Phantom Penis in Transexuals

[Paolo]

http://www.newscientist.com/blogs/short ... penis.html

A phantom penis, and how to remove it (http://www.newscientist.com/blogs/short ... penis.html)

The Neurotopia blog draws our attention (http://scienceblogs.com/neurotopia/2008 ... imb_is.php) to an intriguing paper in Acta Medica Okayama (http://www.lib.okayama-u.ac.jp/www/acta/). Titled "Phantom erectile penis after sex reassignment surgery (http://www.ncbi.nlm.nih.gov/pubmed/18596839)", it's a report by a group of surgeons at Okayama University (http://www.okayama-u.ac.jp/index_e.html) in Japan.

They describe a twist on "phantom limb (http://www.newscientist.com/article/mg1 ... iring.html)" syndrome, in which people who have lost a limb still experience sensation in it. Their patient experienced a phantom erect penis.

Phantom penises were first observed in 1951 (http://www.ncbi.nlm.nih.gov/pubmed/14932307), and a 1999 review (http://www.ncbi.nlm.nih.gov/pubmed/10068809) concluded that they were extremely rare. So what happened here?

Well, essentially this is a snapshot of how much sexual reassignment surgery has advanced in recent years.

The surgeons carried out vaginoplasty, an operation to convert a penis into a vagina, on several male-to-female transsexuals. (There's a detailed introduction to vaginoplasty here (http://ai.eecs.umich.edu/people/conway/ ... rview.html), including a series of illustrative diagrams and photos)

They used a new variant on the operation (http://www.ncbi.nlm.nih.gov/pubmed/18183081), using skin from the scrotum (rendered hairless by laser treatment beforehand) to make the interior of the vagina. This is normally done using skin from the penis, but this often means there isn't enough skin to make a suitably-sized vagina - not something the new technique suffers from.

After the operations, several patients reported phantom penises, but these disappeared within weeks. This is what we would expect if the brain is reorganising itself to respond correctly to the new genitals.

However, one patient was less lucky. Her phantom penis persisted for 6 months, and was always in a state of erection. That's perhaps not surprising, as many people with phantom limbs report fairly strong sensations, like itching or pain.

The surgeons wondered whether the phantom penis was related to several components (specifically the bulbospongiosus muscle (http://en.wikipedia.org/wiki/Bulbospongiosus_muscle) and corpus spongiosum penis (http://en.wikipedia.org/wiki/Corpus_spongiosum_penis)), which they had left in place in the operation. These sections are involved in various aspects of erection, including the accompanying sensations.

Accordingly, they went back in and, in a second operation, removed both the offending bits, and this time the phantom penis was gone.

It's unlikely we'll see many more cases like this. According to Vilayanur Ramachandran (http://cbc.ucsd.edu/ramabio.html), an expert on phantom limbs, male-to-female transsexuals are unlikely to experience phantom penises (http://dx.doi.org/10.1016/j.mehy.2007.02.024) (compared to men who have lost their penises for other reasons), as their brains are likely to be hard-wired for female genitalia. If Ramachandran is right, this case could be a one-of-a-kind.

Categories: Health (http://www.newscientist.com/blogs/short ... ce/health/)

Tags: penis (http://www.newscientist.com/cgi-bin/mt/ ... eBlogs=180) | phantom limb (http://www.newscientist.com/cgi-bin/mt/ ... eBlogs=180) | sex (http://www.newscientist.com/cgi-bin/mt/ ... eBlogs=180) | transsexual (http://www.newscientist.com/cgi-bin/mt/ ... eBlogs=180)

[DeaconBlues (imported)]

Very interestin post and links.

I was pretty shocked to read about just how dreadfully slow the American culture has been in accepting and understanding transsexualism when compared with other relatively "conservative" places like Mexico and Morocco. Not that it is said clearly in the information, but it is clear that transexual surgery and procedures were much more readily available to TS women in Morocco than in the U.S.

[homptydumpty (imported)]

this all makes good sense.

i remember once my testicles where removed, the body filled the void with fluid. i can feel them when i think about them, in a way. so i can imagine once the penis is inverted, some times the loss of the external appendage causes mental stimulation replicating that of the lost penis. or something....

[Blaise (imported)]

Very interestin post and links.

I was pretty shocked to read about just how dreadfully slow the American culture has been in accepting and understanding transsexualism when compared with other relatively "conservative" places like Mexico and Morocco. Not that it is said clearly in the information, but it is clear that transexual surgery and procedures were much more readily available to TS women in Morocco than in the U.S.

I am trying to remember when I became aware that there are many transsexuals. I knew about transsexuals at a fairly early age--around 12-13. But I think that my introduction to the literature was not until I as in my thirties. By the way, that was through Ecumenical Ministries of Oregon in Portland around 1976-77. I am certain that I read more before them but not much.

The Eunuch Archive is a great resource, I think. It ought to be able to reach many people.

[Blaise (imported)]

http://www.newscientist.com/blogs/short ... penis.html

A phantom penis, and how to remove it (http://www.newscientist.com/blogs/short ... penis.html)

The Neurotopia blog draws our attention (http://scienceblogs.com/neurotopia/2008 ... imb_is.php) to an intriguing paper in Acta Medica Okayama (http://www.lib.okayama-u.ac.jp/www/acta/). Titled "Phantom erectile penis after sex reassignment surgery (http://www.ncbi.nlm.nih.gov/pubmed/18596839)", it's a report by a group of surgeons at Okayama University (http://www.okayama-u.ac.jp/index_e.html) in Japan.

They describe a twist on "phantom limb (http://www.newscientist.com/article/mg1 ... iring.html)" syndrome, in which people who have lost a limb still experience sensation in it. Their patient experienced a phantom erect penis.

Phantom penises were first observed in 1951 (http://www.ncbi.nlm.nih.gov/pubmed/14932307), and a 1999 review (http://www.ncbi.nlm.nih.gov/pubmed/10068809) concluded that they were extremely rare. So what happened here?

Well, essentially this is a snapshot of how much sexual reassignment surgery has advanced in recent years.

The surgeons carried out vaginoplasty, an operation to convert a penis into a vagina, on several male-to-female transsexuals. (There's a detailed introduction to vaginoplasty here (http://ai.eecs.umich.edu/people/conway/ ... rview.html), including a series of illustrative diagrams and photos)

They used a new variant on the operation (http://www.ncbi.nlm.nih.gov/pubmed/18183081), using skin from the scrotum (rendered hairless by laser treatment beforehand) to make the interior of the vagina. This is normally done using skin from the penis, but this often means there isn't enough skin to make a suitably-sized vagina - not something the new technique suffers from.

After the operations, several patients reported phantom penises, but these disappeared within weeks. This is what we would expect if the brain is reorganising itself to respond correctly to the new genitals.

However, one patient was less lucky. Her phantom penis persisted for 6 months, and was always in a state of erection. That's perhaps not surprising, as many people with phantom limbs report fairly strong sensations, like itching or pain.

The surgeons wondered whether the phantom penis was related to several components (specifically the bulbospongiosus muscle (http://en.wikipedia.org/wiki/Bulbospongiosus_muscle) and corpus spongiosum penis (http://en.wikipedia.org/wiki/Corpus_spongiosum_penis)), which they had left in place in the operation. These sections are involved in various aspects of erection, including the accompanying sensations.

Accordingly, they went back in and, in a second operation, removed both the offending bits, and this time the phantom penis was gone.

It's unlikely we'll see many more cases like this. According to Vilayanur Ramachandran (http://cbc.ucsd.edu/ramabio.html), an expert on phantom limbs, male-to-female transsexuals are unlikely to experience phantom penises (http://dx.doi.org/10.1016/j.mehy.2007.02.024) (compared to men who have lost their penises for other reasons), as their brains are likely to be hard-wired for female genitalia. If Ramachandran is right, this case could be a one-of-a-kind.

Categories: Health (http://www.newscientist.com/blogs/short ... ce/health/)

Tags: penis (http://www.newscientist.com/cgi-bin/mt/ ... eBlogs=180) | phantom limb (http://www.newscientist.com/cgi-bin/mt/ ... eBlogs=180) | sex (http://www.newscientist.com/cgi-bin/mt/ ... eBlogs=180) | transsexual (http://www.newscientist.com/cgi-bin/mt/ ... eBlogs=180)

Intriguing article. Thank you.

[joydivision_27 (imported)]

"The Phantom Penis" would have been a much better name for the first Star Wars prequel ....

[calmeilles (imported)]

"The Phantom Penis" would have been a much better name for the first Star Wars prequel ....

That one's already been made. Though they called it something else:

http://uk.youtube.com/watch?v=fFmYBcqGDt8

[mrt (imported)]

I know others have mentioned this before but the latest info about phantom pain suggests that trauma during surgery wires the brain and is one of the reasons some people have phantom pain after the testicles or penis are removed. What is being done now is to numb parts that are amputated even tho the patient is already "under" and this has shown great success. And not just for Orchiectomy or GRS for example.

BTW if you have ever watched SRS/GRS surgery they "clamp" the testes which if the person was awake would be the screaming hit the ceiling and barf level pain so I think this idea has great merit to numb everything that is being cut out or clamped.

[homptydumpty (imported)]

What is being done now is to numb parts that are amputated even tho the patient is already "under" and this has shown great success.

BTW if you have ever watched SRS/GRS surgery they "clamp" the testes which if the person was awake would be the screaming hit the ceiling and barf level pain so I think this idea has great merit to numb everything that is being cut out or clamped.

I have had only mild phantom pain in my groin near the site of me removed testis. Nothing unmanageable.

During my surgery with Dr.Kimmel i did experience some pain on the second testicle as it was being removed, though once i brought the pain to the doctors attention he injected the sight again with painkiller.

[randy (imported)]

phantom penis you say.. hmm

i just thought of a really good halloween costume.