The University of Stellenbosch has performed its second penis transplant operation, after doing the world's first at Tygerberg Hospital in December 2014.
This is the third penis transplant conducted to date globally, with the second one conducted in Boston at Massachusetts General Hospital.
The recipient‚ a 40-year-old man‚ has been without a penis for 17 years after a botched traditional circumcision.
"He is certainly one of the happiest patients we have seen in our ward. He is doing remarkably well. There are no signs of rejection and all the reconnected structures seem to be healing well‚" said Prof Andre Van der Merwe‚ head of the division of urology at Stellenbosch University's faculty of medicine and health sciences.
The patient is expected to regain full use of his penis within six months of the transplant‚ it was said in the release.
Medical tattooing will be used to correct the colour discrepancy between the recipient and the donor organ in six to eight months after the operation.
"Patients describe a penis transplant as 'receiving a new life'. For these men, the penis defines manhood and the loss of this organ causes tremendous emotional and psychological distress‚" said the urology division's Dr Amir Zarrabi‚ who was a member of the transplant team. "I usually see cases of partial or total amputations in July and December — the period when traditional circumcisions are performed."
The team consisted of Van der Merwe‚ Dr Alexander Zühlke‚ who heads the division of plastic and reconstructive surgery‚ Prof Rafique Moosa‚ head of the department of medicine‚ Zarrabi and Dr Zamira Keyser of Tygerberg Hospital. They were assisted by transplant co-ordinators‚ anaesthetists‚ theatre nurses‚ a psychologist‚ an ethicist and other support staff.
The first penis transplant patient from December 2014 is using his penis as normal.
"The patient is doing extremely well‚ both physically and mentally"‚ Van der Merwe said. "He is living a normal life. His urinary and sexual functions have returned to normal‚ and he has virtually forgotten that he had a transplant."
The transplant procedure is very complicated as nerves‚ blood vessels and muscle from the donor organ have to be connected to the recipient.
"The diverse presentation of the blood vessels and nerves makes the operation very challenging and means each case is unique. All these structures need to be treated with the utmost delicacy and respect in order to be connected perfectly to ensure good circulation and function in the long term‚" said Zühlke.
Microsurgery was used to connect small blood vessels and nerves.
It is thought that up 250 partial or complete penile amputations take place a year in SA due to botched traditional circumcisions.
"At Stellenbosch University and Tygerberg Hospital we are committed to finding cost-effective solutions to help these men‚" Van der Merwe said. The procedure was part of a proof-of-concept study to develop a cost-effective penile transplant procedure that could be performed in a typical theatre setting in a South African public-sector hospital‚ he said.
The costs of the second procedure was much less than the first.
The biggest challenge to rolling out this procedure is the shortage of organs. "I think the lack of penis transplants across the world since we performed the first one in 2014‚ is mostly due to a lack of donors. It might be easier to donate organs that you cannot see‚ like a kidney‚ than something like a hand or a penis‚" said Van der Merwe.
"We are extremely grateful to the donor's family who so generously donated not only the penis‚ but also the kidneys‚ skin and corneas of their beloved son. Through this donation they are changing the lives of many patients.
The patient had counselling over two years to explain and ensure he understood the operation was not a tried-and-tested treatment‚ but is still an experimental procedure with many risks.
TMG Digital
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