Misgivings lead to reversal of penis transplant

Chinese doctors say they successfully transplanted a penis on a man who lost his own in an accident, but had to remove it two weeks later because of psychological problems experienced by the man and his wife.

The case appears to be the first such transplant reported in a medical journal — European Urology, published by the European Association of Urology.

The Chinese doctors could not be reached for comment, and their report does not explain how the 44-year-old man lost his penis. It says only that "an unfortunate traumatic accident" left him unable to urinate or have sex normally.

Surgeons led by Dr. Hu Weilie at Guangzhou General Hospital performed the transplant in September 2005, a hospital spokesperson said Tuesday. The penis came from a 22-year-old brain-dead man whose parents agreed to donate his organ.

"There was a strong demand from both the patient and his wife" for a transplant, and the operation "was discussed again and again" and approved by the hospital's ethics committee, Hu wrote.

The procedure involves standard microsurgery techniques to reconnect blood vessels and nerves. From a medical point of view, "the main hurdle is the functional recovery," said Dr. W.P. Andrew Lee, chief of plastic surgery at the University of Pittsburgh Medical Center.

Psychological issues are keenly important. The world's first hand-transplant recipient stopped taking immune-suppression drugs and later requested that the hand be amputated.

Two weeks after the penis transplant, the recipient and his wife requested that the organ be removed "because of the wife's psychological rejection as well as the swollen shape of the transplanted penis," the surgeons reported in the journal.

Lab examination showed no sign of rejection by the body, the doctors reported.

If adequate attention had been paid to the need for counseling and other psychological concerns surrounding the transplant, "the need for penile amputation could probably have been avoided," Dr. Yoram Vardi, a neurology and urology specialist at the Rambam Medical Center in Haifa, Israel, wrote in an accompanying commentary in the journal.