Space & Innovation

First US Penis Transplant Performed on 64-Year-Old Man

The patient, who lost most of his penis to cancer, is recovering well after the 15-hour surgery.

A 64-year-old man who lost most of his penis to cancer is recovering well after undergoing the United States' first penis transplant operation, doctors said Monday.

The 15-hour surgery took place earlier this month at Massachusetts General Hospital in Boston, and is the third such operation known in the world.

"The patient, Thomas Manning, 64, of Halifax, Massachusetts, continues to recover well, with blood flow established to the donor organ and no signs of bleeding, rejection or infection," the hospital said in a statement.

"While the patient is still early in the post-surgical healing process, his physicians say they are cautiously optimistic he will regain function that he lost in 2012."

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The penis came from a dead donor who matched Manning's blood type and skin tone.

Manning expressed his gratitude to the donor and his family, which has asked to remain anonymous, and said he wanted to go public with his story to eliminate the shame and stigma associated with the loss of a penis.

"In sharing this success with all of you, it's my hope we can usher in a bright future for this type of transplantation," Manning said in a statement.

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Doctors at Massachusetts General have been working on the procedure for more than three years, including practicing on cadavers, with the goal of perfecting the method before they offer it to a wider pool of candidates, particularly soldiers who sustained genital damage or loss in war zones.

In an interview with The New York Times, Manning said doctors discovered he had a rare form of penile cancer in 2012.

After removing the tumor, he was left with a stump about an inch long (2.5 centimeters).

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Manning, who was single when he was diagnosed with cancer, had to sit in order to urinate and was fearful of becoming intimate with a woman.

"I wouldn't go near anybody," he was quoted as saying.

"I couldn't have a relationship with anybody. You can't tell a woman, ‘I had a penis amputation.'"

The operation's three main goals were to reconstruct the genitalia to a more natural appearance, to allow the patient to urinate normally and potentially to achieve sexual function.

"We are hopeful that these reconstructive techniques will allow us to alleviate the suffering and despair of those who have experienced devastating genitourinary injuries and are often so despondent they consider taking their own lives," said doctor Curtis Cetrulo of the MGH Division of Plastic and Reconstructive Surgery and the Transplant Center.

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The first penis transplant in the world took place in China in 2006, but it was later removed due to "a severe psychological problem of the recipient and his wife," doctors said.

The world's first successful penis transplant was announced last year in South Africa.

The donated organ was grafted onto a 21-year-old man who lost his penis in a botched circumcision.

June 28, 2012 --

Today the Supreme Court upheld the 2010 health care law in a dramatic victory for President Barack Obama. The lead up to today's decision has prompted debate between opponents and supporters of the Patient Protection and Affordable Care Act two years ago. Take a look at how we got to the health care system we have in place today.

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Prior to the 20th century, nothing even close to what could be called a health care system existed in the United States. Although the Civil War had led to some medical breakthroughs in terms of surgical techniques and pain management, medical knowledge, techniques and treatment availability at the time left little hope that patients would actually recover from severe ailments. As NPR's Alex Blumberg and Adam Davidson point out, medical treatments may have been downright medieval at the time, consisting of potions. But at least it was cheap. "In 1900, the average American spent $5 a year on health care ($100 in today's money)," they note in their report.

How the Civil War Changed Modern Medicine

In 1912, Theodore Roosevelt was the first presidential candidate to get behind the idea of a national health insurance plan. Roosevelt ultimately didn't win election that year. Proponents of government-provided health care tried to press the issue through state initiatives, only to see their efforts fail in 16 states. Roosevelt's plan may have certainly been ahead of its time, particularly since there weren't that many services that doctors could actually provide patients during that era.

At the same time, however, developments within the medical community changed the face of the industry. The horrors of World War I led to advances in the areas of wound care, sanitation, pain management and more, according to an article published in the Journal of the Royal Society of Medicine. Hospitals in the United States began to widely adopt the practice of using antiseptics to sanitize their facilities, preventing the possibility of medical personnel or patients becoming exposed to infection. That decade also saw the introduction of the first employer group insurance contracts (though not specifically for health insurance) as well as the first physician service and industrial health plans.

In 1928, Alexander Fleming made one of the most important discoveries in the history of medicine: penicillin, a life-saving drug used to treat countless millions. It would be decades, however, before penicillin would be mass-produced. Fleming's discovery was the signature achievement in an era that saw medical treatment become more effective, and, as a result, expensive. The Great Depression also fueled concerns about affordability of medical treatment as millions of Americans suddenly found themselves out of work. In 1929, Baylor Hospital provided the first group health insurance plan in the United States through an agreement with Dallas-area teachers. The plan was the forerunner of Blue Cross. The effort wasn't just meant to be in the best interests of patients, but also the hospitals. Patient facilities saw more empty beds as fewer patients during the Great Depression could afford treatment without participating in these collective prepaid health insurance plans.

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As part of his push to create a social safety net for Americans during the Great Depression, President Franklin D. Roosevelt advocated the passage of national health insurance. Roosevelt pushed ahead with efforts to pass Social Security first, a bill which intentionally omitted any mention of medical care to ensure its passage. Harry Truman attempted to carry on Roosevelt's legacy in 1945 by calling on Congress to create such a program. His efforts failed, partly due to criticism by the American Medical Association (AMA), who called the plan "socialized medicine." In this photo taken in 1937, First Lady Eleanor Roosevelt examines a chart of enrollment of health care insurance plans.

Like its predecessor, World War II would lead to new medical advancements, including the widespread adoption of antibiotics and the use of ultrasound. The war would also have a similar effect in terms of the spread of employer-sponsored health plans. Because the nation was in a state of emergency and had a legally mandated wage freeze as a result, employers had to attract workers to assist the war effort by providing them with benefits, including health insurance. Tax laws passed between 1943 and 1945 also gave breaks to employers who provided insurance to their employees, which gave businesses all the more incentive to offer coverage. Following the war, employer-sponsored health insurance became common. In 1951, around 77 million Americans had some kind of coverage, according to an insurance industry trade group. That era also saw one of the most celebrated medical achievements in history: Jonas Salk's polio vaccine.

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Although health insurance was widely available to employed Americans in the mid-20th century, the unemployed and the elderly were often excluded from these plans. President John F. Kennedy campaigned on the issue of insuring these groups. President Lyndon B. Johnson succeeded where Kennedy left off, securing the passage of a bill through Congress creating Medicare and Medicaid. At the bill-signing ceremony, shown here, Johnson presented former president Truman with the nation's first Medicare card. Within the medical industry itself, an increasing number of doctors began specializing in certain fields of medicine rather than acting as general physicians. By 1960, more than two-thirds of doctors reported themselves as full-time specialists, rather than general practitioners.

Starting with Richard Nixon in 1970, presidents have offered successive plans for covering the nation's uninsured, but they have have stalled for different reasons. In 1974, Nixon put forward a plan to cover all Americans through private insurance, only to have the Watergate scandal force him out of office. An economic crisis prevented Jimmy Carter from pushing forward with a national health plan. Congress late in Reagan's second term attempted to expand Medicare, only to have the law repealed the following year. Bill Clinton had a 1,300-page health care reform bill that was never even taken up for a vote in Congress. Since Nixon's presidency, health care costs have continued to rise, often outpacing inflation. This increase is due to a number of factors, including the increased use of new medical technologies for diagnosis and treatment. The Patient Protection and Affordable Care Act signed by President Barack Obama was intended to cover the 30 million Americans who live without health insurance, according to the bill's authors. It has been the most far-reaching piece of health care legislation since Johnson's signed the legislation creating the Medicare and Medicaid health care programs.

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