A urological team from Cape Town, South Africa recently published in the prestigious journal The Lancet a case report of Penile allotransplantation for penis amputation with 24 months of follow-up.
So far, four penile allotransplantations were published: one in Guangzhou, China, in 2005 (Unfortunately, removed after only 2 weeks), one in Boston and two in Cape Town. However, this is the first report of a penis transplant resulting in resuming penile function. The recipient first reported satisfactory sexual intercourse 5 weeks after surgery and subsequently, reported regular sexual intercourse from 3 months after the operation. Despite several acute complications, quality-of-life and physical health scores improved substantially after the operation. At 24 months, maximum urine flow rate was within normal range, and mostly, IIEF score was normal, confirming restoration of erectile function.
The authors recalled that in South Africa many men are rendered aphallic due to severe complications of traditional circumcisions. So far, the only available reconstructive surgeries after penile loss were phalloplasties and prostheses. This report shows that penile allotransplantation is now a feasible option that can give hope to many mutilated men.
Obviously, the benefit of a successful penile transplant must be weighed against the inevitable lifelong immunosuppression, laying the emphasis upon selection of the recipients, and the ethical issues pertaining to the procedure.
Eric Huyghe MD
Department of Urology, Toulouse Rangueil University Hospital, Toulouse, France