Abstract
BackgroundIn South Africa, penile loss is a recognised complication of ritual circumcision which has a profoundly negative effect on these men's psyches and their everyday lives. The purpose of this paper was to investigate the experiences of the first two South African penile allograft transplantation recipients in order to assess the psychosocial impact of this surgery. Materials and methodsA qualitative descriptive phenomenology approach was used. A total of four in-depth interviews were conducted with the two South African penile transplant recipients. The interviews were transcribed verbatim while adding the field and observational notes. Thematic analysis was used to derive meaning from the collected data. ResultsAfter the penile loss, both participants reported feeling suicidal for the following reasons: their communities shunned them and regarded them as ‘dead,’ they felt severely ashamed of their disfigured bodies, they were unable to develop intimate relationships and could not have children. Transplantation gave them a fully functional penis, which resolved the majority of these issues. The participants were able to build relationships and satisfy their own and their partners' sexual and relationship needs. The transplant led to complete restoration of their self-image and manhood. They were, however, still persecuted by their traditional communities as they had not successfully completed the ritual circumcision ceremony. ConclusionThis study emphasises the necessity of offering penile transplantation as treatment for penile loss as this is not only life enhancing but lifesaving, especially within the South African context.
Highlights
Complete or partial penile loss are recognised complications of ritual circumcision in South Africa, with some 250 men suffering this fate each year [1]; beside penile loss, this ritual carries a real mortality risk
Penile loss is to cultural purists an indication of weakness and has a significant impact on how these men are perceived by their commu nities
Maslow’s hi erarchy of needs is a theory that depicts the basic needs of an individual that should be met in order for that person to reach self-actualisation, that is to become the most that he or she can be
Summary
Complete or partial penile loss are recognised complications of ritual circumcision in South Africa, with some 250 men suffering this fate each year [1]; beside penile loss, this ritual carries a real mortality risk. Penile loss is to cultural purists an indication of weakness and has a significant impact on how these men are perceived by their commu nities They are ostracised and are not regarded as ‘men’ in the tradi tional environment where they are treated as ‘boys’ by men younger than themselves; this is because they failed to complete the ritual circumcision and are left without a functioning penis. While they are perceived as boys, they are treated as if ‘dead’ and not worth including in the affairs of the community. Conclusion: This study emphasises the necessity of offering penile transplantation as treatment for penile loss as this is life enhancing but lifesaving, especially within the South African context
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