Weeks after the world's first penis reduction surgery, doctors at Stellenbosch University and Tygerberg Hospital (pictured) in Cape Town, South Africa have performed the world's first successful penis transplant. The patient is a 21-year-old who lost his penis in a botched circumcision. He's now "able to pass urine, have an erection, orgasm and ejaculate" following the surgery that took place last December.
The man was 18 and already sexually active when he had the circumcision. The procedure is part of the transition from boyhood to adulthood in parts of South Africa. The boy was left with just 1cm of his original penis. Doctors say South Africa has some of the greatest need for penis transplants anywhere in the world. Dozens, although some say hundreds, of boys are maimed or die each year during traditional initiation ceremonies. Surgeons at Stellenbosch University and Tygerberg Hospital performed a nine-hour operation to attach a donated penis. One of the surgeons, Andre Van der Merwe, who normally performs kidney transplants, told the BBC News website: "This is definitely much more difficult, the blood vessels are 1.5 mm wide. In the kidney it can be 1 cm." The team used some of the techniques that had been developed to perform the first face transplants in order to connect the tiny blood vessels and nerves. The operation took place on 11 December last year. Three months later doctors say the recovery has been rapid. Full sensation has not returned and doctors suggest this could take two years. However, the man is able to pass urine, have an erection, orgasm and ejaculate. The procedure required a lot of preparation. The team needed to be sure the patient was aware of the risks of a life-time of immunosuppressant drugs. Also some patients cannot cope with a transplant if they fail to recognise it as part of their body. "Psychologically, we knew it would have a massive effect on the ego," said Dr Van der Merwe. It took "a hell of a lot of time" to get ethical approval, he added. One of the concerns is a heart transplant balances the risk of the operation against a certain death, but a penis transplant would not extend life span. Dr Van der Merwe told the BBC: "You may say it doesn't save their life, but any of these young men when they have penile amputations are ostracised, stigmatised and take their own life. If you don't have a penis you are essentially dead, if you give a penis back you can bring them back to life." Further attempts on other patients are expected to take place in three months time.There have been multiple attempts, including one in China. While those surgeries went fine, the patients later rejected the donated penis.