The First Penile Transplant

“Civilization began the first time an angry person cast a word instead of a rock.” This is famous quote from Sigmund Freud, whom I respect and admire profoundly. I often wonder Freud would turn his grave seeing the “civilization” we have in the 21st century.

In medical field, the world is a very different place since the Freudian era. From the first discovery of Penicillin in by Fleming in 1950’s to the first organ transplantation by Bernard in the sixties, these landmark “firsts” did not just transformed the scientific communities, they simply changed the world.

This week, we read with interest about another medical “first”, interestingly also originated from South Africa, where the first organ transplantation was performed all those years ago. Some of use read with amazement of the first successful human transplantation of a penis, others with much amusement. To me, such bold move may have the potential to become another “firsts” that will change the landscape of “manhood”, and also mankind.

Dear Dr. G,

I have been a big fan of your column. Your words are witty and humorous, and the article really brightens up my Sunday. I read with a lot of interests and amusement the first human penile transplantation that was carried out in South Africa recently. Do you think this is a true story? How is such operation even possible? Is the new penis function? How do you assess the functionality? Don’t get me wrong. I am really quite happy with my manhood and will not contemplate a penile transplant. However, I am interested in your view about the ethical issues on this matter. I mean the heart and kidney transplantations are of course noble in saving lives. With the first penis transplantation being successful; this may mean the volunteering organ donation will include one’s private parts in the future? Now, that is a scary thought. I look forward to your shrewd comments.

David.

Transplantation is a surgical relocation of an organ from a source to a host. Surgical transplantation may be from an allograft obtained from a human donor, or artificially grown tissue. The transplantation of an organ from a different host will require the suppression of the host immunity, to prevent the rejection of the graft. Such immunosuppression is only possible with the first discovery of agents such as Cyclosporine, by Sir Roy Calne from Cambridge in 1960’s.

The issue of transplantation has always been controversial. The taboo of retrieving an organ from a living or a dead donor, for the benefit of the recipients
may not even be acceptable these days, five decades following the first revolutionary operation.

Today, the idea of surgical transplantation of a face, limb and a penis is definitely more provocative and contentious, as the loss of such organs is often considered non-life threatening and the surgical intervention deemed unnecessary.

In reality, the first penile transplantation was actually performed in Guangzhou, China. In 2006, a forty four year old man who lost most of his manhood after an accident received a brand new penis from a 22 year-old chap who was already brain-dead. The operation, although technically was the first, was not “world-shattering”, because the new organ was taken down fifteen days later. Apparently, the recipient and his wife were so psychologically traumatized by the transformation.

Of course, nearly a decade following the failed attempt in China, we get all excited about the first successful penile transplant in South Africa. The poor chap apparently had a botch circumcision at the age of 18, and was considered the perfect candidate for this first operation three years later. After a nine-hour painstaking microsurgery, the outcome has been published in the scientific journal.

The new man apparently is doing swimmingly well with the restoration of urinary and sexual functions. The assessment of the urination ability, erectile competence and ejaculatory capability were all perceived to be pleasing, three months following the transplant.

If you consider the idea of a severed penis being reconnected by other man’s organ a fictional lunacy; think about this, Bioengineered penises were already accomplished in Wake Forest, North Carolina in 2008. The Scientist, Anthony Atala, had grown penises from scratch in the lab and transplanted them onto 12 rabbits. All the rabbits were able to mate and four actually produced off springs. Now, that will get you thinking!

The prolific American poet from the 19th century, Emily Dickinson once said: “Whenever a thing is done for the first time, it releases a demon.” I am certain whether “demon” indeed will be unleashed for the lucky recipient of the penis in South Africa. The success of the first penile transplant is not just the triumph of medical achievement. Of course, the techniques of microsurgery and micro-neurovascular anastomosis are a giant leaps to make many “impossible” operations possible in future days. On the other hand, the serious question for the future is: “If I agree to organ donation, does that mean the private part is also may not be private no more?”