BOSTON, May 16 (UPI) -- A man whose penis was amputated because of cancer four years ago received the first transplant performed in the United States, doctors in Boston report.
Surgeons at Massachusetts General Hospital conducted the first genitourinary reconstructive penile transplant in the country for 64-year-old Thomas Manning in early May, announcing today blood flow to the new organ has been established and he is expected to regain function.
The surgery is one of a handful done anywhere in the world -- one in China was ultimately unsuccessful, while a man in South Africa impregnated his girlfriend a few months after receiving a transplant -- and is part of a program to restore genital and pelvic function to military veterans, The New York Times reported.
Manning's doctors said they are "cautiously optimistic" he will regain normal urination and sexual function during the next several weeks, and expect his surgery to help establish techniques to provide more treatment for patients who have sustained injuries or lost their genitals because of disease.
"We are hopeful that these reconstructive techniques will allow us to alleviate the suffering and despair of those who have experienced devastating genitourinary injuries and are often so despondent they consider taking their own lives," Dr. Curtis Cetrulo, a surgeon in the Division of Plastic and Reconstructive Surgery and the Transplant Center at Massachusetts General Hospital, said in a press release. "The entire transplant team has worked tirelessly to ensure that our patient is on the path to recovery, thanks in part to the gift of organ donation."
Manning had a curative partial penectomy in 2012 after being diagnosed with penile cancer, with which around 2,000 men per year are diagnosed. The surgery to receive a transplant has been in planning by his surgical team for more than three years and required development of specific, new surgical techniques.
The 15-hour operation was performed on May 8 and 9, with doctors connecting the vascular and neural structures of a penis from a deceased donor to Manning, who has not shown signs of rejection or infection since.
The day after surgery, Manning hemorrhaged and had to be rushed back into surgery, but has not had any complications since.
"If I'm lucky, I get 75 percent of what I used to be," Manning told The Times. "Before the surgery I was 10 percent. But they made no promises. That was part of the deal."
In addition to another patient whose penis was destroyed by burns in a car crash awaiting a donor, who will be treated by Cetrulo, doctors at John Hopkins University are expected to begin a planned 60-patient study on penile transplants aimed specifically at wounded soldiers.
The first patient in that program is waiting for a donor organ, which requires explicit permission from the donor.
"These proof-of-principle cases will help establish the techniques used in this procedure and will forge the path to future treatment of patients with significant pelvic and genitourinary tissue loss related to cancer, trauma or infection," said Dr. Dicken Ko, director of the Urology Regional Program at Massachusetts General Hospital. "We are delighted to have taken the first steps to help those patients who have suffered silently for far too long."
