Professor Andr� van der Merwe led the surgery. Photo: Health-e-news

Cape Town - The world’s first successful penis transplant, which surgeons predict will give the young recipient the ability to father his own children naturally, has been performed at Tygerberg Hospital.

 

This pioneering operation also restored the dignity of the 21-year-old man, who lost his penis when it developed gangrene after a ritual circumcision.

“The patient is very happy and he’s doing well,” said Professor André van der Merwe, head of Stellenbosch University’s urology division, who led the surgery.

In a marathon nine-hour operation doctors transplanted the entire penis (from the glans to the base) from an organ donor. The patient’s own penis had to be amputated three years ago in order to save his life, leaving him with a stump no longer than 1.5cm, after which he was unable to urinate standing up or have sexual intercourse.

The patient has made a full recovery from the transplant, which took place three months ago. He is able to get erections, urinate standing up, and has sensation in the organ.

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

“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 ritual circumcision,” Van der Merwe said.

Although there are no formal records on the number of penile amputations per year due to ritual circumcision, one study reported up to 55 cases in the Eastern Cape alone. Experts estimate that as many as 250 amputations per year are done 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,” Van der Merwe said.

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

“The research was conducted in partnership with local public health structures and will be delivered to the people who need it most,” said Dr Nicola Barsdorf, head of health research ethics at Stellenbosch University’s faculty of medicine and health sciences.

“Once the surgery is made broadly available, it will be offered in state facilities and be accessible to vulnerable groups that are often unable to afford state-of-the-art health care.”

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

The planning and preparation for the study started in 2010. After extensive research Van der Merwe and his surgical team decided to use some parts of the model and techniques developed for the first facial transplant. The surgeons connected blood vessels and nerves as small as 1mm to 2mm using microsurgery usually employed in plastic and reconstructive surgery.

“South Africa remains at the forefront of medical progress,” said Professor Jimmy Volmink, dean of Stellenbosch University’s medicine and health sciences faculty.

“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.”

Health-e News