'The best decision in my life': an American with transplanted genitals spoke about his feelings
A US Navy veteran, one of four men who had a penile transplant, said he thought about suicide after losing both legs in Afghanistan, but now he feels “normal.” Writes about it Dailymail.
The veteran, who had the fourth and most difficult penile transplant in the world, said it was "the best decision he has ever made."
The US Navy soldier, known only as Ray, looked after wounded soldiers during an Taliban ambush, and in 2010 he stepped on a roadside bomb.
Over thirty, Ray lost both legs, genitals, and part of the abdominal wall, and after a tragic accident was forced to learn how to walk with prostheses.
After the operation in 2018, the soldier stated that he even thought about suicide.
A team of doctors from Johns Hopkins University in Baltimore successfully transplanted a new penis and scrotum from a deceased donor to Ray's body, making him the fourth patient in the world to receive such a transplant - and the most difficult operation ever.
Ray said that he was almost used to his new organ, and that he was also able to urinate normally.
In an interview, he said: “I have no regrets. It was one of the best decisions I have ever made. ”
For the first time, speaking to the media about his injury, Ray said that he "remembers everything."
“I remember thinking quickly, 'This is not good.' “It was one of those traumas that really stress you and you think, 'Why am I continuing to live?' Probably, I always just kept the hope that everything can still be fixed, ”the young man recalls with bitterness.
In 2013, Ray met Dr. Richard Redett, a plastic surgeon at Johns Hopkins Medicine in Baltimore, who decided that he might be the perfect candidate for a penile transplant. His team runs a program aimed at transplanting a penis to 60 soldiers.
Ray said, “Actually, that could fix me. I could return to normal again. ”
Before Ray, there were only three penile transplants - the first was in China in 2006, but without success.
Ray received life-changing news in March 2018, a donor appeared in another state. The operation was performed by 25 surgeons.
“We felt so confident that we could do something we had never done before,” said Dr. Redett.
Most men who need a penis undergo phalloplasty - a penis made from tissue, blood vessels, and nerves taken from the forearm or thigh.
“For Ray, there was only one way out: either a transplant or live the rest of his life with this defect,” said Dr. Redett.
During the operation to create the penis, there is a high risk of infection, and the patient does not restore its natural use.
General penile transplantation, when part of the body is transferred from one person to another, is called a vascularized composite allotransplantation.
Ray could have had a transplant because he had an urethra and a certain set of blood vessels designed for transplant work.
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Surgeons had to suture nerves, arteries, veins and blood vessels thinner than human hair. The donor scrotum was also transplanted.
To ensure success, the Ray procedure should be more extensive than any of the previous transplants.
Not only did Ray's surgical team, led by Dr. Redett, have to collect a donor penis and attach it to Ray's body, the situation was complicated by the fact that as a result of the explosion, part of the abdominal tissue, part of the thigh, and also his scrotum were affected.
For ethical reasons, the testes were not transplanted to avoid the risk that the patient will have donor children.
Doctors had to prevent the death of each interconnected part. If one area began to die, the rest could not function.
They also had to take two major arteries and veins to attach to the intact veins of Ray's penis.
Dr. Redett and his team practiced this process many times until they adjusted the best procedure for the operation and remembered the location of each vein, artery and nerve.
Dr. Redett and his team operated on the veteran for almost the entire day.
The operation took 14 hours - longer than during the previous three transplants.
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Ray's intact urethra was attached to his new penis, nerves, arteries and veins were connected, abdominal tissue, penile trunk and scrotum were reassembled, and the skin was replaced.
“You know how to do this, but you can only breathe a sigh of relief after the blood has flowed through the last blood vessel released from the clamp,” said Dr. Redett.
It is not clear whether his scrotum is empty or contains testicular prostheses. He will not be able to have biological children because his own reproductive tissue has been destroyed.
However, he takes testosterone to compensate for the loss of his testicles, and is undergoing treatment with another drug, Cialis, to stimulate spontaneous erection.
Ray had to wait two days after surgery before he first saw the transplanted organ, describing it as "swollen" and in need of treatment.
“Deep down, you know that this is a transplant, and you are wondering what came of it all. After I went through the operation, all these problems just disappeared, ”he said.
Dr. V.P. Andrew Lee, chairman of the plastic and reconstructive surgery department at Johns Hopkins, said they hope that Ray will be able to achieve orgasm, but he will not be able to ejaculate because he does not have testicles.
After surgery, Ray was assigned an immunosuppressive regimen to prevent tissue rejection, which is a problem with any transplant operation.
Urologist Andre Van der Mervecalls, a South African surgeon who performed the world's first successful penile transplant in the 2014 year, said the Ray procedure was “the most difficult to date” due to the extent of his injury.
Despite the fact that he left his identity a secret, and only relatives knew about the operation, Ray said that he wanted to let other veterans know about such opportunities.
The wars in Iraq and Afghanistan led to an unprecedented number of soldiers with genital injuries.
According to a report published in 2017, between October 2001 and August 2013, 1367 male US soldiers received one or more genitourinary injuries.
When bombs explode from below, high-tech protective equipment can protect the body and vital organs of soldiers, but their genitals are vulnerable and are directly in the path of the explosion.
Military urologists wrote that the number of groin injuries received “reached a level that has never been recorded in the history of war”.
Most injuries have been associated with external genitalia, including the scrotum, testicles, penis, and urethra, which may interfere with certain functions.
According to the US Department of Defense TOUGH (Injury and Urogenital Health Results) report, almost 94 percent of patients were 35 years old and younger “at peak years of sexual development and reproductive potential.
TOUGH says that among foot soldiers with genital urinary tract injuries from Iraq and Afghanistan, 502 were so seriously injured that penile transplantation might be their only option.
As ForumDaily wrote earlier:
- 26 March 2018 year the penis, scrotum and part of the abdominal wall were transplanted to the veteran from a deceased donor. The donor's testicles were removed for ethical reasons in order to avoid the risk that the patient will have donor children.
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