It is a seminal moment for medicine. Surgeons in South Africa declared today that they have performed the world’s first penis transplant with a successful long-term result. The patient, a 21-year-old man, was operated on in December and has, according to surgeons at Stellenbosch University and Tygerberg Hospital, “regained all function in the newly transplanted organ.”

“It’s a massive breakthrough,” says professor André van der Merwe, head of the university’s division of urology. After a nine-hour operation in December, surgeons expected the transplant to take two years to become fully functional. But the patient surprised doctors with the speed with which he gained full use of the organ.

“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,” according to Van der Merwe. Thousands of young men undergo ritual circumcision, without anaesthetic, as part of initiation in the bush—and those who have not been circumcised are ridiculed, according to a 2012 BBC report. Already this year, 26 boys have died from the ritual. Some 250 penis amputations are performed in South Africa every year as a result of botched circumcisions.

The patient who underwent the successful procedure is the first in a 10-man pilot program to go undergo a transplant.