Phantom Penis in Transexuals
Posted: Fri Oct 24, 2008 8:27 am
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)
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)