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While for some the idea of a laboratory-grown penis may seem the stuff of science fiction, for others it could well be the answer to a dream. For those who suffer from congenital birth defects such as a deformed penis or no penis at all, as well as victims of traumatic groin injuries, this advance in reconstructive bioengineering offers hope for a normal — or near-normal — life.
News of this breakthrough in medical science comes from North Carolina’s Wake Forest Institute for Regenerative Medicine, which hopes to win FDA approval soon for testing in human subjects.
Long-Running Project
The institute, led by researcher Anthony Atala, M.D., has been hard at work on this penile reconstructive project for several years. In May 2006, according to WebMD.com, Dr. Atala provided an update on its progress at an annual meeting of the American Urological Association in Atlanta.
Of the institute’s work on the project, Dr. Atala told WebMD, “Our goal is eventually to treat infants and adults with birth defects, penis trauma, or penis cancer.”
In his report to the 2006 AUA meeting, Dr. Atala told of the institute’s success in animal testing of the penis reconstruction model. In a study with male rabbits, institute researchers removed the animals’ penises and replaced them with organs grown from the animals’ own penile cells.
Rabbit Penises Functional
The laboratory-grown penises transplanted onto rabbits proved to be fully functional, according to Dr. Atala. Rabbits with replacement penises were able to get erections, mate with female rabbits, and successfully impregnate their mates.
If and when clinical trials get the green light, donor organs from recently deceased humans will be carefully cleansed to remove any cells that might eventually cause the organ to be rejected by its new host. After a few weeks of this preparation, the donor organ will be transformed into a sort of “scaffold” of the original organ, according to an article at WashingtonPost.com.
Human Penile Cells Harvested
At the same time that this scaffold is being prepared, cells harvested from whatever remains of the host’s penile tissue are cultivated in the laboratory. Once the so-called scaffold is ready and fully cleansed of potentially rejectable cells, it is seeded with the penile cells harvested from the donor.
Despite the success of the laboratory-grown penises in the institute’s rabbit study, it is unclear whether this technology will work as well in humans.
Dr. Atala, who began his career in medicine as a pediatric urologist, told Reuters he was deeply troubled to see infants born with deficient or badly deformed genitalia, conditions for which there were really “no good options,” at least until now.
Ambitious Mission
The institute, based at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, “is working to grow tissues and organs and develop healing cell therapies for more than 30 different areas of the body,” according to its website.
High on the list of its past success stories was the successful 2006 implantation of laboratory-engineered bladders into young patients with spina bifida. Building on that success, the institute is continuing to evaluate the technology for use in patients with spinal cord injuries. A similar study focuses on use of the technology in patients with bladder cancer.
In 2011, the institute reported success in implanting laboratory-engineered urethras in five boys, a technology that is now being further evaluated in ongoing clinical studies.
Vaginas Implanted
In a project that most closely parallels the laboratory-grown penis study, scientists at the institute implanted laboratory-engineered vaginas into four teenage patients, according to an announcement in April 2014.
Recipients of the laboratory-grown vaginas were all born with a rare genetic condition in which the uterus and vagina are either absent or underdeveloped. Each of the implanted vaginas was grown in the laboratory from the patient’s own cells.
Reporting on the follow-up to this study, an institute representative said that all four patients were experiencing normal function.
Penis Transplant a Bust
Other attempts at surgical penis replacement have had little or no success. In 2005 a Chinese surgeon transplanted a penis from a human donor into a patient whose penis had been damaged beyond repair in an accident.
The transplant surgery itself was a success. Only a short time after the procedure, the transplanted penis had a healthy blood supply, and the transplant recipient was able to urinate normally. However, psychological problems — on the part of both the recipient and his wife — forced surgeons to remove the transplanted organ, even though there were no signs of organ rejection.
For Dr. Atala, the successful animal study of laboratory-grown penises represented an important milestone in proving a concept — that laboratory-engineered penises could be transplanted to humans — on which he’d been working since 1992.
Prosthetic Option
Apart from the ill-fated penis transplant surgery in China, the only other option available to men with damaged or underdeveloped penises has been around since the 1970s. As described in an article at TheGuardian.com, that option involves the construction of a penis with skin and muscle from the recipient’s forearm or thigh.
In that procedure, “sexual function can be restored with a penile prosthetic placed inside,” according to TheGuardian.com. “The prosthetics can be either malleable rods, with the penis left in a permanently semi-rigid state and thus difficult to conceal, or inflatable rods, which have a saline pump housed in the scrotum. Both technologies have been around since the 1970s. The aesthetics are crude and penetration is awkward.”
Despite the institute’s success with laboratory-engineered vaginas, work on the lab-grown penis has proved far more daunting a challenge, Dr. Atala told TheGuardian.com.
Penis More Complex
He points to the increasing architectural complexity of organs as they go from flat structures such as skin or cylindrical structures such as vaginas to “hollow, non-tubular organs like the bladder. As a solid organ, the penis tops this list in both density of cells and structural complexity,” according to TheGuardian.com. “It consists of a spongy erectile tissue unique to it. During an erection, signals from the nerves trigger blood vessels to dilate, filling this spongy tissue with blood and causing the penis to lengthen and stiffen.”
The leap from lab-grown penises in animals to lab-grown phalluses in humans is a daunting exercise in scaling up, Dr. Atala told TheGuardian.com. He said that the institute has engineered half a dozen human penises, but they’re not yet ready to be transplanted into human recipients.
For now, said Dr. Atala, they’re undergoing rigorous testing to ensure they are safe and effective. “We’re trying to get approval from the U.S. Food and Drug Administration so we know everything is perfect before we move to a first in-man test.”
Much of the work at the Wake Forest research center is funded by the U.S. Armed Forces Institute of Regenerative Medicine, according to Dr. Atala. He said the institute hopes that Wake Forest-developed technologies can be used to help soldiers who sustain battlefield injuries.
Don Amerman is a freelance author who writes extensively about a wide array of nutrition and health-related topics.
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