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‘Penis transplant restores Man’s pride’

Dr Andre* Van der Merwe, * Head of the Division of Urology at Stellenbosch University's FacultyA victim of a botched circumcision process has received a new lease on life
after undergoing a successful penis transplant in April 2017, ensuring that
his manhood was fully restored and that he will be able to enjoy unfettered
access to the ‘pleasures of the flesh.’

The ground breaking surgery was performed by the pioneering urologist Andre Van
der Merwe and his team at the Tygerberg Academic Hospital. Van der Merwe*
also* conducted the first successful penile transplant in December 2014.

The soft spoken head of the Division of Urology at Stellenbosch
University's Faculty, who comes from a long generation of Dutch farmers
told a team from Positive Vibes Key Correspondents that the importance of
the penis was in the male psyche was not properly understood.

“The importance of the penis in male psychology is underestimated,” said
Van Der Merwe. He stressed, “People who lose their penises are scared to
talk about it. Patients are embarrassed to raise the issue art support
group meetings.”

Van Der Merwe related how he encountered men who had lost their penises
during circumcision and who were ostracized from family members and not
allowed to participate in decision making.

“The loss of self-esteem is more impactful after losing their penis as
opposed to losing a kidney,” said Van Der Merwe.  He cited the work of the
renown German psychosexual development theorist to emphasize his point and
the complexity of opinions around the subject.

Sigmund Freud maintained that young girls experience anxiety upon
realization that they do not have a penis
<https://en.wikipedia.org/wiki/Human_penis>. He considered this realization
a defining moment in a series of transitions toward a mature female
sexuality and gender identity
<https://en.wikipedia.org/wiki/Gender_identity> and argued that penis envy
stage begins the transition from an attachment to the mother to competition
for attention, recognition and affection of the father.

The parallel reaction of a boy <https://en.wikipedia.org/wiki/Boy>'s
realization that women do not have a penis is castration anxiety
<https://en.wikipedia.org/wiki/Castration_anxiety>.

A penis transplant is relatively expensive process with first costing about
ZAR 252,000.00 for 1st month in hospital including surgery and medication
with costs falling with the passage of time.

“The surgical complications are early on. If you survive the first two
weeks I think you will be alright,” said Van Der Merwe.

He said, “We screen patients to determine their psychology and ensure cell
stability. It really does not make sense to use people who cannot stick to
medication.”

*T*raditional circumcision <https://en.wikipedia.org/wiki/Circumcision> and
initiation <https://en.wikipedia.org/wiki/Initiation> into manhood, is an
ancient initiation rite practised by many rural communities around Africa
and more especially the amaXhosa
<https://en.wikipedia.org/wiki/Xhosa_people>. The ritual
<https://en.wikipedia.org/wiki/Ritual> is traditionally intended as a
teaching institution, to prepare young males for the responsibilities of
manhood.

The initiation ritual is commonly conducted during June or December. During
the ritual process the traditional surgeon (*ingcibi*) severs the foreskin
<https://en.wikipedia.org/wiki/Foreskin> using an assegaai (sharp knife),
after which he says "You are a man!" The initiate shouts in reply
"Ndiyindoda!" ("I am a man!").

Given the archaic nature of the process lots of initiates have succumbed to
circumcision complications caused by the incompetence of traditional
practitioners.  However some communities have learnt from these mishaps
like the amaMpondo <https://en.wikipedia.org/wiki/Pondo_people> who practised
the ritual until King Faku
<https://en.wikipedia.org/wiki/Faku_a_Ngqungqushe> prohibited it in the
1820s after he had lost several of his sons from complications.

Unfortunately this lesson has not been replicated in rural communities and
in January 2014, Desmond Tutu <https://en.wikipedia.org/wiki/Desmond_Tutu> felt
compelled to urge traditional leadership and government to intervene, and
"to draw on the skills of qualified medical practitioners to enhance our
traditional circumcision practices."

“Xhosa’s are not encouraged to go to Western doctors. Many go to the bust
and take poison and never come back,” said Van Der Merwe.

He maintained that many African men come to them very desperate and willing
to do anything to help restore their manhood. This was the case with the
recipient of the latest penis who benefitted from a white donor. Black
South Africans allegedly believe it is a very bad omen to remove vital male
organs because you will not be able to use them in the next life.

“We are considering medical tattooing to colour white donors penis black,”
said Van Der Merwe. The patient whose name cannot be divulged lost use of
his penis at 17 years.

Penis transplants typically are restricted to exclude people older than 40
years, TB patients, those who are mentally disabled and individuals
burdened diseases of the blood vessels.

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