A team of reconstructive surgeons at Johns Hopkins Hospital in the US have performed the world’s first total penis and scrotum transplant.

The team consisted of nine plastic surgeons and two urological surgeons who performed the surgery over 14 hours. They transplanted, from a deceased donor, the entire penis, scrotum without testicles and partial abdominal wall.

The transplant recipient was a wounded veteran who sustained injuries in Afghanistan and wishes to remain anonymous.

Johns Hopkins University School of Medicine professor and director of plastic and reconstructive surgery Wei-Ping Andrew Lee, MD, said: “We are hopeful that this transplant will help restore near-normal urinary and sexual functions for this young man.”

The recipient said: “It’s a real mind-boggling injury to suffer, it is not an easy one to accept. When I first woke up, I felt finally more normal… [with] a level of confidence as well. Confidence… like finally I’m okay now.”

The transplant recipient has recovered from the surgery and is expected to be discharged from the hospital this week.

Lee further explained that while it is possible to reconstruct a penis using tissue from other parts of the body, a prosthesis implant is necessary for a patient to achieve an erection. This comes with a much higher rate of infection. Another issue being that wounded servicemen often do not have enough viable tissue from other body parts to work with.

The penis and scrotum transplant fits into the vascularized composite allotransplantation category. This type of surgery involves transplanting skin, muscles and tendons, nerves, bone and blood vessels.

As with any transplant surgery, tissue rejection is a concern. The penis transplant patient has been put on a regimen of immunosuppressive drugs to prevent rejection. Lee’s team has developed an immune modulation protocol aimed at minimising the number of these drugs needed.

Johns Hopkins University also performed America’s first bilateral arm transplant.