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The Problems with Penis Transplantation

The past half-century has yielded revolutionary advancements in transplantation medicine: the first pancreas transplant in 1966; the first heart transplant in 1967; the first hand transplant in 1998; the first ovarian transplant in 2005; the first full facial transplant in 2010.

But somewhat forgotten amongst the successes of the past is the first penis transplant, conducted in 2006 at the General Hospital of Guangzhou Military Command in China.

After a traumatic accident, a 44-year-old man was left with a half-inch stump of a phallus. He was unable to have sex with his wife, or even urinate standing up. As NBC reported, lead surgeon Hu Weille considered the man a prime candidate for the procedure.

"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 in the peer

reviewed journal European Urology.

Eight months after the man's unfortunate disfiguration, he received a sparkling new penis from a 22-year-old brain dead donor, one which Hu described as having an "excellent cosmetic appearance." But though the operation was an apparent success, with no signs of rejection, the new penis was amputated after two weeks at the behest of the man and his wife.

"The patient finally decided to give up the treatment because of the

wife's psychological rejection as well as the swollen shape of the

transplanted penis," Hu wrote in the report describing the surgery.

shutterstock_109218035.jpgUnlike all of the other transplantation breakthroughs, penile transplantation has yet to be replicated, or even attempted for a second time. The hesitance isn't tied to the difficulty of the procedure itself, which simply involves reconnecting the urethra and erectile tissue, as well as suturing together veins, arteries, and nerves. Instead, as the first case elucidates, the problems are tied to the recovery process.

Prior experience has made clear that transplant recipients, particularly those that receive external tissues such as hands or parts of the face, can have severe issues adjusting to their new body parts. In the wake of their procedures, all recipients require some form of psychological support.

Moreover, penile transplant recipients will be forced to take powerful immunosuppressive drugs for the rest of their lives in order to prevent their immune system from attacking the penis as a foreign invader.

"These drugs... predispose a patient to opportunistic infections, end-organ damage, diabetes and lymphoma," Hu noted in a 2010 review. The disconcerting side effects raise a cost-benefit conundrum. Is a new penis really worth the health sacrifice?

There are also ethical issues as far as the donor is concerned. Since the male member holds somewhat of a lionized, mystical status in many societies (at least among men), many organ donors could have issues with donating their penis versus donating internal organs like the heart or pancreas. Hu also warns that donor and patient privacy must be of the utmost importance, especially if the penis is donated by a living patient seeking to switch genders.*

Though there are numerous speed bumps on the road to successful penis transplantation, the procedure will undoubtedly be attempted again.

*Update on 8/22: As both Hu and an enlightened commenter point out, transplanting a penis donated by a transsexual patient is likely unsuitable at this time, as the penile skin is currently used to reconstruct the vagina during a surgical sex change.

(Image: Large Banana via Shutterstock)