Articles written for the SBAWS
formerly, the Evergreen Spina Bifida Association
David B. Shurtleff, M.D. is the SBAWS’s medical advisor. He received his M.D. degree from Tuft’s University Medical School and received postgraduate training at Massachusetts General Hospital, Children’s Orthopedic Hospital & Medical Center and the University of Washington Medical School. He’s held numerous faculty positions at the UW Medical School. Currently retired but previously on staff at Children’s Hospital and Medical Center, University Hospital, Harborview Medical Center, and has held numerous other staff positions at various medical institutions. He has received too many honors to mention, maintains 2 board certifications, is licensed in three states, belongs to many .
professional organizations, has had numerous special national and local responsibilities, been a reviewer for many medical journals, has guest lectured on innumerable occasions and has been published in the world’s most prestigious medical publications. Throughout his career, Dr. Shurtleff has been on the “cutting edge” in his treatment of patients with Spina Bifida
Surgery restores penile nerves for males with Spina Bifida
by Dr. David Shurtleff with Celeste McCormick
Dr. David Shurtleff, Professor of Pediatrics at the University of Washington and both friend and Medical Advisor to SBAWS, announces a major medical advance for men with spinal cord impairment: the first and (and also the first successful) case in the United States of thigh nerve to dorsalpenile nerve to produce sensation in a previously insensitive penis. Known as the "TOMAX" procedure,it entails transferring a branch of the nerve supplying sensation from the thigh skin to the dorsalnerve of the penis.
Dr. Max Overgoor of The Netherlands already experienced success with 18 successful operations; those operations included two patients who had experienced spinal cord trauma resulting in lost sensation or development and 16 patients with Spina Bifida. Dr. Shurtleff invited Dr. Overgoor to Seattle to assist with the procedure. Dr. Thomas Lendvay, Urologist and Dr. Anthony Avellino, Neurosurgeon, both with Seattle Children's Hospital, performed the operation under Dr. Overgoor’s direction. This first US patient to have the procedure, a 20 year old with Myelomeningocele, had the TOMAX procedure performed at Seattle Children's in March 2009. He recently notified Dr. Shurtleff that he is experiencing tingling at the site of the operation in the head of his penis. Dr. Overgoor explained that his 18 successful patients reported this pattern as a precursor to the return of full sensation in the area of the transplanted nerve. It is hoped that this medical advancement will add tremendously to the medical community’s ability to treat boys and young men and will greatly enhance their psychological development.
Eligible patients must have sensation over the anterior and medial skin of the thigh. Any male with trauma to the spine or any form of Spina Bifida would qualify if he has this combination of nerve function and loss. Dr. Shurtleff advises patients to be informed of the operation’s potential and undergo the procedure only when the boy (or man) is old enough to understand its significance. The only barrier to wider-spread use of the TOMAX procedure in the United States is a cost of $15,000 - $20,000 for the hospitalization and whether Medicaid, Medicare or insurance companies will reimburse for the procedure. Seattle Children's Hospital's Medical Director convinced the hospital to waive the hospital cost for the first patient and the surgeons charged no operative fee.Use of the procedure may become more common if men start applying to their insurance companies and/or the government for coverage of the operation. In the meantime, Dr. Shurtleff urgently wants to form an advocacy group of interested males and/or their parents to help lobby the government and insurance companies. Dr. Shurtleff has permission to assess one adult per month at Seattle Children’s Hospital. Please contact him if you are interested in learning more about this procedure and securing financing or reimbursement.
Contact Dr. Shurtleff:
Department of Pediatrics,
University of Washington,
Seattle WA 98195
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