Hello. Yours is an interesting, although somewhat frightening,
question. I say "frightening" because surgeons encounter 'cut off'
penises in three circumstances: felonious assault, accidental injury
and self-mutilation. I am answering your question on the assumption
that you're just curious about it. But if it is self-mutilation or an
amputation fetish that you are 'really' thinking about, professional
help can save you from a terrible mistake.
The Answer:
It is fair to assume that a "penis transplant" might be easier to
achieve than a hand transplant, but there are no reported instances.
There are many reported cases of a person's own severed penis being
reattached (I review some of these below). Foreign tissue will always
carry a risk of rejection because the body's immune system will treat
it as an unwelcome invader. But powerful drugs have been developed
that make it possible to overcome the rejection response. So yes, it
could be done.
There are a number of cases reported in medical journals where
surgeons have successfully restored a person's own severed penis. The
reports don't say a lot about 'sensitivity' as you call it, but they
do report good restoration of erectile and urinary function.
"Current replantation techniques rely on microsurgical approximation
of the dorsal structures and cavernosal arteries with uniformly good
results. Phallic replacement may be necessary when the amputated
segment is lost. Microsurgical free forearm flap phalloplasty is the
current mainstay of penile replacement surgery. Although urethral
complications remain problematic, the results continue to be
acceptable with regard to appearance and function."
Jezior JR. Brady JD. Schlossberg SM.
Department of Urology, Eastern Virginia Medical School, The Devine
Center for Genitourinary Reconstruction, Norfolk 23510, USA.
Management of penile amputation injuries.World Journal of Surgery.
25(12):1602-9, 2001 Dec.
[Found via Medline; no internet cite is available.]
One such operation is described by a pair of surgeons in Brazil:
"On December 18, 2000, a 44-year-old Brazilian farm worker had his
penis avulsed [torn off], along with a portion of anterior thigh skin.
... Two hours later, he arrived at the emergency room in hemorrhagic
shock. ... The penis was improperly transported inside a plastic bag
full of water and ice rocks .... The patient was taken to the
operating room, where an initial examination revealed that the
perineal stump consisted of the proximal two-thirds of the corporal
bodies and a major portion of the urethra, both of which were denuded
of skin. The amputated part consisted of the entire penile skin, the
glans, the distal portion of the urethra, and the third distal part of
the corporal bodies."
Reconstructive surgery was undertaken:
"[W]e performed a suprapubic cystostomy and began dissection of the
structures in the stump and the amputated part. We performed
debridement on both sides, causing a slight decrease in penile length.
In the stump, all structures (two dorsal arteries, two dorsal nerves,
and one dorsal vein) were dissected. Unfortunately, the dorsal vein
was not suitable for anastomosis because of the trauma to it. However,
all structures in the amputated penis were preserved.
"After suturing the macroscopic structures (corporal bodies and
urethra), we began the microsurgical procedure using 10-0 nylon for
the anastomosis. We performed two neurorrhaphies, two arterial
anastomoses, and one venous anastomosis."
The procedure was a success:
"Following discharge [after 4 weeks in hospital], the patient
reported a gradual return of tactile sensation and the occurrence of
spontaneous erections. An Eco-Doppler demonstrated patency of the
vessels. Follow-up at 7 months revealed that urinary flow was still
good, with no sign of urethral stenosis [narrowing]."
Mayrink M. da Costa PR.
Successful primary microsurgical replantation of an avulsed penis.
Plastic & Reconstructive Surgery. 109(3):1202-3, 2002 Mar.
[Found via Medline; no internet cite is available.]
Here's another successful replantation:
"We describe the technique of microsurgical penile replantation and a
case followed up after two years. The patient was a young man with
decompensated schizophrenia who emasculated himself with a kitchen
knife. A particularly good functional result was achieved including
restoration of sensation in the penile shaft and in the glans, and
return of erectile capacity."
Lidman D. Danielsson P. Abdiu A. Fahraeus B.
Department of Plastic Surgery, Hand Surgery and Burns, University
Hospital, Linkoping, Sweden.
The functional result two years after a microsurgical penile
replantation. Case
Scandinavian Journal of Plastic & Reconstructive Surgery & Hand
Surgery. 33(3):325-8, 1999 Sep.
[Found via Medline; no internet cite is available.]
There are dozens more cases like this, but unless you're a surgeon
they're all going to sound the same (generally it is the successful
cases that get reported).
Since your question concerns the possibility of transplant, I also
looked further at how nerves are reattached in a transplant. As the
following case describes, modern surgical techniques do allow nerve
connections to be restored.
Here is an interesting case--a double hand transplant. And besides
attaching bone, tendon, muscle and skin, they were able to attach
nerves so the patient will have feeling in his new hands:
"The first hand transplants generated much discussion not only among
hand surgeons and transplant surgeons, but also the public and became
even more controversial after removal of the very first transplant.
The reason for this is simply that a hand transplant is not a
life-saving procedure, and its benefits must be carefully weighed
against the potential risks of long-term immunosuppression. Encouraged
by more recent results with experimental limb transplantation in large
animal models and the two clinical cases ..., we decided to perform a
double-hand transplant in a man who had lost his hands during an
attempt to deactivate a bomb and who already requested this transplant
shortly after the accident in 1994. The transplant was eventually
performed on March 7, 2000, after almost 1 year of waiting for a
suitable donor.
....
"After trimming and fixation of both bones with seven-hole metal
plates, the radial and ulnar artery were anastomosed with interrupted
8-0 Prolene sutures. After completing the cephalic and basilic vein
anastomoses, the right graft was reperfused after a total cold
ischemia time of 150 min. Next, all hand and finger flexors and
extensors were repaired. The ulnar, median, and the superficial
sensory branch of the radial nerve were then anastomosed with 9-0
nylon 12 cm above the wrist. The skin was closed, and an autologous
split-thickness skin graft was used to cover a small defect...."
Margreiter R. Brandacher G. Ninkovic M. Steurer W. Kreczy A.
Schneeberger S.
A double-hand transplant can be worth the effort!
Transplantation. 74(1):85-90, 2002 Jul 15.
So with these techniques, a penis transplant is possible.
Having read through many of these cases of a severed penis in
preparing this answer, I want to repeat my advice to you if you are
'really' thinking about it. It's not hard to find material on the
Internet about fetishism and 'body modification,' and you can read
about people on-line who are doing really scary things to themselves.
Just because some of these mutilations have been surgically reversed
doesn't mean they're not life-threatening, and a really bad idea.
Search terms used (on Medline):
penis and (replantation or amputation) and human
nerve regereration and transplant
I hope this answers your question. If you need further information
along these lines, or if any of my Answer is unclear, please use the
Clarification Request to tell me what you need. I would appreciate it
if you would hold off on rating this answer until I have a chance to
clarify my Answer.
Sincerely,
richard-ga |
Request for Answer Clarification by
emperoroftheuniverse-ga
on
24 Aug 2002 21:20 PDT
I like your answer so far, and for $8.00 it would have been more than
enough. But for 200, I'm afraid I'm going to need a little more.
First, if you must know, I'm not considering mutilating myself, nor am
I "just curious", I have something medically wrong with my penis,
which is not really fixable, and my doctor and I have discussed the
option of a transplant. That's why I want to know, if I did, would it
just be numb or would I still be able to feel normal, pleasure
sensation? Anyway, like I said, I would have to give the answer you
gave me a good rating, but, it's still incomplete. So, now that you
know what my deal is, maybe you could give me a little more specific
data on nerve tissue and how well it can be reconnected by different
various microsurgical techniques, what it's rate of actually "taking"
and providing sensitivity from a transplanted organ is, how much
sensitivity actually returns (full or just partial, or none, or
partial at first and possibly nearly full eventually?), as well as
other specifics of that nature. I know blood vessels can almost always
be connected, so I'm not worried about that. For both sensitivity and
function, nerves are the key. I want to know if I'm looking at a numb
penis or a fully sensitive one.
P.S. I know full well the situation of organ rejection, which is why I
am prepared to wait for a clone penis which my body wouldn't reject.
Of course they will soon be doing theraputic cloning in England, in
probably less than a year or two, and since the defect of my penis was
caused by accidental physical damage and is not genetic, that won't be
a problem.
So, all your concerns are answered, and now, how 'bout mine? I wanna
know about sensitivity and nerves.
|
Clarification of Answer by
richard-ga
on
25 Aug 2002 06:58 PDT
Reading your request for clarification mage me mindful of the
following from the Google Answers FAQ:
Do you answer medical, financial, or legal questions?
We will provide background information and links to other sources for
questions of a professional nature, but Google Answers is not a
substitute for professional advice and counsel. If you have a question
of this nature, we strongly recommend you consult a professional.
I am concerned that you may be looking to Google Answers as a
substitute for professional advice. On the other hand, I do not want
to deprive you of useful information. So rather than answer your
Clarification Request directly, I have put together a list of medical
references for you to share with your physician.
Please refer your physician to the following references:
1. Garcia de Alba A. de la Pena-Salcedo JA. Lopez-Monjardin H.
Clifton JF. Palacio-Lopez E.
Clinica de Microcirugia Reconstructiva Hospital Juarez de Mexico,
Mexico, D.F. hjuarezm@data.net.mx
Microsurgical penile reconstruction with a sensitive radial forearm
free flap.
Microsurgery. 20(4):181-5, 2000.
2. de Stefani S. Liguori G. Ciampalini S. Trombetta C. Pascone M.
Bertolotto M. Belgrano E. [Radial fascio-cutaneous flap of the forearm
and myocutaneous gracilis muscle flap in urologic surgery: surgical
anatomy and techniques]. [Italian] [Journal Article] Archivio Italiano
di Urologia, Andrologia. 72(2):37-43, 2000 Jun.
3. Kawanishi Y. Kimura K. Yamaguchi K. Nakatsuji H. Kishimoto T.
Kojima K. Yamamoto A. Numata A. [Microsurgical penile
revascularization in patients with pure arteriogenic erectile
dysfunction]. [Japanese] [Clinical Trial. Journal Article] Nippon
Hinyokika Gakkai Zasshi - Japanese Journal of Urology. 91(2):62-8,
2000 Feb.
4. Mutaf M. A new surgical procedure for phallic reconstruction:
Istanbul flap. [Journal Article] Plastic & Reconstructive Surgery.
105(4):1361-70, 2000 Apr.
5. Sarramon JP. Malavaud B. Bertrand N. Rischmann P. [Vascular
microsurgery in the treatment of vasculogenic erectile dysfunction:
clinical experience apropos of 115 operations performed according to 2
different surgical techniques]. [French] [Journal Article] Progres en
Urologie. 9(4):707-14, 1999 Sep.
6. Mutaf M. A new surgical procedure for phallic reconstruction:
Istanbul flap. [Journal Article] Plastic & Reconstructive Surgery.
105(4):1361-70, 2000 Apr.
7. Lidman D. Danielsson P. Abdiu A. Fahraeus B. The functional result
two years after a microsurgical penile replantation. Case report.
[Journal Article] Scandinavian Journal of Plastic & Reconstructive
Surgery & Hand Surgery. 33(3):325-8, 1999 Sep.
8. Rashid M. Afzal W. ur Rehman S. Single stage reconstruction of the
amputated penis using a microsurgical radial forearm flap transfer.
[Journal Article] JPMA - Journal of the Pakistan Medical Association.
48(3):82-5, 1998 Mar.
9. Drawz B. Drawz G. Kittner C. Seiter H. Schuemichen C. Penile
perfusion and functional scintigraphy: preliminary clinical results
before and after microsurgical revascularization. [Journal Article]
British Journal of Urology. 82(2):241-5, 1998 Aug.
10. Darewicz J. Gatek L. Malczyk E. Darewicz B. Rogowski K. Kudelski
J. Microsurgical replantation of the amputated penis and scrotum in a
29-year-old man. [Journal Article] Urologia Internationalis.
57(3):197-8, 1996.
11. Fan J. Eriksson M. Rosenlund AF. Nordstrom RE. An unusually
avulsed penis successfully replanted by using microsurgical technique.
[Letter] Plastic & Reconstructive Surgery. 98(3):571-3, 1996 Sep.
12 Legaillard P. Pelissier P. Martin D. Baudet J. Staged approach to
phallic construction and penile reconstruction. [Journal Article]
Microsurgery. 16(5):309-13, 1995.
13 Cheng KX. Hwang WY. Eid AE. Wang SL. Chang TS. Fu KD. Analysis of
136 cases of reconstructed penis using various methods. [Journal
Article] Plastic & Reconstructive Surgery. 95(6):1070-80; discussion
1081-4, 1995 May.
14 Lizza EF. Zorgniotti AW. Experience with the long-term effect of
microsurgical penile revascularization. [Journal Article]
International Journal of Impotence Research. 6(3):145-52, 1994 Sep.
15 Byun JS. Cho BC. Baik BS. Results of one-stage penile
reconstruction using an innervated radial osteocutaneous flap.
[Journal Article] Journal of Reconstructive Microsurgery.
10(5):321-31, 1994 Sep.
16 Stefanovic KB. Clark SA. Buncke HJ. Microsurgical vascularized
free temporoparietal fascia transfer for Peyronie's disease: an
experimental study. [Journal Article] Journal of Reconstructive
Microsurgery. 10(1):39-45; discussion 45-6, 1994 Jan.
17 Wester JU. Lauridsen FK. Siemssen SJ. [Microvascular
reimplantation of the penis]. [Danish] [Journal Article] Ugeskrift for
Laeger. 155(17):1301-3, 1993 Apr 26.
18 Wells MD. Boyd JB. Bulbul MA. Penile replantation. [Journal
Article] Annals of Plastic Surgery. 26(6):577-81, 1991 Jun.
Best of luck.
Sincerely,
richard-ga
|
