Reconstructive penis transplants are for cisgender males who have suffered extreme loss of penis structure or function. You may consider such transplant if you have almost no function of your penis from traumatic injury, severe micropenis, congenital absence or loss of the penis after surgical treatment for penile cancer.

Patients may also not be a candidate for alternative or conventional reconstructive surgery.

Since 2018, 4 patients have successfully received penis transplants from institutions around the world.

Johns Hopkins was the fourth successful penis transplant and the first-ever penis and scrotum transplant in the world. The first successful penis transplant was in South Africa in 2014, followed by Massachusetts General Hospital in 2016 and South Africa in 2017.

The goals of penis reconstruction are to create a functionally and aesthetically acceptable phallus with minimal donor site morbidity. The main functional goals are urination, restoration of sexual function, and restoration of the patient’s sense of wholeness and self.

Patients waiting for a penile donation can be called into the hospital for surgery at any time. After surgery, you will be placed in a surgical intensive care unit (SICU) for several days. Once the surgical team feels comfortable with you being moved out of the SICU, you will move to a transplant unit, where you will receive care specially designed for all types of transplant patients. You can expect to be in the hospital anywhere from four weeks to three months. The amount of time spent in the hospital depends on a number of factors, including the amount of support and assistance you have at home, the distance from your home to the hospital for follow-up care, and any delays that might occur in recovery.

Penis donation is not included in the commonly used driver’s license organ donation registry. Penis donation involves a special and sensitive consent process with donor families. For Johns Hopkins patients, this process is facilitated through specially trained and experienced coordinators from the Living Legacy Foundation of Maryland, which is the organ procurement organization for the state of Maryland (with the exception of Charles, Montgomery and Prince Georges counties, which are covered by the Washington Regional Transplant Community).

In addition to matching blood type, immunological, and viral parameters, penis donation involves careful emphasis on matching skin color, skin tone, gender, and ethnicity/race.

Once you are approved for a penis transplant, you will have to wait for a matching donor to become available. This can range from a few weeks to several months. The donor must have matching blood and tissue types as well as matching skin color, skin tone, gender, ethnicity, race and size of penis.

Patients waiting for a penis donation can be called into the hospital for surgery at any time. The immediate postoperative care is located in an ICU setting. Upon release from the ICU, the patient will be transferred to a hospital ward previously identified and properly in-serviced for care of penis transplant patients. The patient and family receive a thorough orientation to the unit and call system and are encouraged to communicate fully with the nursing staff and physicians.

You can expect to be in the hospital anywhere from four weeks to three months. The amount of time spent in the hospital depends on a number of factors, including the amount of support and assistance you have at home, the distance from your home to the hospital for follow-up care, and any delays that might occur in recovery.

The goals of penile reconstruction are to create a functionally and aesthetically acceptable penis with minimal donor site morbidity.

The main functional goals are urination, restoration of sexual function, and restoration of the patient’s sense of wholeness and self. These objectives necessitate fulfilling multiple goals including providing of a realistic appearance, the ability to void (urinate) while standing, return of erogenous full sensation, the ability for the new penis to become erect or to be conducive to the insertion of a penile prosthesis which will allow penetration during sexual intercourse, and counseling assistance to help with the psychological needs.

Rejection refers to the body’s immune response towards the new transplant. Believing the tissues to be foreign, the body’s natural response is to attack and can occur within days to months after transplant.

Rejection episode will appear as a rash on the transplanted skin/organ. This is usually treated with topical prescription ointments or short course of intravenous steroids (based on the severity of the rejection). The transplant physician may want to perform a biopsy of the rash to confirm a severity of the rejection.

No patient taking his immunosuppression drugs on time and as advised has lost a transplanted penis.