Doctors just performed the first penis transplant in the US

A 64-year-old cancer survivor has received the first penis transplant in the United States, The New York Times reported.

A team of about twelve doctors and more than two dozen additional healthcare workers completed the extremely complex 15-hour surgery at Massachusetts General Hospital on May 8 and 9.

“We’re cautiously optimistic,” Dr. Curtis L. Cetrulo, a leader of the surgical team, told the Times. “It’s uncharted waters for us.”

Doctors hope the patient, Thomas Manning, will regain the ability to urinate normally and — eventually — sexual function, but the procedure is highly experimental.

Before this surgery, only two full penis transplants had ever been reported in the world: an unsuccessful one in China, and a successful one in South Africa in 2014. (The South African man conceived his first child last year.)

Donor penises come from recently deceased men, whose families have to specifically agree to the donation.

After the surgery, transplant patients have to go on drugs that suppress their immune system so that their body doesn’t attack the foreign organ, which can make them more susceptible to infections.

Part of the reason the full penis transplant is so complicated is that there are so many nerves and blood vessels that have to be connected under the skin tissue.

Penis transplant graphicTuffaha, et al., Plastic and reconstructive surgery, 2014An illustration of how a penis transplant works.

Manning began his journey to the operating table in 2012, when he was injured at work. Doctors at the hospital where he was being treated spotted something troubling: A growth on his penis that turned out to be cancer.

Penile cancer is very rare, with about 2,000 new cases in the US each year and 340 deaths. Manning’s cancer was especially aggressive; it might have killed him if doctors hadn’t noticed it when they did.

To save him, they had to remove nearly all of his penis.

He was left, Denise Grady writes in the Times, with “a stump about an inch long. He had to sit to urinate. Intimacy was out of the picture.”

He started asking about the possibility of a transplant almost immediately.

In December, a front-page story in The New York Times had reported that the first US transplant could happen in the next year. Doctors at Johns Hopkins University were planning to perform the procedure on 60 men — focusing on injured veterans who had lost at least three-quarters of their penis, according to information from the clinical trial.

But after Manning’s story came out, Dr. Cetrulo told the Times that the Department of Defence “does not like to have wounded warriors undergo unproven techniques — i.e., they do not want them to be ‘guinea pigs,’ as they have already sacrificed so much.” The plan now is to work out the technique on civilians first.

Eventually, however, surgery could be potentially life-changing for many veterans. Nearly 1,400 men had their genitals wounded in Iraq or Afghanistan between 2001 and 2013, the Times story reported.

As surgeons get better at performing complex transplants — recently of hands and even entire faces — conditions that are incredibly psychologically damaging but not life threatening finally have the potential to be treated.

“To be missing the penis and parts of the scrotum is devastating,” Dr. Richard J. Redett, one of the surgeons conducting the Johns Hopkins trial, told The New York Times. “That part of the body is so strongly associated with your sense of self and identify as a male.”

Read the full story in The New York Times here.

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