Tuesday, October 14, 2014

Lab-Grown Penises Aren't Science Fiction Any More

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The Internet has been abuzz lately about recent reports that Frankenstein penises–i.e. bioengineered penises created for transplants–could become available soon. You’ve got questions, we’ve got answers. Consult the following FAQ for all your burning queries about the exciting new world of made-to-order penises.


How soon will lab-made penises be available? Should I add them to my Christmas shopping list?


Not so fast. According to researchers at the Wake Forest Institute for Regenerative Medicine in Winston-Salem, North Carolina, who’ve been developing the bioengineered penises, they don’t expect to begin human testing until at least 2019. And even that depends on whether they get FDA approval.


You’re 100% positive this isn’t just the plot of a campy horror movie? This sounds like a Re-Animator sequel.


That would admittedly be an awesome movie, but no, this is a real thing that’s actually happening. The research team, led by Dr. Anthony Atala, have been trying to develop a working synthetic penis since 1992. They had a breakthrough in 2008, when they successfully engineered a rabbit penis. Of the 12 rabbits who got new penises, eight were able to ejaculate, and four actually impregnated lady rabbits. The next step is to do the same thing but with people.


They’ve been working on this since 1992? We’ve had heart transplants since 1967. Why are penises taking so long? 


It’s true that organ transplants have come a long way in the last half-century. Patients are now able to get new hearts, kidneys, lungs, livers, hands, tongues, even entire faces. A Swedish woman with a womb transplant just delivered her first baby last month. But penises transplants are apparently much more complicated. “It would take a huge orchestration of nerves, blood vessels, and urethra to all come together to make (a penile transplant) work,” says Dr. Andrew Kramer, a urologist at the University of Maryland Medical Center. The science of penis reconstruction is “really in its infancy,” Dr. Kramer says. “It barely exists. We can move a piece of muscle from your arm and make a neo-phallus, but they don’t look good, and they won’t work for sex or urination. It’s just for aesthetics, which isn’t that great.”


Explain what’s involved in a bioengineered penises. Are they making penises from scratch?


Not exactly. They start with a donor penis, which as Dr. Atala explains, is used as a sort of penile scaffold. “First, cells are removed from the donor tissue to create the support structure,” he said. “Then, a patient’s own cells would be placed onto this scaffold. The scaffold would then be used during reconstructive surgery to fashion a penis.”


Couldn’t they just surgically attach a donor penis without all the cell-scrubbing? Has that ever been tried?


It has, yes. The first attempt at a penile transplant happened in China in 2006. A 44-year-old man lost most of his penis in an “unfortunate traumatic accident” (further details weren’t provided) that left him with a half-inch stump. He received a new penis from a 22-year-old, brain-dead donor. The surgeon, Dr. Weilie Hu, claimed it was in “excellent cosmetic appearance,” but the surgery was unsuccessful, and not for the expected reason.


What’s the expected reason?


The most common cause for organ transplant rejection is the recipient’s immune system treating the new organ or tissue like a foreign invader and attacking it. Instead, the problem was the guy’s wife.


You don’t mean . . . she pulled a John Wayne Bobbitt on him?


No, nothing that crazy. She just didn’t like the looks of it, and declined to have sex with him. According to Dr. Hu, “the patient finally decided to give up the treatment because of the wife’s psychological rejection.” Two weeks later, he asked for the penis to be removed.


Yikes. That seems like a pretty extreme reaction. What the hell was wrong with it?


Short answer: It wasn’t his dick. This isn’t an uncommon problem for transplant surgery when the organs aren’t inside the body. You get somebody else’s heart, you still look like yourself. But when your outward appearance has been altered, it can be a rough adjustment. The French surgeon who performed the first face transplant discovered just what a big emotional hurdle this can be. “Psychological consequences of hand and face allografts show that it is not so easy to use and see permanently a dead person’s hands,” he wrote. “Nor is it easy to look in a mirror to see a dead person’s face.” Now imagine masturbating and realizing you’re holding another guy’s erect penis.


Okay, point taken. That would be weird. But how are these new lab-made penises going to be any different?


Psychologically, it’s anybody’s guess. It’s still a penis that isn’t entirely yours. But it won’t just be a penis that belonged to some other guy. It will be reconstructed using your own cells. Whether that makes a difference remains to be seen.


If or when these bioengineered penises become available, how can I get one? Is there a waiting list or something?


Dr. Atala tells us that “the exact eligibility criteria for the study have not yet been determined.” But the research is being funded by the U.S. Armed Forces Institute of Regenerative Medicine, so soldiers who’ve suffered penis-related injuries during combat will likely be top candidates.


“There’s going to be two types of people inquiring about these penis transplants,” says Dr. Leo Doumanian, a reconstruction surgeon at the USC Institute of Urology. “People with genital defects, aggressive penile cancer, or other penis maladies. And then people that need it because of vanity, or because they feel insecure. Some of these insecurities are justified, and some of them are not.”


Wait, let’s back up. When Dr. Doumanian says “other penis maladies,” what is he referring to exactly?


Oh, all sorts of things. “Men can get them bitten off, cut off, all sorts of things,” says Dr. Kramer. “It’s hardly rare.” This past summer, a Birmingham, Alabama man filed a lawsuit, claiming he had a botched circumcision that resulted in a castration. And don’t forget gun-related penis losses. “Many men try to look tough and put a gun in their belt gangster-style,” says Dr. Kramer. “Then it goes off because they forget to turn off the safety, and they blow off their penis.” (Don’t laugh. It’s happened as recently as this summer.)


“I had one guy who was so aroused by self-mutilation, he strangulated his own penis and it fell off,” says Dr. Kramer. “I don’t know how that aroused him, but his psychiatrist said it did. A year earlier he’d blown off his testicles with a shotgun. He was a weird guy.”


And that’s just the tip of the iceberg. We’ve already documented most of this for you in 9 Weird Things That Can Happen to Your Penis.


So what you’re saying is, we’re not 5 years away from me being able to walk into a urologist’s office and say, “Hey, can I have a new penis?”


Probably not, no. “If this heads into prime time,” Dr. Doumanian says of lab-made penises, “I’m sure there’ll be a catalogue of requirements to make sure that everything is justified, and that the patient is prepared, both mentally and physically, for the transplant.” In other words, just wanting a new penis doesn’t mean you’ll get one.


But just for the sake of argument, let’s say I do get cleared for a new penis. My insurance is going to cover it, and the doctor is on board with the procedure. Do I get to pick my penis?


How do you mean?


Did you see that Sarah Silverman video where she decides to get a penis, and there’s a big selection of dicks for her to choose from, and she asks, “Do you have anything more European?”


Yes, we’ve seen it. You know that a was a joke, right?


Duh, obviously. But, you know … is there any truth in that? If someone was getting a penis transplant, do they have any say in what the penis looks like? Or do they just get whatever’s available?


Sorry. “Patients don’t have a shopping list of penises to choose from,” says Dr. Kramer. But it’s not like penises are picked with a Secret Santa-style randomness. “I’m sure they try to match them based on the color of a recipient’s skin, just to make it match somewhat,” Kramer says.


What if I want more than one?


Excuse me?


Not that I’d want more than one, but is it medically possible? I’m asking for a friend.


“No,” says Dr. Doumanian.


 What about having a penis attached to an area on your body other than the groin?


 Like where?


 Have you ever seen the porno Edward Penishands?


Yes. Oh wait, are you serious?


Just hypothetically!


“If you desire functionality, then placement in the groin area with the pelvic vessels is the only place where the phallus has any chance of being a true sexual organ in modern day convention and sense,” says Dr. Doumanian. He also points out that one of the tenants of medicine is “primum non nocere” (Latin for “first, do no harm”). So no, a urology surgeon with any sense of medical morality is not going to replace your fingers with penises.


Or as Dr. Kramer put it more succinctly when we posed the question to him, “Why? Why?”


 


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Lab-Grown Penises Aren't Science Fiction Any More

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