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15 “Gripping” Facts About America’s First Male Genital Transplant

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15 “Gripping” Facts About America’s First Male Genital Transplant

via USAToday

Last May, one man had a surgery performed on him that no other man in the country has ever had. Only two other men in the world have, in fact, and one was successful and one was not, giving our man a 50/50 shot. But 64-year-old Thomas Manning of Halifax, Massachusetts, is no ordinary man when it comes to his male member.

First of all, for four years he had no genitalia. Most men would let that fact ruin them, or depress them, or embarrass them. But Manning did none of those things, and he publicly shared details and gave interviews when he eventually had another man’s genitalia transplanted onto his body. A true inspiration for his openness and desire to help others in his situation, Thomas Manning was the perfect candidate for that reason alone.

That being said, there is a ton of crazy information about the actual surgery, and like me, I am sure you are dying to know the details. A testament to just how far a human being will go to feel normal again, the world’s two other recipients raise questions about the psychological consequences (for both the patient and his spouse, who is essentially having sex with another man’s male member) and moral ones (one of the two fathered a child with that “other” genitalia). Some doctors believe it is not ethical, nor, from a medical standpoint, feel it is not worth compromising the immune system for the rest of the recipient’s life, and therefore will not perform it. But doctors in two Massachusetts hospitals feel just the opposite, and made Manning their first patient.

Read on to find out these 15 details about America’s first ever penis transplant. I know you’re curious!

15. It Took A Team of 50

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I cannot even picture a room big enough to hold 50 surgeons, doctors, and nurses, not to mention the patient, his bed, and all of the medical equipment needed to perform a landmark surgery such as this. But such a room must exist, because this huge team all worked together to perform Thomas Manning’s genitalia transplant. Some other numbers are: 15 (the number of hours it took, so the team of 50 probably rotated in and out), and 3.5 (the number of years this surgery was “in the making”, with all the practice and preparation it took).

The surgery took place at Massachusetts General Hospital in Boston on May 8 and 9 of this year, and it has been called a “surgical milestone.” Manning said afterward, “Today I begin a new chapter filled with personal hope and hope for others who have suffered genital injuries, particularly for our service members who put their lives on the line and suffer serious damage as a result.”

14. Who’s Your Daddy?

via youtube.com

via youtube.com

According to Dr. Dicken Ko, director of Massachusetts General Hospital’s Regional Urology Program, the goal of a penis transplant is first to reconstruct the genitalia so it looks natural. Second is urinary function. Third, sexual function is not guaranteed but hopeful. Reproduction may be possible, but is not technically a goal of the surgery. This is because down the line, reproducing could potentially become an ethical issue if the recipient were to impregnate a woman, the issue being who the potential father is (it sounds like an amazing paternity episode of Maury Povich waiting to happen!).

Obviously, all the other goals take precedence over reproduction. I think even getting a “normal”-looking genitalia, and urinary and sexual function would be good enough without needing to have the ability to reproduce. Plus, the dude is 64, anyway, although that is nearly 20 years younger than one of Hollywood’s newest dads, Mick Jagger (yuck).

13. Urged To Keep It A Secret

via usatoday.com

via usatoday.com

Thomas Manning was encouraged by people close to him to keep the surgery a secret. But he did no such thing, obviously. Manning said he does not advertise, but he won’t lie about it, either. If someone asks, he will talk about it. He is not ashamed, and says he has nothing to be ashamed of. I tend to agree, and I like that a man is being so open about something that so many men would consider taboo or embarrassing.

Manning says that men tend to judge masculinity by their bodies (especially one specific appendage- the one he happened to be lacking). He was toughened up by some of his male friends poking fun at him about it, but does not seem disturbed in the least. Since the surgery he has been interviewed, photographed, and the subject of countless articles and news reports regarding his transplant. Doctors reported that he had a very healthy emotional outlook on everything. It sure seems like it!

12. Three Years In The Making

via massgeneral.org

via massgeneral.org

Massachusetts General Hospital (above) spent three years in various preparations for this operation. Some of the things they did to prepare themselves for this surgery none of them had ever performed are things I thought they would have already done in medical school. They dissected multiple cadavers to map out the anatomy (perhaps medical school did not provide adequate in-depth penile dissections?), and they operated on “five or six” donated bodies to practice removing the tissue needed for the transplant. Practice makes perfect, as they say, and even though apparently they only “practiced” a half dozen times, it seems as though they got it right when it came to the big day. That is quite a bit of time, money, and effort by a significant amount of people over three years to prepare for this one surgery. And they did not even know who they would be doing it on through those three years of practice.

11. A Baby Could Still Happen…

via wecare.com

via wecare.com

Even though reproduction is technically not a goal for those who undergo a genitalia transplant, it can still happen. The second-ever procedure of this kind took place in Cape Town, South Africa, on December 11, 2014. By the next June, it was announced to the world that his girlfriend was not only pregnant by him, but already four months along! That means that everything started working for the anonymous 21-year-old man pretty quickly.

In March 2015, his surgery was officially pronounced a success (the world’s first success), as his urinary and sexual functions were all fully restored (and apparently, had been for at least a month). This man’s original penis (that sounds so weird) had been amputated in a life-saving procedure after a ceremonial, coming-of-age circumcision that went awry. Perhaps because of the recipient’s anonymity, there have been no further reports of the pregnancy or birth of the first child ever conceived after a genitalia transplant. Pictured above: part of the surgical team that are credited with the first-ever successful penis transplant.

10. The One That Started It All

via wikimedia.org

via wikimedia.org

Before Thomas Manning, and even before the South African man, there was the first-ever penis transplant in Guangzhou, China in 2006. The transplant was ultimately dubbed a failure, but not necessarily because it didn’t work. The recipient, who had lost his own penis in an accident earlier that year, ended up with a surgery that was actually considered a success, as ten days post-operation, the organ had a rich blood supply, the man could urinate normally, and there were no signs of his body rejecting the foreign appendage. So what went wrong? Despite the fact that it was a surgical success, the patient and his wife could not overcome their severe psychological reaction to it, and two weeks after first attaching it to his body, surgeons cut it off.

Doctors in other countries who have performed transplants on body parts such as the hands, legs, or even the face, say that a psychological struggle is not uncommon, as recipients often see their new body part only as that of a dead person, and they do not see it as a true part of their body.

9. Donor Family & Manning To Have A Doughnut Date

via washtimes.com

via washtimes.com

I think donating a deceased family member’s most private of parts (much less discussing it with doctors and knowing it is still out there somewhere, along with about a million other weird thoughts) would be a very challenging thing to do. Obviously, there are a select few people who can do that, and then there is the family of Thomas Manning’s new organ, who went above and beyond just donating their younger family member’s penis. They have also “reached out” to Manning, according to him. It is beyond me why you would want to “reach out”, or hang out, or meet, or even talk to the dude now walking around with such a strange and personal part of your late loved one’s. It would just be weird. I could see any other body part, but a man’s genitalia? Anyway, the two sides hope to form a friendship, and Manning suggested starting that friendship by going to Dunkin’ Donuts. Odd.

8. The “Stump”

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After Manning’s penis had to be amputated due to his aggressive penile cancer (which, by the way, affects 2,000 people per year, around 340 of whom die), he was left with a “one-inch stump”. He could only urinate by sitting down, or doing it into a bottle. Obviously, intimacy was out of the question. He lost his penis four years ago, and had been living with the embarrassment and physically challenging “stump” ever since that fateful day in 2012. That day, he’d had an accident at work. Heavy equipment had fallen on him and caused severe injuries. It was in the emergency room while treating those injuries that doctors first noticed an abnormal growth on his penis that Manning himself had not. It turned out to be a serious and potentially fatal type of penile cancer. But, as we have come to expect from him, Manning retains a positive view even on that accident, saying, “If not for the accident, I would’ve been in the ground two years ago.”

7. The Waiting List

via yahoo.com

via yahoo.com

There are currently two men (that we know of) on the waiting list to have this same surgery. The first is a man whose penis was destroyed by burns in a car accident, and the second is a combat veteran who was injured in Afghanistan. This man is going to have his surgery done at Johns Hopkins instead of Massachusetts General, where Manning went, and where the car crash victim will go once a matching donor becomes available (how do you go about “matching” such a thing, anyway?). Both of these planned surgeries are costing between $50,000-$75,000, but both hospitals are footing the bill and the doctors are all donating their time. Dr. Curtis Cetrulo of Massachusetts General stated that they will continue to do this surgery on civilians to perfect it before moving onto wounded veterans, a group who has a real need for it, and who no one wants to be the so-called guinea pigs, as they have sacrificed enough. They will even train military doctors to perform penis transplants.

6. Eye On The Prize

via nymag.com

via nymag.com

There was a time back in 2012 when it probably felt to Thomas Manning like it could be an eternity- literally or figuratively- before he got a new penis, if he ever did. After his partial penectomy (a procedure that a few hundred men per year undergo due to cancer), Manning began inquiring about the rare option of a penis transplant before he was even discharged from the hospital. No one there, or even in the country, was even considering such a thing at that time, and even Manning’s own doctor thought the idea was preposterous. But as Manning says, he “kept his eye on the prize”, never giving up hope. It was three years before his doctors asked him if he was still interested in having it done. He was, of course, and it was only an astonishing two weeks before a donor matching his blood type and skin tone became available.

5. The Organ Banks

via neob.org

via neob.org

Dr. Cetrulo says one of the main reasons Manning’s surgery happened so fast was because of the New England Organ Bank. They are the ones who ask the families of the dying about considering organ donation. They do not assume that any family who donates internal organs will also be willing to donate less common parts for transplant, such as a face, hands, or in Manning’s case, a penis. Visible and/or intimate parts like these have only recently begun to be experimental transplants, so when a family is asked about organ donation in general, this is a separate request. However, to my surprise, apparently several families so far have agreed to allow the penis to be removed, and “none have declined”, according to Jill Stinebring, the New England Organ Bank’s Regional Director of Organ Donation Services. Luckily for Manning, time and luck was on his side, and a match was found for him practically immediately, compared to other people waiting for vital and non-vital organs.

4. Veterans are the Focus

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It came as a surprise to me (but not after I actually thought about it) that there is a huge need for penis transplants among army veterans. It makes sense, but I suppose it had never really crossed my mind before. From 2001-2013, 1,367 men in the military suffered “genitourinary” injuries in Iraq or Afghanistan, according to the Department of Defense Trauma Registry. Most, if not all, of these injuries could be helped with penis transplants. Most of these men were under the age of 35 and had lost their penises (all or part) to homemade bombs, also known as improvised explosive devices, or I.E.D.’s. So, therefore, veterans are a very large focus of upcoming surgeries of this sort. These men have already been through so much, and then came home to not even being able to go to the bathroom standing up, along with many other issues. It is a different kind of wound that is almost worse than losing a limb like so many do, because of the stigma associated with a man not having a penis. It is therefore not noticeable or talked about.

3. It is Lifesaving

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Perhaps it is not lifesaving in the traditional sense, but a penis transplant truly could save a life. This is because many veterans who come home from war (already suffering from post-traumatic stress) having lost all or part of their penis contemplate committing suicide. The shame added to everything else is often too much to bear and Dr. Cetrulo, for one, definitely believes he can help save lives this way. Especially for the younger men, the 18 to 20-year-olds, with literally everything to look forward to in terms of sex for the rest of their lives, having the hope of intimacy (where there was none before) can make all the difference.

For now, the surgery is still considered experimental, but hopefully in the near future, reconstructive surgery and transplants can help these men lead the lives they deserve after they have sacrificed so much. Because if anyone deserves to be healthy and happy, it is the people who defend our right to freedom, risking their own lives and often paying a steep price.

2. The Process

via nytimes.com

via nytimes.com

As we have seen, once a donor is found (matching the recipient’s blood type, skin tone, and being within five to 10 years of his age), doctors have only a few hours to remove the deceased man’s penis and pelvic muscles, and get it to the operating room. Dozens of medical professionals who have prepped long and hard for this will be waiting with the recipient ready to go, meaning his skin and muscle have already been cut away to expose dozens of blood vessels, nerves, and the urethra, which is where urine and semen flow through. All of these new parts must be stitched to the recipient’s, which as you can imagine is very time-consuming and must be done with the utmost precision. These connections, due to the fact that they are in the penis, are very tiny and complex, making a difficult procedure even harder. To add to that, each surgery is unique depending on the patient’s specific injury and anatomy. The patient is also injected with some of the donor’s bone marrow to minimize the chances of the recipient’s body rejecting it. Before all of that (and after all of it, as well), patients are required to undergo psychological counseling.

1. No Guarantee

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As with any surgery, it is a risk. Any time you are operated on, things can go wrong. Especially considering this surgery is so new and still experimental, the men undergoing this procedure should maintain a healthy level of hope, meaning they should not get it up (haha). There is always the risk that a patient’s body could reject the penis, no matter how much bone marrow he receives, or how great of a match to the donor he is. Furthermore, there is no promise of sexual function. The recipient may not be able to get an erection, forcing him to take Viagra or even getting a penile prosthetic (yes, it’s a thing). A penile prosthetic is an inflatable synthetic device surgically inserted into the chambers of the penis. The man can then pump in fluid whenever he desires an erection. Those who suffer from erectile dysfunction use these prosthetics. And as we saw with the Chinese guy, even if everything is physically perfect, that still may not be enough to make it a success. So for the recipient of another man’s penis, there are many unknowns and until it happens, whether or not it is successful is up in the air.

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