I would’ve been in the ground two years ago.”
Doctors said that to save his life, they would have to remove most of his penis, in an operation called a partial penectomy. Mr. Manning’s urologic oncologist, Dr. Adam S. Feldman, estimated that a few hundred men a year needed full or partial penectomies because of cancer.
Manning was left with a stump about an inch long. He had to sit to urinate. Intimacy was out of the picture. He was single and was not involved with anyone when the cancer was found. After the amputation, new relationships were unthinkable. “I wouldn’t go near anybody. I couldn’t have a relationship with anybody. You can’t tell a woman, ‘I had a penis amputation. “Don’t hide behind a rock,” he said.
“Some people close to him urged him to keep the operation a secret, but he refused, saying that was like lying, and he had nothing to be ashamed of.
“I didn’t advertise, but if people asked, I told them the truth,” he said, adding that a few male friends made “guy talk” jokes at his expense, but that it toughened him up. Men judge their masculinity with their bodies,” he said.
Manning has had one serious complication. The day after his surgery, he began to hemorrhage and was rushed back to the operating room.
Since then, his recovery has been smoother, he said. He has no regrets. He looks forward to going back to work and hopes to eventually have a love life again.
“If I’m lucky, I get 75 percent of what I used to be,” he said. “Before the surgery I was 10 per cent. But they made no promises. That was part of the deal.”