Penile Transplant

[JesusA (imported)]

From this morning's news. The detailed academic article will probably not be published for months.

Stellenbosch University doctors perform first successful penile transplant in the world

13 March 2015

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

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. 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," says 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, Prof Rafique Moosa, head of the FMHS Department of Medicine, transplant coordinators, anaesthetists, theatre nurses, a psychologist, an ethicist and other support staff.

The patient, whose identity is being protected for ethical reasons, has made a full recovery and has regained all function in the newly transplanted organ.

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

"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," says Graewe. "It was a privilege to be part of this first successful penis transplant in the world."

"Western Cape Government Health (WCGH) is very proud to be part of this ground-breaking scientific achievement," says Dr Beth Engelbrecht, head of the WCGH. "We are proud of the medical team, who also form part of our own staff compliment at Tygerberg Hospital. It is good to know that a young man's life has been significantly changed with this very complex surgical feat. From experience we know that penile dysfunction and disfigurement has a major adverse psychological effect on people."

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," explains Van der Merwe.

Three years ago the 21-year-old recipient's penis had to be amputated in order to save his life when he developed severe complications after a traditional circumcision. 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," says Van der Merwe.

"The heroes in all of this for me are the donor, and his family. They saved the lives of many people because they donated the heart, lungs, kidneys, liver, skin, corneas, and then the penis," says Van der Merwe. Finding a donor organ was one of the major challenges of the study.

The planning and preparation for the study started in 2010. After extensive research Van der Merwe and his surgical team decided to employ some parts of the model and techniques developed for the first facial transplant.

"We used the same type of microscopic surgery to connect small blood vessels and nerves, and the psychological evaluation of patients was also similar. The procedure has to be sustainable and has to work in our environment at Tygerberg," says 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.

Media enquiries

Mandi Barnard
Marketing Coordinator
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Marketing and Communication Office
Faculty of Medicine and Health Sciences
Stellenbosch University

Prof André van der Merwe
Head of the Division of Urology
[email protected]
Department of Surgical Sciences
Faculty of Medicine and Health Sciences
Stellenbosch University

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[SplitDik (imported)]

Wow, 250 amputations a year due to circumcision complications. That's an interesting statistic.

[C&TL2745 (imported)]

I wonder whether they're accepting any donors who are still alive. Looks like it could be an opportunity for some guys here.

I plan to tell my hubby when he gets home. I don't think he'll want to get the surgery, but when he finds himself really missing his penis, the thought that not having one is not necessarily a permanent situation might brighten his mood.

Sandi

[Kortpeel (imported)]

Wow, 250 amputations a year due to circumcision complications. That's an interesting statistic.

I understand that the circumcisions are a right of passage of Xhosa boys around the age of sixteen. They go to an initiation school for two or three weeks where they learn ancient tribal secrets and aspects of their culture. The schools are held out in the bush miles from anywhere and far from orthodox medical facilities. Originally it was experienced trial elders who ran the schools but these days a criminal element is also running initiation schools to make a quick easy buck.

The actual circumcision is done by stretching the foreskin and just slicing (sawing?) it off with anything that is sharp. Broken glass is popular because it is cheap, easily obtainable and sharp. Hygiene practices are not a part of the culture. The same piece of glass may be used for all the initiates.

The authorities are trying to establish a principle that only trained and qualified people may perform the actual circumcisions but there is a resistance to this on custom and practice grounds. They've been doing it this way from pre-colonial times.

One of the reasons for the persistence of the practice is that until recently no Xhosa girl would have sex with an uncircumcised man. He is still regarded as a boy until he has been through the initiation. Now that girls in this country are being educated I hope they will have more sense.

That's why there are 250 amputations a year. Snag is that there is going to be a shortage of donors too. The time may come when there is a market for penises.

[Mac (imported)]

I wonder whether they're accepting any donors who are still alive. Looks like it could be an opportunity for some guys here.

I plan to tell my hubby when he gets home. I don't think he'll want to get the surgery, but when he finds himself really missing his penis, the thought that not having one is not necessarily a permanent situation might brighten his mood.

Sandi

I would be willing to donate the whole thing (penis, testicles, etc) as long as I received a proper and functional reroute.

[kristoff]

Kortpeel, haven't seen you on here, or posting, in ages. welcome back.

[anthonyg (imported)]

That's just amazing. A new step in urologic surgery. It makes you wonder what's next. I have heard that they will be using 3-D printing for organs soon, maybe in five years. They've already used a 3-D bladder and kidney. Could a penis be next?

https://www.ted.com/talks/anthony_atala ... anguage=en

http://www.ted.com/talks/anthony_atala_ ... _tissue?la nguage=en

[YodaNell (imported)]

I wonder if they also transplanted the testes...or is it just the penis. Can testicles be transplanted. Maybe our amazing doctors in my country will figure this out in the future. I read in our newspaper this morning that more funds are needed to complete this study.

[JesusA (imported)]

I wonder if they also transplanted the testes...or is it just the penis. Can testicles be transplanted. .

In this case it was only the penis. With all of the botched circumcisions in South Africa, it may become a frequent surgery. The major problem will be finding donors....

The first successful testicle transplant was several years ago, between two nearly identical twins. One twin was born with two healthy testicles, the other with none. As young adults one twin donated one of his testicles to his twin in an eight hour surgery. Testicles are much more difficult than penises to attach. Both twins subsequently had children with their functioning single testicle. There was some speculation at the time as to whether or not the child created by the donated testicle should be considered the biological offspring of his mother's husband (the testicle receiver) or of his uncle (the testicle donor).

[paring (imported)]

There are also butchered circumcisions done in USA and Canada and governments would never dare put a ban, on those useless and barbaric procedures, upon defenseless boys. Each years, in USA, there are over 200 babies who die following theirs circumcision and this is without counting those who will have to live their whole life with a mutilated or amputated penis. Check those links

https://www.youtube.com/watch?v=5GrU5N4QdfQ

http://en.wikipedia.org/wiki/David_Reimer

https://www.youtube.com/watch?v=HQYuvYr_dUk

it's only a few of the them. If you dare to run a search on this subject, you will find hundreds more videos and news articles on this matter. I'm one of them, my circumcision has ruined my life. I told my father (he doesn't understand, he is uncut) that I didn't like my circumcision, but I spared him all the details, in fact this is the main source of my castration fantasy. Like the guy in one of the video who tried to kill himself, I've already tried twice and I'm thinking about it everyday, perhaps the third one will do it. Now that I have told you my secrets, perhaps you will understand better the meaning of "Circumcision now, castration then"