Moscow, April 10: A Russian man born with genitals so small that he was unable to have sex has been given the chance to lead a normal love life after a new penis was 'grown' on his arm during pioneering surgery.
In an 11-hour operation, plastic surgeons in Moscow removed the 28-year-old's undersized penis and stitched it on to his left forearm, where they grafted on additional flesh and tissue taken from his inner arm. The newly enlarged organ, which had grown from less than 2 inches to nearly 7 inches, was reattached to his groin.
His surgeon, Professor Mikhail Sokolshchik, of the National Medical Surgical Centre, hopes that the patient will eventually be able to have sexual relations and father children.
The patient, who comes from a Siberian village and was identified only by his first name, Sergei, paid more than '1,000 towards the cost of the operation, which the doctors warned was performed at his own risk.
The bulk of the cost, however, was borne by the clinic, which hopes to market the procedure to similarly afflicted men around the world.
Sokolshchik, who has specialised in microsurgery and phalloplasty ' plastic surgery for male sexual organs ' for 13 years, said: 'We've carried out thousands of operations on patients, ranging from female-to-male transsexuals to the treatment of victims of horrific accidents, and have a wealth of experience in amputation, reconstruction and surgical implants.
'But this operation was highly risky because it was an amputation, reconstruction and reattachment in one go. If it had gone wrong, the patient would have ended up with no genitalia at all.'
It is thought that up to one in 200 men are born with 'micropenises' ' the medical term for male genitalia that are less than two inches long when aroused. Many find intercourse difficult or impossible, often having acute psychological problems as a result.
During Sergei's operation, the surgeons began by removing the tip of his penis - the most sensitive part - and grafting it to his left forearm, allowing cell and tissue material to be kept alive.
Simultaneously, skin from his forearm was cut into two separate flaps, which were rolled up and stitched around flexible tubular silicone implants to fashion a lengthened shaft.
The shaft and tip were then joined as one, before they were removed from the forearm and sewn back on to the base of the man's groin. A section of skin from his thigh was then grafted on to his forearm to reduce visible scarring.
Throughout the operation, doctors swiftly reattached severed veins, capillaries and nerve endings to reduce the risk of sensory damage.
Surgeons have previously used skin from a man's forearm, which is similar in composition to that of the male genitals, in micropenis surgery. Usually, however, the micropenis is not removed. Instead, the artificially created shaft is grafted alongside it.
The result is in some cases largely cosmetic as the new shaft may have only limited sensation.
David Ralph, a consultant urologist at St Peter's Hospital and the Institute of Urology in London, who pioneered the original technique last year, said that Prof Sokolshchik appeared to have taken the procedure a stage further.
"This seems to mean that the small penis has been joined to the top of the new one, which is slightly different to our own technique," he said.
Prof Sokolshchik, who plans to publish full details of the procedure in a medical journal, said the patient was coming to the end of his two-month recuperation period since the operation.
Sergei should soon be able to have sex for the first time. He will not be able to achieve an erection, but will be in a permanent state of semi-arousal. "He has never had a partner or sex because of his micropenis," Prof Sokolshchik said.
"Now he has the opportunity to begin his sexual and romantic life and to father children, assuming his sperm count is normal."
He declined to give further details about Sergei, beyond saying that he contacted the centre eight months ago after reading about it on the internet.
Sergei still faces challenges in his quest for a successful love life. "He has never had a partner before and lives in a village in an extremely remote area," said Prof Sokolshchik. "It may not be that easy for him."