Dr. Adder

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Dr. Adder is a dark science fiction novel by K. W. Jeter set in a future where the United States has largely broken down into reluctantly cooperating enclaves run by a wide variety of strongmen and warlords, with a veneer of government control that seems largely interested in controlling technology. Dr. Adder is an artist-surgeon, who modifies sexual organs of his patients to satisfy the weirdest of perversion; he is clearly depicted as a partly criminal, partly counter-cultural figure in a future Los Angeles which anticipates the cyberpunk idea of the Sprawl.
Dr. Adder is Jeter's debut novel. It was originally completed in 1972, and then published in 1984 by Bluejay Books — the first fictional work it ever published — with illustrations by Matt R. Howarth.
According to Philip K. Dick, the publication of this book was delayed for a decade due to the extreme violence and graphic sex, and but for this delay it would have been recognized as the first cyberpunk novel.