Chinese surgeons have performed the world's first penis transplant on a man whose organ was damaged beyond repair in an accident this year.
The incident left the man with a 1cm-long stump with which he was unable to urinate or have sexual intercourse. "His quality of life was affected severely," said Dr Weilie Hu, a surgeon at Guangzhou General Hospital.
Doctors spent 15 hours attaching a 10cm penis to the 44-year-old patient after the parents of a brain-dead man half his age agreed to donate their son's organ.
The procedure, described in a case study due to appear in the journal European Urology next month, represents a big leap forward in transplant surgery; it required complex microsurgery to connect nerves and tiny blood vessels.
The surgical team claims the operation was a success. After 10 days, tests revealed the organ had a rich blood supply and the man was able to urinate normally.
Doctors have previously succeeded in reuniting men with their sexual organs after traumatic accidents or attacks, but the Guangzhou operation is the first in which a donor penis has successfully been attached to another man.
Although the operation was a surgical success, surgeons said they had to remove the penis two weeks later.
"Because of a severe psychological problem of the recipient and his wife, the transplanted penis regretfully had to be cut off," Dr Hu said.
An examination of the organ showed no signs of it being rejected by the body.
Jean-Michel Dubernard, the French surgeon who performed the world's first face transplant on a woman who had been attacked by a dog this year, said psychological factors were a serious issue for many patients receiving certain "allografts", or organs from donors.
"Psychological consequences of hand and face allografts show that it is not so easy to use and see permanently a dead person's hands, nor is it easy to look in a mirror to see a dead person's face," he wrote in the journal.
"Clearly, in the Chinese case the failure at a very early stage was first psychological. It involved the recipient's wife and raised many questions."
In 2001, surgeons were forced to amputate the world's first transplanted hand from Clint Hallam, a 50-year-old New Zealander, who said he wanted the "hideous and withered" hand removed because he had become "mentally detached" from it.
The original transplant was conducted by Prof Dubernard's team at the Edouard Herriot Hospital in Lyons, who have since performed the world's first double arm transplant.
Andrew George, a transplant expert at Imperial College, London, said: "Doing a penis transplant should be no more complex than anything else.
But it takes time for nerve sensations to kick in and it's not clear whether the patient would ever be able to have sex with it.
The question is whether it's right to be doing a transplant for what may be seen as cosmetic reasons."