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There comes a time in every urologist's career that a patient makes a request that leaves a physician speechless. That question was "can you make my penis smaller"?'
Rafael Carrion, urologist at the University of South Florida
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Published: 09:46 BST, 12 February 2015 | Updated: 14:06 BST, 12 February 2015
A 17-year-old boy has undergone the world's first penis reduction surgery, surgeons claim.
The American teen requested the surgery after his penis grew too large, restricting his ability to have sex or play competitive sports.
The boy's surgeons were shocked when he came to them complaining that his penis was too big.
When flaccid, it measured almost seven inches in length and had a circumference of 10 inches - around the size of a grapefruit.
Surgeons described it as being shaped like an American football.
The surgeon who treated the teenager, Rafael Carrion, a urologist at the University of South Florida, told MailOnline: 'There comes a time in every urologist's career that a patient makes a request so rare and impossible to comprehend that all training breaks down and leaves the physician speechless.
'That question was "can you make my penis smaller"?'
A 17-year-old boy in Florida is thought to be the first person to undergo penis reduction surgery. The teenager requested the operation after his penis (pictured on an X-ray) grew too large
The teenager had suffered from several bouts of priapism - an unwanted erection, due to having a condition in which abnormally-shaped blood cells block vessels in the penis, causing it to swell.
These episodes had left his penis bloated and misshapen.
He said he was unable to have sex or play competitive sport, had difficulty wearing his pants due to his 'large and heavy phallus', and was embarrassed by how visible it appeared underneath regular clothing.
Though his penis was so large, it did not grow when he had erections - it merely became firmer.
'His penis had inflated like a balloon,' said Dr Carrion.
'It sounds like a man's dream - a tremendously inflated phallus - but unfortunately although it was a generous length, it's girth was just massive, especially around the middle.
'It looked like an American football.'
Dr Carrion and his team looked at the medical literature but couldn't find any precedent for what to do.
'Lord knows there's a global race on how to make it longer and thicker in plastic surgery circles, but very little on how to make it smaller,' he said.
In the end, they decided to embark on a surgical technique normally used to treat Peyronie's disease, a condition where scar tissue develops along the penis, causing it to bend.
The surgeons sliced along an old circumcision scar, unwrapped the skin of the penis, and cut out two segments of tissue from either side.
'It was a bit like having two side tummy-tucks - that's how we explained it to him,' said Dr Carrion.
The teenager said he was unable to have sex or play competitive sport, had difficulty wearing his pants due to his 'large and heavy phallus', and was embarrassed by how visible it appeared underneath clothing (file pic)
The doctors were able to bypass the urethra - the tube which carries urine through the penis - and all of the nerves that provide sensation.
The teenager spent just two days in hospital before returning home, apparently 'ecstatic' with his new penis.
The doctors did not take final measurements of the penis, although Dr Carrion told MailOnline the result was 'generous'.
'It's slightly longer and slightly thicker than the average male, but now it looks symmetrical, and the patient was very satisfied,' he said.
The teen now has no problem having normal erections and has full sensation.
'It looks cosmetically appealing, and he said it was a life-changing event, he's all smiles,' said Carrion.
Since the paper describing the surgery was published in The Journal of Sexual Medicine, Dr Carrion has only had one person approach him to request the same surgery.
He said: 'This [second] man seems to have a naturally large penis, because there's nothing unusual in his medical history, so it doesn't seem like there's any real abnormality in this case'.
Whereas the first teenager had an obvious medical condition that needed treating, performing surgery on someone who is completely healthy but having difficulties with the size of his penis is another matter, said Dr Carrion.
'These are controversial waters we're stepping in,' he added. 'Who is to judge what is a legitimate complaint and what isn't?
'You don't normally have men complaining about this kind of thing. These are very unique cases.'
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