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    Penile transplant could happen here, U.S. surgeons say

    Penile transplant surgery, performed successfully for the first time in South Africa, is technically feasible and has potential clinical applications in the United States, according two leading U.S. urologists.

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    The groundbreaking, 9-hour surgery was performed in December 2014 at Tygerberg Hospital in Bellville, Cape Town and led by urologist André van der Merwe, MB, ChB, of Stellenbosch University. The 21-year-old recipient's penis had to be amputated to save his life when he developed severe complications after a traditional circumcision.

    While such “ritual” circumcisions are rare in the U.S., two of the country’s leaders in sexual medicine told Urology Times the transplant surgery could play a role in certain patients.

    “To show that this is something that’s technically feasible, I think that’s great,” said Arthur L. Burnett, MD, MBA, of Johns Hopkins Medicine, Baltimore. “I think there are situations where men can sustain serious genital trauma in somewhat less sensational but more noble situations here, from war injuries to post-penile cancer penectomies. So I think there are some real indications.”

    “We are fortunate in this country that this particular injury—loss of the phallus after a traditional, non-medical circumcision—is vanishingly rare, but there are situations in which this might be applicable such as after various types of trauma or cancer,” added William O. Brant, MD, of University of Utah Health Care in Salt Lake City. “Currently, the approach is a ‘free-flap phalloplasty’ to create a new phallus, but this is also done uncommonly and by a few experienced practitioners.

    “In my view, the most important aspect of this surgery is that this 21-year-old man was cared for expertly and thoroughly,” Dr. Brant wrote in an email to Urology Times. “In both the lay press and even in the views of insurance payers, penile and sexual health is often treated as a purely cosmetic issue. Worse, it is often treated as something that is not important for patient health or quality of life.

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    “However, we know that phallic loss or significant erectile dysfunction (which might be better termed as ‘end-stage penile disease’) is a truly significant issue with ramifications that include loss of self-esteem, loss of relationship intimacy and communication, a decline in the man's feelings of general health and masculinity, etc.”

    NEXT: Not the first group to perform penile transplant

    Richard R. Kerr
    Kerr is group content director for Urology Times.


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