In 2012 a man checked himself into a South African hospital under grim circumstances. He had recently undergone a ritual circumcision, but the procedure was a disaster. His penis had been too tightly wrapped, causing life-threatening gangrene to set in. To save his life, the young man had come to the hospital that day to have his penis amputated.
His story has a happy ending, however. The young man became the recipient of the world’s first successful penis transplant. He now appears to have made a complete recovery with a fully functional penis.
His story has a happy ending, however. The young man became the recipient of the world’s first successful penis transplant. He now appears to have made a complete recovery with a fully functional penis.
No one knows how many penis amputations occur each year. Ritual male circumcision practiced by certain ethnic groups in South Africa acts as a rite of passage for young men. Traditionally, male teenagers attend circumcision schools where they are instructed in sex education and family values. At the end of that process, they are circumcised.
Problems started in recent years as formerly close-knit communities began to degrade and old traditions fell away. The people who now perform the circumcisions often have little if any training. They charge exorbitant prices for the dangerous operation, which entails wrapping the penis at its base to stem the flow of blood before removing the foreskin. When the penis is wrapped too tightly, things go awry.
Sometimes, gangrenous penises fall off on their own. Each year, stories also hit the news of men who died from their infection after refusing to visit a Western hospital for fear of being ostracized. Some who do seek help are turned away by nurses who come from the same culture. Still others, unable to cope with the shame, commit suicide after losing their penis. Those who survive losing an infected penis oftentimes do not tell their relatives or even parents. Living with that secret means they must always be wary about using the bathroom or undressing in front of others, and it prevents them from pursuing romantic relationships.
Dr. Andre Van der Merwe became interested in this problem in 2010 and built a team of others who also believed that penis transplants were worth investigating. They began by working with cadavers in the lab, making sure they understood all the ins and outs of this new type of transplant. All of the tests and ethical reviews went well, and they soon gained approval to begin a clinical trial with humans.
That’s when they hit a major roadblock: They simply could not find a donor. “I think there’s a lot of emotional gravity that goes with the organ,” van der Merwe says. “The psychology stretches deeper than we care to admit in everyday life.”
In South Africa, even if a man signs himself up as an organ donor, his family must give final written approval of that request following his death. Time and again, families flat-out refused to consider giving up the penis of a deceased father, brother, husband or son. “I cannot even count how many no’s we got. It was very frustrating,” van der Merwe says. “People just don’t want their relatives going to the grave without a penis.”
Then, an idea struck. Van der Merwe offered to fashion a faux penis out of a donor’s skin instead—a way to preserve the deceased’s dignity while also allowing him to do one final good deed. “People all of a sudden were thinking about the request, rather than just bluntly saying ‘no,’” van der Merwe says. On the fourth or fifth try—a year and a half after they began the search for a donor—one family finally said yes to a full penis donation.
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