Revival of a Severed Manhood

The Oxford dictionary defines “manhood” as the state of being a man rather than a child. It is also synonymous with the qualities traditionally associated with men such as courage, strength and sexual potency.

Hence many instances, one’s manhood is informally used euphemistically to refer to a man’s penis.

Mike Tyson famously said: “When I fight someone, I want to break his will. I want to take his manhood. I want to rip out his heart and show it to him.”

I am not an avid enthusiast of football, but hearing the news of how the UAE thrash Malaysia in 2018 World Cup qualifying match with a perfect 10, and Malaysia scored nil.

It certainly felt like the some one had ripped out the hearts of the national football team. I think such ridicule had brought mockery of the Malaysian sports as if someone had taken the nation’s “manhood.”

The fact is the United Arab Emirates is not exactly the Mike Tyson of the sporting world. So, how can our national squad be thrashed to a 10-0 defeat, and became historically the worse ever downfall in the world stage.

We shouldn’t forget, three months prior to the mortification; the team was already flogged with a 6-0 loss at the hands of the Palestine during the qualifier.

Should Malaysia’s coach for the national football team resign following the international display of the “loss of the manhood”?

Of course.

Some one has to be accountable for such disgrace and ignominy. After all, he signed a two-and- a-half year contract in a bid to lift the team out of the doldrums. Sadly, it seems like our football harimau’s pride had since sunk to the new low.

The real question is how do we recover from this loss of “manhood” of the harimaus.

From one euphemism of a severed manhood, we move on this week to talk about the real amputation of a penis. The recent story of a successful transplanted penis had gripped the attention of the media and the medical world.

How this pioneering surgery is viewed as a surgical marvel or an ethical minefield is the point of discussion brought up by a reader.

Dear Dr. G,

I read with interest the recent news of the world’s first penis transplant patient is to father a child. I am just intrigued to hear more about such success in surgery to bring the misfortune to a physiological norm.

The fact that a man can recover his urination function and some degree of sexual function following a disaster of losing his penis is phenomenal, but to regain the reproductive parameters is just the icing on the cake!

I am always led to believe the male sexual organ has intricate complexity that would be impossible to replace or restore. After all, this is an organ that has three functions.

And most instances, it probably has a “mind” of its own.

Is such surgery completely possible? The pioneering operation of the transplanted penis also sounded some alarms about how the potential ethical issues of such breakthrough. I am interested in your view.

John

In ancient civilization, the removal of a human penis is sometimes used to demonstrate superiority or dominance over an enemy. In ancient China, for crimes including adultery and promiscuity, men were documented to have the penises cut off in addition to castration as punishment.

In the modern era, the penile amputation is also known as penectomies. This is done for medical reasons such as cancer or trauma, which necessitates the surgical removal of most part of the penis.

Sadly, in many countries such as South Africa, botched circumcisions have also resulted in full or partial penectomies. The statistic can be as high as 250 men faced with such tragic loss of manhood per year in the African nation.

The first penile transplant was actually performed on a Chinese man whose organ was damaged beyond repair in an accident in 2006. Doctors in China spent 15 hours attaching a 10cm penis to a 44 year-old patient after the parent of a brain-dead man half his age agreed to donate their son’s organ.

Apparently, 10 days after the transplant, no evidence of graft rejection was detected, the blood supply was optimal and the urination function restored.

Although the operative success was technically a surgical first, the graft had to be removed two weeks following the 15-hour operations due to severe psychological distress.

Nearly a decade after the publication of the Chinese success, the surgeons in Tygerberg Hospital in Cape Town had announced the recipient of world’s first successful transplanted “functional” penis is to father a child.

This had generated tremendous excitement and debates in the medical arena.

The utilization of the microscopic surgery to connect small vessels and nerve and the modern immunosuppressive medications have made transplantation possible.

The penis has the structural make up of the two cylindrical shaped erectile tissues that are sponge-like when flaccid and rigid when the “sponge” is blood filled during arousal (corpus cavernosum).

The less rigid sponge-like structures are also surrounding the urethra allows semi-rigidity (corpus spongiosum), allowing ejaculation to take place without occlusion.

The reconnection of the corpus cavernosum and spongiosum to the donor’s penis is a breakthrough that is only possible when the intricate anastomosis leading to reinstatement of urinary, sexual and reproductive functions.

Undoubtedly, the taboo of a transplanted sexual organ will generate debates like many decades ago when IVF was first introduced. It is only natural to raise apprehensions and anxiety how such pioneering revelation can change the landscape of ethics.

Indeed, the potential success of the penile transplant can unleash less comfortable discussions of psychological trauma of the recipients, non-medical applications or even the issues of gender reassignment.

The former British Prime Minister Benjamin Disreali, who played the central role in the creation of the modern Conservative Party once said: “Youth is a blunder; Manhood is a struggle, Old age a regret”.

The new surgical revelation hopefully will not lead to blunders, struggles and regrets, like our national football.