AUA 2017: Penile Transplantation: The Future of Reconstruction?

Boston, MA (UroToday.com) This session began with a talk by Dr Curtis Cetrulo regarding vascularized composite allotransplantation, or the transplant of an organ that is requires a blood supply. The majority of this work has been accomplished in hand transplants. These transplants provide both functional and psychosocial improvements in patients’ lives. Potential complications include acute rejection, which 85% of patients develop within 1 year, and chronic rejection that results in chronic vasculopathy. An ongoing goal is to create a protocol that allows for tolerance, or a state where chronic immunosuppression is not required.

Dr Dicken Ko then described the experience at Massachusettes General with the first penile transplant in North America. The aims of this procedure were to restore normal genital appearance as well as sexual and urinary function. The first successful pentile allotransplantation was performed in China in 2005 and an additional success was achieved in South Africa in 2014.

The first attempt at Massachusetts General was in a patient with a history of T3 penile cancer. They completed CTAs in order to understand the vascular anatomy of the recipient. For the harvest, they completed a wide dissection to include the bilateral external pudendal arteries. At one year, he has sensation to the mid shaft and spontaneous erectile function with Cialis.

Dr Bud Burnett finished the session with a talk on penile transplantation in the wounded warrior. Over 1300 soldiers have suffered genital injuries since 2005 and the average age of those injured is twenty-four. At Johns Hopkins a promising program is being developed to treat these patients and restore genitourinary function to these men.

Written By: Lisa Parrillo, MD, Genitourinary Reconstructive Surgery Fellow, University of Colorado

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA

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