Back in 2012, Massachusetts resident Thomas Manning, now 64, received a diagnosis that would change his life.
Doctors told him he had penile cancer, a rare type of cancer that hits just over 2,000 men each year, according to data from the American Cancer Society.
Surgery is the most common treatment. So in order to save his life, doctors performed a procedure called a partial penectomy, a surgical technique in which the cancer—and most of the penis—is removed.
The treatment left him with an inch-long penile stump and the need to sit down to urinate. It also removed any kind of intimacy from the equation.
But all that may change. On Monday, Manning became the first man in the United States to receive a penile transplant.
What Is a Penile Transplant?
While heart transplants have been around since 1967, penile transplants are still experimental. In fact, only two other transplants have been reported worldwide.
The first one, back in 2006 in China, failed. But the second one, in South Africa in 2014, was successful. That recipient even reportedly fathered a child a few months later.
The science behind penile transplants - officially called genitourinary vascularised composite allograft (GUVCA) transplants - is pretty complicated.
“It would take a huge orchestration of nerves, blood vessels, and urethra to all come together to make (a penile transplant) work,” says Dr Andrew Kramer, a urologist at the University of Maryland Medical Centre, told us previously.
Plus, along with restoring urinary and sexual function, another goal of a penile transplant is to have the reconstructed organ resemble a normal penis, which adds to the challenge.
How Penis Transplants Work
A deceased anonymous donor - who matched Manning in blood type and skin tone -provided the penis for the transplant.
The operation, which took place at Massachusetts General Hospital, took 15 hours and included 7 attending surgeons, 6 fellows/residents, and more than 30 additional staff.
Surgeons worked to connect the arteries, veins, nerves, urethra, and pieces of skin from the donor penis to Manning’s body.
Their goal? To reflect an anatomically correct penis - and to help make sure it eventually functions as it should.
That means if the transplant is successful, Manning will be able to urinate normally.
The doctors are also “cautiously optimistic” that his sexual function will be restored, they said in a statement.
But it’s not an overnight process—achieving urinary and sexual functioning may take 6 to 12 months, according to doctors at Johns Hopkins who are also preparing to perform penile transplants.
So What Happens Next?
Currently, blood flow has been restored to the donor organ, and Manning’s body shows no signs of rejecting it, the Massachusetts General statement also said.
But like any other kind of organ transplant, rejection still is a real concern with a penis transplant. That means that the recipient’s immune system could identify the transplanted organ or tissue as foreign and attack it.
The doctors who performed Manning’s transplant say that the risk of rejection is 6 to 18 per cent during the first year.
In order to minimize the chances of rejection, doctors must choose a donor who matches the recipient in blood type, which makes it less likely his immune system will attack the new organ.
Organ transplant recipients also reduce their chances of rejection by taking medications to suppress their immune system. They take these drugs for the rest of their lives, and as a result, remain at higher risk of coming down with infections.