A 21-year-old man in South Africa has received the world’s first successful penis transplant and accepts the organ as his own, doctors said on Friday.

The operation took a team of surgeons nine hours and has allowed the patient to become sexually active.

The man’s penis was amputated three years ago after a circumcision went wrong at a traditional initiation ceremony. The patient, who has not been named, received the new organ from a deceased donor on 11 December and has regained all functions.

Professor Andre van der Merwe, head of the urology division at Stellenbosch University, whose staff carried out the operation at Tygerberg hospital in Cape Town, said the recipient is doing “extremely well” both physically and psychologically.

“The patient accepted the penis as his own,” he told the eNews Channel Africa (eNCA). “He told me in no uncertain terms that the fact it belonged to somebody else is completely out of his mind and he’s moved on with this as his own penis. That’s absolutely the way we want it.”

Van der Merwe indicated that doctors had ensured the donor and recipient were of the same race. “Cosmetically we’ve got a very good match for colour,” he added. “We obviously transplanted a good normal penis and the erections that the patient gets are very good.

“We repaired a small hole in his urethra, the pee pipe, last week so we could remove his catheter and just that induced an erection on the operating table. We were so surprised at that erection that he certainly is getting very good results for his transplant.”

Van der Merwe described the groundbreaking operation as “very, very difficult”. He told eNCA: “What we did was to manage the small blood vessels in the penis, which are really only a little bit more than a millimetre wide, to existing blood vessels in the abdomen that has come down, and we could connect that up.

“So many things could have gone wrong. Actually one of the blood vessels did clot up for a few hours. We could relieve the clot, thankfully.”

Immediately after the operation there was an “oozing” that led to bleeding, he continued. “We were dealing with infection and clot formation and bleeding. That was the most difficult thing initially.”

But the patient is “a very fit young man” and making “a good recovery”.

In 2006, a Chinese man had a penis transplant but his doctors removed the organ after two weeks due to “a severe psychological problem of the recipient and his wife”.

But the South African man and his partner are coping well, according to Van der Merwe. “Huge psychological effects. If you add an organ you make a ripple effect on somebody’s ego, you can even induce psychosis … He was obviously carefully screened to be psychologically stable before we did this.”

The recipient’s girlfriend was offered counselling but declined, Van der Merwe said during the interview broadcast on Friday. “We were very thankful that it all worked out in the end and the patient’s doing well … The patient is sexually active again and is very happy.”

Every year thousands of teenage boys from the Xhosa tribe in South Africa embark on a secretive rite of passage in Eastern Cape province, spending up to a month in seclusion where they study, undergo circumcision by a traditional surgeon, and apply white clay to their bodies.

While many initiation schools are officially sanctioned, others are unregulated and bogus surgeons are blamed every year for numerous deaths and injuries, including gangrene caused by unsterilised blades. Experts estimate that around 250 lose their penises each year to medical complications.

“There is a greater need in South Africa for this type of procedure than elsewhere in the world,” Van der Merwe said in a statement. “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.”

Van der Merwe described the anonymous donor and his family as “the heroes” of the story. “They saved the lives of many people because they donated the heart, lungs, kidneys, liver, skin, corneas and then the penis,” he said.

The South African team included three senior doctors, transplant coordinators, anaesthetists, theatre nurses, a psychologist and an ethicist. The driving force was Professor Frank Graewe, head of plastic reconstructive surgery at Stellenbosch University. He said: “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.”

The team now now plan to perform nine more similar operations. Some techniques were developed from the first facial transplant in France in 2005.

In 1967, Christiaan Barnard performed the world’s first heart transplant at Groote Schuur hospital in Cape Town.