Doctors who performed the world's first successful penis and scrotum transplant did not transfer the deceased donor's testes to the patient for various ethical considerations.

The team of nine Johns Hopkins plastic surgeons and two urological surgeons excluded the donors' testicles during transplant subsequent to consultations made with bioethicists. The latter advised that the sperm-generating testicular tissue would make it possible for the patient to have children but with the donor's genetic DNA.

Sexual Functions

The patient, a U.S Armed Forces veteran, hopefully would regain almost normal urinary and sexual functions through time, says Wei-Ping Andrew Lee, director of plastic and reconstructive surgery at the Johns Hopkins University School of Medicine.

Sensation in the penis area and the ability to get an erection will also return in about six months, adds Richard Redett, a plastic surgeon and the clinical director of the genitourinary transplant program.

As for bearing children in the future, the patient will not be able to have biological offspring especially that he was not given a new set of testicles.

A child conceived with donated testicles would have the genetic composition of the individual who gave the testes, explains Damon Cooney, a plastic surgery professor at the Johns Hopkins. This simple premise could make for complicated ethical debates. Cooney adds, however, that a testicle transplant is medically achievable if not for this ethical concern. 

For the case at hand, the testicles donor was already dead and could no longer be asked for his consent.

"It's effectively a sperm donation without consent, and that should not happen," highlights Jeffrey Kahn, director of the Johns Hopkins Berman Institute of Bioethics.

Transplanted testicles, in general, would continue to produce the sperm that has the DNA composition of the organ donor, adds Michael Eisenberg, a urologist at Stanford University.

Aside from the penis and scrotum, the patient also received bone marrow infusions from the donor.

Veteran Has New Penis and Scrotum

The patient, who wished to remain anonymous, was severely injured when an improvised device exploded while serving in Afghanistan. He also lost both legs in the explosion.

After the 14-hour medical procedure, the patient woke up feeling finally more normal. He said he gained back a level of confidence.

He described losing his genitals as a mind-boggling injury. "It is not an easy one to accept," he says.

The donor's family members, meanwhile, were supportive of the veteran and the team of doctors at Johns Hopkins. In a statement, they said they feel proud that their family member was able to help the man who served the country.

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