Man has his penis reconstructed using tissue from his arm

Man has his penis reconstructed using tissue from his arm 16 years after it was burnt off in an electric shock in India

• The man, known as Ramesh, had lost function in his penis since the age of nine
• He was bullied, embarrassed and couldn’t urinate standing due to his injuries
• Surgeons created the penis using a skin graft with tissue, vessels and nerves
• In a year, Ramesh will have implants inserted which will allow an erection
• It will restore full feeling and sexual function, a ‘miracle’ for Ramesh 

An Indian man has had his penis reconstructed using tissue from his arm, 16 years after it was burnt off by an electric shock.

The 25-year-old man, known as Ramesh, underwent a gruelling eight hour operation where surgeons took tissue with blood vessels and nerves from his hand and forearm so that the penis would have full feeling.   

Ramesh, a government civil servant, will have implants inserted into the penis, which will enable an erection. 

It is not clear how his love life was affected by the accident, but surgeons say that when he is recovered from the operation he is expected to enjoy full sexual function.  

Implants, which act like small pumps which can inflate the penis, are a life-changing procedure for men who have debilitating injuries or birth defects.

For Ramesh, it’s ‘nothing less than a miracle’ that surgeons were able to restore his genitals’ functions. 

He was bullied and labelled as ‘kinnar’ by other children, which means a man that identifies as a woman.   

A 25-year-old Indian man has had his penis reconstructed using tissue from his arm, 16 years after it was burnt off from an electric shock. Stock photo

The Times of India reported that Ramesh, whose name has been changed, was nine years old when he was burnt from head to toe.

He had been shocked by a high powered electric transmission line in his small village of Madhya Pradesh’s Barwani district.

Ramesh said he was constantly depressed as a child because doing every day activities was difficult.

He couldn’t stand and urinate like other boys because his penis was so damaged. Doing so would leave him in soaked clothes.

Ramesh had a phalloplasty, which is the construction or reconstruction of a penis. 

Normally a phalloplasty is a common for transgender and nonbinary people, as well as for people who have had their penis damaged in trauma, cancer, or congenital defect. 

Ramesh had what is known as a radial forearm free-flap (RFF) phalloplasty. During this procedure, a flap of skin, normally from the forearm, is used to build the shaft of the penis. 

The tissue, with all of it’s blood vessels and nerves in tact, is used to make a tube-within-a-tube structure. The larger tube is rolled up around the inside tube.

A phalloplasty can include a number of separate procedures, which include a vaginectomy or vaginal mucosal ablation to remove or partially remove the vagina, a phalloplasty to turn a flap of donor skin into a phallus, or a scrotectomy to turn the labia majora into a scrotum, either with or without testicular implants. 

Ramesh will also have penile implants to allow for erection.

Normally in this procedure, there are three parts that are connected by tubing – two cylinders in the penis, an inflatable pump in the scrotum, and a saline fluid-filled container in the abdomen. 

Squeezing the pump in the scrotum causes fluid to moves from the container in the abdomen into the cylinders, creating an erection. 

When the release valve is squeezed, fluid drains from the cylinder and back into the container, making the penis flaccid.  

Implants can also be semirigid, which are always firm. The penis can be bent away from the body for sex, and toward the body for concealment the rest of the time.   

Even his parents were worried about how their son, who was otherwise fit and healthy, would move forward in life.  

Ramesh met Dr Saumya Nayak, a well-known plastic surgeon from Vadodara, Gujarat, working at Luxor Hospital.

Dr Nayak was able to perform a radical forearm free-flap phalloplasty, which can be used to create a penis that never existed in transgender surgery.

He said: ‘We reconstructed his penis from tissues of his hand through microvascular penile reconstruction.

‘We took a flap of tissue from his forearm by tube in tube technique and reconstructed the penis.

‘Three blood vessels including one artery and two veins were joined so that sensation is restored.’

The blood vessels and nerves, still within the forearm tissue, are reattached using microscopic precision. This will allow blood to flow naturally in the penis and sensitivity to return.

It is likely the urethra was reconstructed during the procedure, meaning Ramesh could stand and urinate again.  

It will take a year-and-a-half for Ramesh to fully recover before the second stage of his surgery will take place.

Dr Nayak will insert implants into the penis, which will ‘restore almost 100 per cent function’.

Implants are devices placed inside the penis, typically to fix erectile dysfunction.

There are two main types of penile implants; semirigid devices which always remain firm with rods, and the more common inflatable implants which use pumps that are placed in the testicles. 

British plastic surgeon Douglas McGeorge told MailOnline penis reconstruction procedures have been used for a long time but is not very common in the UK.

He said: ‘It’s the standard way to make a phallus. When the wounds are healed, you can insert implants. 

‘You can imagine it like taking a piece of A4 paper and rolling it into a tube. The tube is sewn on and the vessels are attached. The tissue becomes revasculised and survives.’ 

In 2018,  Andrew Wardle, 44, made headlines when he received penis implants on the NHS, becoming known as the ‘bionic man’.

Mr Wardle, of Stalybridge, Greater Manchester, was born without a penis due to a rare defect, and began having surgery in 2015.

Surgeons performed a phalloplasty, where a penis was constructed using skin, muscles and nerves from Mr Wardle’s left arm and right leg, molded into the right shape then attached to his body.   

Then, in December 2017, Mr Wardle had the ‘erection pump’ stage of the procedure, which would allow him to have sex for the first time.

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