A 36-year-old man born without testicles received one transplanted from his identical twin brother in a six-hour operation performed Tuesday in Belgrade, Serbia, by an international team of surgeons.
The surgery was performed at the University Children’s Clinic in Tirsova, a section of Belgrade. The Serbian brothers are doing well, doctors said. By Friday, the recipient already had normal testosterone levels. Surgeons operated on the brothers simultaneously in adjoining rooms. The procedure was challenging because it required sewing together two arteries and two veins that were less than 2 millimeters wide.
The team did not connect a structure called the vas deferens, which carries sperm out of the testicles. The surgeons could not find the tissue in the recipient needed for the connection, which means that for now, he cannot father children in the usual way. Bojovic said that after the penis transplant, the surgical team received inquiries from people undergoing female-to-male sex reassignment who wondered if they might receive transplants instead of the usual surgery, which creates a penis from the patient’s own tissue.
The lead surgeon, Djordjevic, said that he had developed a surgical plan for transplanting a penis onto a body that is anatomically female, and that he hoped to begin performing that surgery within the next year or so.But he would not transplant testicles as part of transgender surgery, he said. Doing so would open up the thorny possibility that the recipient could have children produced by the donor’s sperm.
The brother without testicles had not reached puberty until he was given testosterone at age 18, which caused a growth spurt that left him 4 inches taller than his brother. He needed regular testosterone injections to maintain his masculine characteristics, but the hormone levels fluctuated and sometimes caused mood swings.
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