A 36-year-old man from Serbia who was born without testicles undergoes a successful transplantation of a single testicle that was donated by his twin brother.
The 6-hour transplantation was the third of its kind and done by an international group of surgeons.
With this new transplantation, the recipient will now be able to have children of his own as he is an identical twin and so the DNA that will be passed onto his children will almost be an exact match of his own.
This historic operation may offer hope for transgender patients and men with severe groin injuries and their ability to have children; however, the ethics is murky outside of this quite unique case of identical twins- one a donor, one a recipient.
Man Is Born without Testicles
Babies born with both missing testicles are very rare. One study from 1974 points out that one in every five thousand male babies will be born without one testicle.
And, one in every twenty thousand male babies are estimated to be born with both testicles missing, claims the research by the University of Southern California.
What Are the Causes for Missing Testicles?
For now, the exact reasons for missing testicles aren’t known. Some scientists claim that this may be a result of a genetic condition; however, the case of these identical twin brothers, one without, one with a testicle, sheds doubt on this theory.
In the absence of testosterone, men may not go through puberty and grow too little hair or too much in some areas, develop breast tissues, lack sex drive, and be more prone to loss of muscle and depression.
Without the needed structures for production and containment of sperm, men who don’t have testicles are infertile.
The other symptoms can be managed using hormone injections; however, this patient who underwent the surgery wanted to be able to have children of his own and normalize his testosterone levels.
What Did the Procedure Looked Like?
Testicle transplantation is a long and delicate procedure and thus, it requires maximum efficiency. When the testicle is removed properly from the donor, there’s little window for intervention.
If the testicle isn’t reconnected to blood supply within 4 to 6 hours, the tissue will begin to die.
The surgeons need to sew together 4 major blood vessels for the testicle to get life-giving and oxygen-rich blood. Doing this requires up to 60 minutes per one vessel. So, there’s a little margin for errors.
In this case, the team successfully connected the blood vessels in around 2 hours. The surgeons claim they couldn’t find sufficient gland tissue in the body of the recipient to connect the tubule which would carry sperm from the testicle to the recipient’s penis.
Therefore, his testicle will be able to carry sperm which will be collected and used for embryo fertilization, but he won’t be able to reproduce sexually. A second intervention may be necessary for his duct reconstruction.
The levels of testosterone in the patient had achieved the normal range and both the donor and recipient look good. They’ll soon be heading back home.