Wednesday, September 20, 2006

World's 1st penis transplant - "On again, off again!"

I missed the announcement of this tabloid-esq Plastic Surgery first, but some Plastic Surgeons performed the world's first penis transplant in China recently. The man had the surgery in Guangzhou, China after his own penis was damaged beyond repair in an accident this year, leaving him with a 1cm stump with which he was unable to urinate or have sexual intercourse. Surgeons at Guangzhou General Hospital said it took 15 hours of microsurgery on the unidentified 44-year-old man to attach the 4-inch organ donated by the family of a younger brain-dead patient.

The surgery itself went without problems which is not surprising. The techniques of microsurgical & urologic surgery used are well-established & have been used to reattach a number of traumatic amputations (eg. John Wayne Bobbit from a few years back). After 10 days, tests revealed the organ had a rich blood supply and the man could urinate normally. This is a truly remarkable achievement to get such brisk return of function IMO.

Much like the face and hand transplants done prior, the real problems with these procedures are

1. How can the morbidity of the immunosuppressive be reduced to justify more widespread use? Our current immunosuppresive therapy has advanced tremendously, but we still require patients to take expensive drugs indefinitely which predispose them to opportunistic infections and cancers.

2. Are we as a society prepared to pay for these VERY expensive transplant scenarios when the healthcare system is going bankrupt?

3. How well are these transplanted organs going to function & what are we going to consider a success?

4. Who is a qualified candiate psychologically to receive part of another human?

It's this last point that has reared it's head again with this patient. Surgeons had to remove the penis after just two weeks. "Because of a severe psychological problem of the recipient and his wife, the transplanted penis regretfully had to be cut off," Dr Hu (the surgeon who performed the procedure) said.


This once again show a breakdown in patient screening that plagued the first hand & partial face transplant patients performed by Dr. Jean-Michel Dubernard in France. The desire for publicity runs ahead of measures to allow true "informed consent" to patients.


1 comment:

Anonymous said...

Yikes. Wonder if China shows those "take-on-the-donor-psyche-after- transplant" slasher flicks? Maybe the donor had been a real "pr$$k??"