The first penis transplant surgery in the US would take place in a few months at the John Hopkins University School of Medicine. The patient is a soldier whose private parts were damaged by a bomb blast in Afghanistan.

The procedure represents a breakthrough for more than 1,000 American soldiers whose genitals are the hidden victims of the US participation in the wars in Iraq and Afghanistan. Seattle Times reports that from 2001 through 2013, a total of 1,367 male soldiers have become victims of improvised explosive devices and suffering from genitourinary injuries.

The genital that would be transplanted would come from a deceased donor. Within months, the recipient of the penis would develop urinary function, sensation and the ability to have sex.

Most of the victims of explosion are male soldiers below 35 who lost part or all of their penises or testicles, according to records of the Department of Defense Trauma Registry. That would deprive them not only of the basic function of having sex but also the opportunity to sire children.

“I think one would agree it is as devastating as anything that our wounded warrior suffer, for a young man to come home in his early 20s with the pelvic area completely destroyed,” says Dr WP Andrew Lee, chairman of plastic and reconstructive surgery at John Hopkins.

Although a penis transplant done in 2014 in South Africa was successful with the recipient of the organ having gotten his girlfriend pregnant, the first one in China failed. Lee cautions patients of possibly complications of the procedure such as bleeding, infection and the drug to prevent organ rejection would boost the odds against cancer.

He likewise says they should be realistic and not expect to regain all functions, although the surgeon says fathering kids is a realistic goal. Soldiers who would eventually have penis transplants would have their biological children if their testes are intact and not damaged by the explosion. But it would be a different case for those who would have testicle transplants.

Dr Richard Redett, director of pediatric plastic and reconstructive surgery at John Hopkins defends the criticism against the need for penis transplants since missing those body parts strongly linked with manhood are devastating for wounded soldiers. Scott Skiles, polytrauma social-work supervisor at the Veterans Affairs Palo Alto Health Care System, confirms that, saying many young male patients would rather lose their legs and arms than their reproductive system. Doctors add that the first thing most injured soldiers ask when they wake up is if their genitals are still intact.

The cost of the surgery is estimated between $200,000 and $400,000. John Hopkins will pay for the first transplant, but Lee asked Pentagon for more funds to cover succeeding transplants. Time reports that John Hopkins has permission to perform 60 penis transplants, and it is in the process of identifying possible candidates.

Surgeons are donating their times. It would only be available for men injured in combat, not transgender men.

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