Monday, March 16, 2015

Doctors Announce First Successful Penis Transplant: Hope for Guys with a Micropenis?

Doctors at South Africa perform the world's first succesful penis transplantation
The surgical team behind the world's first
successful penis transplantation
Recently, a surgical team from South Africa announced that it has achieved the world's first successful penile transplant operation.

The nine-hour long surgery took place on December 11, 2014. by a team of doctors from the Stellenbosch University in Cape Town and the Tygerberg Hospital.

The 21 year old patient lost his penis in a botched circumcision.

Reportedly, the young man, whose identity was not disclosed "for ethical reasons," has already made an early full recovery, a result which was not expected until December 2016 or later. By full recovery, the doctors refer to the restoration of all the patient's urinary and reproductive functions.

The ground-breaking operation was carried out by a team of surgeons and other specialists from Stellenbosch University (SU) and Tygerberg Hospital. The operation was led by Prof André van der Merwe, head of SU's Division of Urology and was performed at the Tygerberg Hospital in Bellville, Cape Town.

Although this is the second time* a penis transplantation is attempted, this is the first time that a successful long-term result has been achieved.

"South Africa remains at the forefront of medical progress. 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." said Prof Jimmy Volmink, Dean of SU's Faculty of Medicine and Health Sciences (FMHS).

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.

Today, just 3 months after the surgery, the young man appears to have regained all function (including daily erections!) 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." said Van der Merwe.  
 "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. It was a privilege to be part of this first successful penis transplant in the world." said Graewe.
"Western Cape Government Health (WCGH) is very proud to be part of this ground-breaking scientific achievement. 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." said Dr Beth Engelbrecht, head of the WCGH.

The penis transplantation was part of a pilot study that aims to develop a penile transplant procedure that could be performed in a typical South African hospital theatre setting. Apparently, there is a large demand for penises over there!

"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." explained 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 has reported about 60 cases in the Eastern Cape alone, and experts estimate that as many as 250 amputations take place every 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." said 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." said Van der Merwe. Finding a donor organ was one of the major challenges of the study.

The planning and preparation for the study begun 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 that was carried out in France in 2005.

"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." said Van der Merwe.

The team believes that the procedure may one day also be used 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. Who knows, maybe one day adults with a micro penis who currently have next-to-none options can simply get a new, normal sized penis from a cadaver!

As part of the study, nine more patients are expected to receive penile transplants.

* The first penis transplantation was performed in September 2006 at a military hospital in Guangzhou, China. The patient, a 44-year-old male, had lost most of his penis in an accident. The transplanted penis came from a brain-dead 22-year-old male. Although successful, the patient and his wife suffered psychological trauma as a result of the procedure, and had the surgery reversed just 15 days later.

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