After losing all but one centimeter of his penis to a botched circumcision, an anonymous 21-year-old man from South Africa has found himself on the receiving end of the world's first successful penis transplant, according to the surgical team that performed the procedure. But was it actually the first?

Above: The surgical team behind the transplant | Credit: Stellenbosch University

The nine-hour operation was led by professor Andre van der Merwe, head of Stellenbosch University's Division of Urology, on December 11, 2014 (details surrounding the donated penis and its original owner have been withheld). The patient had his penis amputated three years prior to the transplant, when he developed complications following a botched ritualistic circumcision. A statement released today by the university's Marketing & Communications Department claims the patient "has made a full recovery and has regained all function in the newly transplanted organ."

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"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, in the statement.

"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," added Frank Graewe, head of the university's Division of Plastic Reconstructive Surgery. "It was a privilege to be part of this first successful penis transplant in the world." (It remains to be seen whether this penis will be "just as good" as the original – for more, see the last paragraph of this post.)

The team adds that the demand for penis transplants is unusually high in South Africa, where ritualistic circumcision marks the transition from boyhood to adulthood in many parts of the country. It is estimated that as many as several hundred boys die or are maimed by the practice every year, but exact numbers have been difficult to obtain. In 2012, dozens of South African boys died in a three week period as a result of poorly performed circumcisions. By July 11 of that year, 300 initiates had been hospitalized, and five had sustained injuries so serious that their penises had to be amputated.

First Successful Transplant?

This is not the first time surgeons have claimed to have successfully transplanted a penis.

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In 2006, Chinese surgeons performed a similar procedure on a 44-year-old man who had also lost all but one centimeter of his member. A team led by Weilie Hu, a surgeon at Guangzhou General Hospital, spent 15 hours attaching the 10 cm (3.6 in) penis, which was donated by a 22-year-old brain-dead donor. Ten days post-surgery, that surgical team, too, declared the operation a success, when tests revealed the organ had a rich blood supply and allowed the man to urinate normally.

But four days later, two weeks post-surgery, the penis was removed. In a case study published in The European Journal of Urology, the man's surgeons reported that the penis was cut off "because of a severe psychological problem of the recipient and his wife," though the researchers add that a pathological examination later showed no sign of biological rejection (i.e. a negative immunological response to the transplant), a common problem in transplant cases.

At the time, Jean-Michel Dubernard, the French surgeon who performed the world's first face transplant, noted that psychological factors can be an issue for patients who receive transplants (called "allografts") from donors. "Psychological consequences of hand and face allografts show that it is not so easy to use and see permanently a dead person's hands, nor is it easy to look in a mirror to see a dead person's face," wrote Dubernard in a supplementary article to the researchers' case study. "Clearly, in the Chinese case the failure at a very early stage was first psychological. It involved the recipient's wife and raised many questions."

So. Is the South African case truly the first successful penis transplant? I suppose that depends on how you define success. This is uncharted territory, after all. It's still possible the man's body could reject the penis (transplant rejection usually occurs within weeks or months of a transplant, though it's been known to occur years after an operation), and, according to the man's doctors, full sensation has yet to return to the penis, though this could take a couple of years.

In the meantime, however, the man is able to pass urine, produce an erection, orgasm, and ejaculate. That sounds pretty successful to us.

Time will tell. Nine more patients are expected to receive penile transplants as part of the study. We await the officially published results.

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