SA university performs first-ever penis transplant on botched circumcision victim

In a ground-breaking operation, a team of surgeons from Stellenbosch University (SU) and Tygerberg Hospital performed the world’s first-ever successful penile transplant.

The marathon nine-hour operation, led by Prof André van der Merwe, head of SU’s Division of Urology, was performed on 11 December 2014 at Tygerberg Hospital in Bellville, Cape Town.

The 21-year-old patient’s penis was amputated three years ago after he developed severe complications after a botched initiation circumcision.

The recipient, whose identity is being protected for ethical reasons, has made a full recovery and has regained all function in the newly transplanted organ which he received from a deceased organ donor.

“Our goal was that he would be fully functional at two years and we are very surprised by his rapid recovery,” said Van der Merwe. The end result of the transplant was the restoration of all the patient’s urinary and reproductive functions.

This is the second time that this type of procedure was attempted, but the first time in history that a successful long-term result was achieved.

“South Africa remains at the forefront of medical progress,” commented Prof Jimmy Volmink, Dean of SU’s Faculty of Medicine and Health Sciences (FMHS). “This procedure is another excellent example of how medical research, technical know-how and patient-centred care can be combined in the quest to relieve human suffering. It shows what can be achieved through effective partnerships between academic institutions and government health services.”

Van der Merwe was assisted by Prof Frank Graewe, head of the Division of Plastic Reconstructive Surgery at SU FMHS.

“It’s a massive breakthrough. We’ve proved that it can be done – we can give someone an organ that is just as good as the one that he had,” said Graewe. “It was a privilege to be part of this first successful penis transplant in the world.”

The procedure was part of a pilot study to develop a penile transplant procedure that could be performed in a typical South African hospital theatre setting.

“There is a greater need in South Africa for this type of procedure than elsewhere in the world, as many young men lose their penises every year due to complications from traditional circumcision,” explained Van der Merwe.

Although there are no formal records on the number of penile amputations per year due to traditional circumcision, one study reported up to 55 cases in the Eastern Cape alone, and experts estimate as many as 250 amputations per year across the country.

“This is a very serious situation. For a young man of 18 or 19 years the loss of his penis can be deeply traumatic. He doesn’t necessarily have the psychological capability to process this. There are even reports of suicide among these young men,” said Van der Merwe.

This procedure could eventually also be extended to men who have lost their penises from penile cancer or as a last-resort treatment for severe erectile dysfunction due to medication side effects. As part of the study, nine more patients will receive penile transplants.