Penis transplant offers hope to victims of botched circumcisions

In the depths of winter, high in the mountains of South Africa’s Eastern Cape, teenage boys clad only in blankets, with white clay painted on their faces, undergo agonising traditional circumcisions. Hundreds have died as a result of the ritual, and hundreds more have lost their penises due to infection, according to the South African Health Ministry.

For years, Dr Andre van der Merwe, head of urology at Stellenbosch University in the Western Cape, has listened to the heartbreaking stories of dozens of victims, many of whom were suicidal. In 2010, he decided to determine how to perform a penile transplant.

“I thought it would be simple. How wrong I was.”

It took Van der Merwe and a team of surgeons nine hours to conduct what is being called the world’s first successful penile transplant, in December at Tygerberg Hospital in Cape Town. It was a tense day, involving hours struggling to tease out delicate nerve endings and blood vessels from the patient’s hardened scar tissue and graft on a penis taken from the cadaver of an organ donor.

“We were not standing around that operating table for nine hours telling jokes,” he says. “The amount of scar tissue that had been created around the area was huge. It was very difficult to get the nerves out. We couldn’t get the blood vessels out. We had to abandon that effort in the end.” Doctors eventually used another nearby blood vessel.

The result exceeded Van der Merwe’s wildest hopes: He had advised his 21-year-old patient that he might recover his sexual function after perhaps two years. To his astonishment, the man, who has a girlfriend, became sexually active within five weeks.