When John Wayne Bobbitt arrived at the emergency room in 1993, after his then wife Lorena had cut off his penis with a 12-inch knife, the surgeons were dumbfounded. "It was a kind of an out-of-body experience,” James Sehn, MD, the urologist who treated Bobbitt recalled to 20/20 in a January 2019 interview. "It really takes your breath away to see this kind of disfigurement."
John's penis was abandoned on the side of the road outside a 7-Eleven; Lorena had thrown it out the window of her moving car. It would be hours until police located the severed organ, put it on ice, and transported it to the hospital. Finally, after losing a third of his blood volume, and undergoing a nine-hour surgical procedure, John's penis was reattached.
Wild as this story may be, trauma cases of penile lacerations or amputations are not unheard of, says Paul Turek, MD, FACS, FRSM, a board-certified physician with the American Board of Urology and microsurgeon. Although Dr. Turek didn't specifically work on John Bobbitt's case, he explained how penis reattachment surgery typically goes down:
How do you reattach a penis to a body?
If you can find the severed penis, they tend to be relatively easy to reattach compared to other body parts, Dr. Turek says. "The penis is arteries, veins, nerves, and the urethra," he says. "So, compared to say a finger, it's a very basic organ; it’s like a simple car from the 60s without a lot of electronics on it." Basically, surgeons will have to connect one or two arteries, some veins to drain blood, erectile tissue called corpus cavernosum, and the urethra so people can pee.
Usually the way the penis was severed impacts how easy it is to repair. If the cut is clean, like in Bobbitt's case, it's much easier to reconnect, Dr. Turek says. "Corrugated marks" on the penis could indicate a zipper injury or human mouth bite, and the latter tends to be much more difficult to treat, because there's a chance that it could be infected from bacteria in the mouth, he says.
On the other hand, if the amputated part is lost forever, then it's a bit harder, although "honestly now, there are more options," Dr. Turek says. The advent of gender confirmation surgery has brought along lots of scientific advancements when it comes to penis surgery and transplant, he says. For example, surgeons can create a new penis using skin from a person's arm and prosthetic implants, or transplant one from a donor. "It's pretty incredible," he says.
Can you regain sexual function?
The short answer is, usually yes, Dr. Turek says. "Men can have an orgasm without an erection, and men can have an erection without an orgasm — but if you're missing both I'd say you're probably going to be affected," he says. Most people are able to climax and have an erection after a penis reattachment surgery, and there has been a case where a man had his fertility restored after a penile transplant, he says. In cases where the entire penis is taken off, patients may work with a sex therapist to find alternative ways to climax, he says.
What should you do if you're in this scenario?
Obviously, you're going to want to seek medical attention immediately. It's also important to keep the penis cold, preferably on ice "so it doesn't die, basically," Dr. Turek says. Once the whole medical team is there — a urologist, plastic surgeon, and microsurgeon — they can do it all at once. "It's not particularly painful," he says about surgery. "It's just technically quite challenging."