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Johns Hopkins surgeons perform world's first male genital transplant
- craftyguy 9y agoJust like in the intro to Idiocracy.
- dvt 9y agoTake this garbage back to reddit. The recipient was a young Afghanistan vet who lost his urinary as well as sexual function. Have some empathy without resorting to some cheap internet laugh.
- givehimagun 9y agoI want to say +100 to what you said but as a Redditor, don't even bring it to Reddit...it's not welcome there either.
- fastball 9y agoDoes anyone have an idea as to why the testicles weren't included in the transplant? My best guess is that the testosterone produced wouldn't be "compatible" with the recipient and they would want to avoid an immune system rejection? Additionally, I suppose that if sperm is still being produced, you could effectively impregnate a woman with someone else's DNA. That would be... strange. I can see how that might be unwanted by both parties.
- ocdtrekkie 9y agoThe article I read earlier specifically said there were ethical concerns with him potentially being able to father children with the donor's genetic code. Which is a weird ethical concern I'd be intrigued to read more about.
- badosu 9y agoThat creates an interesting twist: since DNA test is legally acceptable as fatherhood proof the recipient could create a lot of trouble for the donor.
- fastball 9y agoI'd assume that the donor in every case (as in this case) would be diseased, so I'm not certain how that could be an issue for the donor.
- ars 9y agoThere have been lawsuits about children born to deceased fathers and inheritance. So it's a real issue. For example: https://www.cbsnews.com/news/can-kids-inherit-sperm-donors-federal-benefits/ https://www.cbsnews.com/news/can-kids-inherit-sperm-donors-f... https://cathompsonlaw.com/estate-planning-for-your-embryos-do-you-have-a-plan/ https://cathompsonlaw.com/estate-planning-for-your-embryos-d...
- mistersquid 9y agoPerhaps it would be possible (ethical?) to set up a system to provide organs from post-operative female-to-male transgender patients to potential recipients.
- khedoros1 9y agoDid you mean male-to-female patients (assuming that you're trying to provide penises)? My understanding is that most of the structure of the penis is used to craft various structures of the newly constructed female genitals (shaft for the vagina, glans for the clitoris, and so on).
- mistersquid 9y agoOh dear, I did mean male-to-female. <embarrassed face> Thank you, also, for clarifying that male-to-female gender reassignment surgery wouldn't result in an organ that could be donated.
- killjoywashere 9y agoThe testes are immunoprivileged. Transplanting testes would probably result in dead nubs of fibrous tissue after a couple years or severe immunosuppression requirements. Even autologous testicular tissue transplant has had only a 1 in 7 success rate (https://www.newscientist.com/article/dn1851-man-fathers-child-after-testicular-transplant/ https://www.newscientist.com/article/dn1851-man-fathers-chil...)
- luddaite 9y agoAdditionally the testes derive their blood supply from the testicular arteries that branch off the aorta all the way up in the abdomen. I would imagine that 'hooking them up' would be a much more complicated surgery since the vessels would have to be passed through the pelvis into the scrotum.
- encoderer 9y agoOh man it’s like having to pass props all the way down through my react components. No wonder the surgeon closed as #wontfix.
- onion2k 9y agoJust need the context API for blood... Somehow.
- davidkuhta 9y agoGraftQL
- mifeng 9y agoNominated for comment of the year,
- killjoywashere 9y agoWell, there are plenty of big arteries in the pelvis the surgeon could anastamose with, and you can harvest the donor artery as far up as you want (it supplies nothing else), so I'm not sure the arterial supply is really the problem. Venous drainage could be a problem. The other thing: they may actually plan to do those transplants down the line, but there's no sense in doing them if the scrotum fails to take.
- deleted 9y ago[deleted]
- philwelch 9y agoThey did transplant the scrotum. I wonder if they included some cosmetic testicles just to make the patient look more "fully equipped".
- serf 9y agopet owners have been doing that for years. [0] [0]: https://www.neuticles.com/ https://www.neuticles.com/
- johnp_ 9y agoWhy not just keep the testes? https://www.parsemus.org/projects/calcium-chloride/ https://www.parsemus.org/projects/calcium-chloride/ Two intratesticular or intraepididymal shots are far cheaper and so much less invasive than two surgeries.
- DoreenMichele 9y agoMy kneejerk reaction is that I imagine appearances are a low priority here compared to regaining basic functionality. I say that as someone who was quite vain about my looks when I was young, but chronic health problems have drastically changed my priorities. That's not intended as dismissive. I just kind of feel like it's a detail likely to be a low priority at this stage, what with it being groundbreaking surgery to begin with, etc. This article indicates he's also missing his lower legs: https://www.npr.org/sections/health-shots/2018/04/23/605054470/veteran-receives-penis-transplant-to-repair-war-wound https://www.npr.org/sections/health-shots/2018/04/23/6050544... No indication if they made the scrotum look like there are testes.
- fjsolwmv 9y agoIf they don't add cosmetic testicles, it's a constant reminder that testicles are missing, which causes psychological stress.
- bonesss 9y agoCosmetic testicles would be tremendously simple, too, compared to the operations complexity. Google tells me that "testicular prostheses have been used for 50 years to replace missing or removed testes"... I would speculate that they would be a relatively simple addition to the surgery itself, but at the very least it would be very simple to do as an additional operation once the transplant stabilized.
- deleted 9y ago[deleted]
- bayesian_horse 9y agoThe testes don't provide a useful or vital enough function for the recipient to warrant the additional risks and effort. Really, the only thing a male body normally needs its rocks is to produce some hormones. Those are easily substituted. Simple silicone implants will satisfy aesthetic properties. The tactile nerve endings aren't vital to recreative copulation.
- delecti 9y agoAs trans people, post-menopausal women, and diabetics can tell you, your body doesn't care where the hormones came from as long as it's the same substance.
- monochromatic 9y ago>male genitals There is nothing male about penises, and it’s hate speech to suggest otherwise. Reported to the cyber police.
- visitor7yu 9y agowithout the testes. he would be able to function sexually and orgasm? will it not be like castration
- zik 9y agoWhile sperm is produced by the testes, most of the semen is produced by the prostate gland which is inside the body - not in the testes.
- purpleidea 9y agoWrong. The semen is produced by the testicles. The ejaculate is produced by approximately three different glands: 1) Testes - produces the semen (1% of the total volume) 2) Prostate - Sugars, etc (30%) 3) Cowper's Gland - mucoproteins, etc...
- delecti 9y agoSperm are produced by the testes, but sperm are a minority of the semen.
- khedoros1 9y agoHe's probably undergoing hormone replacement therapy, as well.
- amyjess 9y agoOrgasm is something that's generated entirely within the nervous system. As long as the nerves of the transplanted penis are properly hooked up to the right pathways, you can orgasm, though it will take some healing time for the nerves to come fully online. You don't need to have an erection or be able to ejaculate semen in order to orgasm. Most men associate orgasm with both, but neither is strictly necessary. Speaking of erections (probably the only time I will ever write these words on HN), they too are not dependent on having testes. Erection is a vascular response within the penis: much of the internal structure of the penis consists of sponge-like tissue that stiffens when filled with blood. Assuming the relevant blood vessels and nerves are properly hooked up, erection should be possible. Of course, you need to take into account healing time and the surgeons doing a perfect job hooking everything up. Testosterone plays a role in signalling for an erection, but you don't need testes for that either: the adrenal glands produce a small amount of testosterone, and exogenous testosterone such as from an injection, a patch, or a gel works just as well (and I would be very much shocked if this guy wasn't on exogenous T already). And in the absence of testosterone entirely, there's always Viagra. And some people can still achieve erections in the absence of testosterone even without Viagra, but this is extremely YMMV. He might even be able to ejaculate if everything is hooked up right, but it'll be watery seminal fluid without sperm. Though that does bring up one difference between this guy and a guy with testes: he's still going to have to take exogenous testosterone for the rest of his life for the sake of his mental health, body shape, and bones. And he'll never be able to conceive, of course.
- deleted 9y ago[deleted]
- akhatri_aus 9y agoThe first transplant was actually in South Africa, in Dec 2014.
- computerphage 9y agoSource?
- mikorym 9y agohttp://www.sun.ac.za/english/Lists/news/DispForm.aspx?ID=2328 http://www.sun.ac.za/english/Lists/news/DispForm.aspx?ID=232...
- russdill 9y agoThis is the first total penis transplant vs partial penis transplant. Previous transplants just attached to an existing "stub".
- justinator 9y agoArt imitates life. https://www.youtube.com/watch?v=byDiILrNbM4 https://www.youtube.com/watch?v=byDiILrNbM4
- DoreenMichele 9y agoThe surgeons and Johns Hopkins volunteered their services, which would otherwise have cost hundreds of thousands of dollars and wouldn't have been covered by veterans benefits or insurance, they say. (because it's still experimental) Hats off to the team of 11 surgeons involved in this (no doubt grueling) 14-hour surgery without being paid. Wow. Sources: https://www.npr.org/sections/health-shots/2018/04/23/605054470/veteran-receives-penis-transplant-to-repair-war-wound https://www.npr.org/sections/health-shots/2018/04/23/6050544... http://time.com/5250397/penis-transplant-johns-hopkins-university/ http://time.com/5250397/penis-transplant-johns-hopkins-unive...
- sitkack 9y agoThat is just the surgery itself, prep was hundreds of additional hours.
- ec109685 9y agoShameful veterans benefits doesn’t cover this. Clearly, if enough of these surgeries are done, the cost then will come down.
- DoreenMichele 9y agoOff the top of my head, my recollection is that lung transplants cost a cool half million on average in the year they occur, plus add ongoing expenses to care for the rest of your life. An article I googled earlier suggests similar costs for other transplant surgeries: http://www.nationalkidneycenter.org/treatment-options/transplant/affording-a-transplant/ http://www.nationalkidneycenter.org/treatment-options/transp... The figures given in this article don't appear particularly more than or out of line with other, more established transplant surgeries.
- userbinator 9y agoI like how the picture in the article almost looks like an access panel on the side of an insulated appliance, seeming to imply that it was as easy as connecting a few wires and pipes... if only[1]! The unrealistic "cleanliness" of these sorts of detailed medical illustrations continues to fascinate and slightly amuse me. [1] https://cdn2.tmbi.com/TFH/Step-By-Step/display/FH12JUN_WATHEA_04.JPG https://cdn2.tmbi.com/TFH/Step-By-Step/display/FH12JUN_WATHE...
- otempomores 9y agoJust imagine wrong nerve connection.. Pleasure = Pain
- himom 9y agoThis is really cool. In general, as an insurance policy against death or ‘nads injury, anyone planning to have kids in the near future and whom can afford it should bank their gametes now and set conditions in their living will / trust about their use. It’s ~$200 USD per year for cryostorage and usable for about 8 years, so rotating donations every year makes sense. If you’re a dude about 35-40, bank several times and get a vasectomy to control reproduction AND insure your potential offspring are the best of you sooner, rather than later, risking more genetic diseases AND insure against partner reproductive deception (relationship anchor baby) AND prevent greater female:male birth ratio due to Y chromosome age-related damage. Also note: attractive people have more girls. If you’re a rich OG with a young model, she’s likely going to water-birth girls. That’s just scientific fact.
- PhasmaFelis 9y ago> Also note: attractive people have more girls. If you’re a rich OG with a young model, she’s likely going to water-birth girls. That’s just scientific fact. What
- mythrwy 9y agoThat's what I said. After I picked myself up off the floor from laughing so hard. But then I goggled it and apparently there is some basis. Ya, I was surprised also. https://www.psychologytoday.com/us/blog/the-scientific-fundamentalist/201101/beautiful-people-have-more-daughters https://www.psychologytoday.com/us/blog/the-scientific-funda...
- agucho 9y agoHa! “The scientific fundamentalist”? I’d look for a second opinion.
- PhasmaFelis 9y agoI was gonna say "fundamentalism does not always imply religion," but I read a few of his posts and he's definitely a nutbar. E.g. "The females of all mammalian species, including humans, always have more power than the males, and, in every human society, women are slightly better off than men are." (Based solely on longevity and reproductive success, "the only two biologically meaningful measures of welfare.") It sounds like he's one of those "women are better off than men because they can get laid whenever they want and I can't" guys.
- garmaine 9y agoSerious question, not wanting to be crass, but does it “work”? That would be a huge breakthrough over reconstruction options that often require an implanted device to mimic an erection. It also, I imagine, requires a great deal of accuracy regarding the surgically connected plumbing in order not cause rupture and internal bleeding as a result of blood pressure.
- ofcourseianal 9y agoDid you read the article, or just the headline?
- garmaine 9y agoYes I read the article. My question was not answered in it.
- Harvey-Specter 9y ago> "We are hopeful that this transplant will help restore near-normal urinary and sexual functions for this young man." - W.P. Andrew Lee Director, plastic and reconstructive surgery
- garmaine 9y ago“We are hopeful” did not indicate success or failure.
- DoctorOetker 9y ago"They transplanted from a deceased donor the entire penis" Is there any research on the statistics of people signing up for organ donation, wealth, death rate etc. to objectively measure if people are ... left to die if the resulting organs are more profitable? A macabre thought indeed. "It's a real mind-boggling injury to suffer; it is not an easy one to accept," the recipient says. "When I first woke up, I felt finally more normal … [with] a level of confidence as well. Confidence … like finally I'm OK now." ^ this is exactly what worries me on the subjects of sex-change, -transplantation etc. : without even any time to recover, time to repeatedly re-assess the new condition, without anonimity (or rather a pseudonym signed by say the government, so that they can prove they actually underwent such an operation, without giving up their identity) how do we know they tell the truth? how can he already be happy without trying his new dick out? or is he really just being happy about officially having a dick again ? how do we prevent people who are fantasizing about a sex change from deciding something they will come to regret, especially if their only source of information is people who 1) did not provably undergo such an operation 2) are no longer anonymous to be able to speak freely how they feel about it?
- jobigoud 9y agoThere are several Internet communities where transgenders can talk pseudonimously.
- aninhumer 9y agoIndeed, I think part of the problem is that the only interactions a lot of people have with trans people is with political advocacy, where people are too busy trying to deal with rampant misinformation to ever get into nuance. And people then assume this is the only form of discourse that trans people ever engage in. Much as people like to deride "safe spaces" as echo chambers, actual safe space trans communities are far more open to discussing conflicting feelings, doubts, regrets etc. because they know people won't use those admissions to judge or invalidate them. Which is of course, exactly the point of a safe space. (PS: The preferred term is "transgender people" or more commonly just "trans people".)
- bayesian_horse 9y agoI can't really sympathize. At least to me, the risks involved in foreign transplants, and the drug regimen with all its effects, seem to outweigh the benefits. For others it may be different.
- jakobov 9y agoWhere are all the jokes?
- pjc50 9y agoI was going to make one about "Johns Thomas surgeons" but it needs a punchline transplant.
- josefresco 9y agoThis is Hacker News, not Reddit.
- mikorym 9y agoSo, just to clarify here; the first successful penis transplant was in 2014 in South Africa [1] (the same team again performed a successful transplant in 2017 [2]). The article posted however is the first penis and scrotum (without testicles for perhaps obvious reasons) transplant. [1] http://www.sun.ac.za/english/Lists/news/DispForm.aspx?ID=2328 http://www.sun.ac.za/english/Lists/news/DispForm.aspx?ID=232... [2] https://www.health24.com/News/Public-Health/see-sa-doctors-perform-second-successful-penis-transplant-20170522 https://www.health24.com/News/Public-Health/see-sa-doctors-p...
- leroy_masochist 9y agoAs a vet who knows a couple of guys who've suffered injuries to their genitals I'm really happy to hear this news. There's a huge stigma around not having a dick anymore and I can acutely remember thinking, before stepping out on patrol, that I'd rather die than have that happen to me. Hopefully this is just one step in a larger journey toward being able to replace damaged/destroyed genitalia with functioning replacements (ie re-growing new appendages using stem cells and patient DNA, etc).
- nylonstrung 9y agoI've read the suicide rate among vets with genital injuries is over 25%. Tragic.
- cat199 9y agoNot to downplay the vast significance of such an injury, but seems to me the far greater tragedy is that our society/culture places so much emphasis on sexual function that a 25% rate of suicide in such cases 'makes sense'. There's a lot more to life than sex - this is basically saying that 1 in 4 males don't think the rest of it is worthwhile otherwise..
- merpnderp 9y agoIs it society and culture or the single most important biological imperative our DNA can express, something hardwired into the parts of our brains older than life on land?
- textor 9y agoCertainly it isn't hardwired in any relevant manner, and people are in fact just fine not reproducing, see vasectomy. Don't just repeat platitudes. People are killing themselves over not being able to have sex, or rather not being able to prove they're proper functional men. It has at least as much to do with social status as with actual sex.
- jk2323 9y agoYeah. Another reason for being an organ donor. Remember, even when you are dead, you best friend could still be working :-)
- otempomores 9y agoHere lies jk2323 except for his best friend who is currently standing in attention in a bus station in Amsterdam.
- toblender 9y agoI'm surprised they were able to reattach the nerves as well. Isn't that something that can't be reattached after being severed. If nerve reattachment now is possible, can't we cure quadriplegics?
- fwdpropaganda 9y agoThey've been able to put penises in women for a while, but only just now they've been able to put them in men? What am I missing?
- pbhjpbhj 9y agoIn construction of simulation organs the person's own tissues are used.
- fwdpropaganda 9y agoGot it, thank you.
- mkchoi212 9y ago
- mkchoi212 9y ago