Surgeons reconstruct urethra from twin’s foreskin
Surgeon and consultant urologist Yazan F. Rawashdeh. Photo: Tonny Foghmar
In a new medical “first” surgeons at Aarhus University Hospital, Aarhus, Denmark, have given a young man a new urethra by transplanting and remodelling foreskin from his identical twin brother.
The patient, in his mid-thirties, was born with hypospadias (a congenital deformity of the urethra) and had undergone multiple previous surgeries.
Corrective surgery was however still needed due to severe scarring and narrowing of the malformed urethra. In such complicated cases the whole malformed urethra needs to be removed and substituted by healthy non-hair bearing skin or buccal mucosa.
- Donor sites for non-hair bearing skin and mucosa from the mouth are quite limited especially in previously operated patients, and their harvest can be associated with long-term complications, explains Yazan F. Rawashdeh Consultant Paediatric Urologist and reconstructive surgeon at The Department of Urology / Paediatrics, Aarhus University Hospital.
Therefore the patient was lucky to have a nonafflicted identical twin willing to donate his foreskin.
After removing the malformed urethra in January 2015, Dr. Rawashdeh and his team used skin from the brother’s foreskin to cover the resulting defect and approximately twelve months later the procedure was completed successfully.
- We have recently seen the patient in the outpatient clinic for follow-up and we are pleased to report a successful cosmetic and functional outcome says Dr. Rawashdeh who is also happy to report that the twins are doing well and have had no complications.
- The Section of Paediatric Urology - Department of Urology at Aarhus University Hospital has the largest experience in Denmark treating hypospadias with about 150-200 operations performed annually.
- The Department of Urology at Aarhus University Hospital is the only Centre in Denmark managing hypospadias and its late complications in adolescents and adults.
- The surgical procedures are performed by Consultant Urologists Yazan F. Rawashdeh and Gitte M. Hvistendahl, specialists in paediatric urology and reconstructive surgery.
- Approximately 1 in 250 boys are born with this birth defect and the number is most likely on the rise. Reasons for this increase are unknown but endocrine disrupting substances in the environment are suspected to play a role.
- Organ and tissue transplantations between identical twins are well known and are usually successful because twins have the same genetic makeup. Thus, obviating the need for immunosuppressive drugs to avoid rejection.