Penis transplants are coming

Many of the soldiers returning from the wars in Iraq and Afghanistan may have lost arms or legs, but some veterans suffer what may be an even more devastating wound: damage to their genitals.

Yet there may be hope: Some of these men may be eligible to receive the first penis transplants in the US, as The New York Times reported.

In the procedure, doctors will surgically attach an organ from a dead donor, and within months, the patient may regain urinary function, sensation, and even the ability to have sex again.

The procedure has been attempted twice before - once in China in 2006, and once in South Africa in 2014 - but only the latter was successful.

The Chinese patient had the organ removed after several weeks due to "apparent psychological rejection." But the 21-year-old South African recipient, the victim of a botched circumcision, regained full sexual and urinary function and recently fathered a child.

According to The New York Times, doctors at Johns Hopkins University in Baltimore will perform the first penis transplant in the US as early as a few months from now on a young soldier injured by a bomb blast in Afghanistan. The university has given approval for a total of 60 transplants.

Here's how the procedure works:

1. An organ donor's penis is surgically removed, with his family's permission.
2. Doctors will attach the organ to the transplant recipient, reconnecting the nerves and blood vessels under a microscope.
3. Afterward, the patient must take drugs for the rest of his life that prevent his body from rejecting the new organ.

Of course, like any surgery, the procedure comes with risks, such as bleeding and infection. In addition, the drugs used to suppress the patient's immune system could increase his risk of developing cancer.

As the South African patient demonstrated, it is possible for recipients of a penis transplant to father children, if their testicles are intact. Any children will be the genetically related to the recipient, not the donor.

Currently, the penis transplant procedure is only being offered for veterans, but in future, it could also be a possibility for people undergoing gender reassignment surgery.

As transplant science has advanced, it has become possible to use tissues - such as the face, hands, and now, genitals - that the donor may not have known they were consenting to give, which is something we'll have to grapple with increasingly in future.

Earlier this month, The New York Times reported that US doctors are planning to perform uterus transplants, offering women without a functioning uterus the chance to have their own child - and sparking the tantalizing (albeit remote) possibility that men could get pregnant.