Surgeons in South Africa announced last week that a penis transplant surgery performed in December had been successful, saying that the patient now had complete urinary and reproductive functionality.

Though not the first attempt at transplanting a donor penis, according to the physicians involved, this is the first time it has been successful. They believe it marks a turning point in helping men who have lost their penises.

The patient, an unidentified 21-year-old, lost his penis three years ago. Doctors were forced to amputate it in order to save the young man’s life when he developed severe complications following a ritual circumcision. The transplant used a penis from an organ donor, whose family had also donated his heart, lungs, kidneys, liver, skin, and corneas to medicine after his death.

It was attached to the recipient during a nine-hour surgery using microsurgical techniques originally developed for the first facial transplant surgery. Like recipients of other organs, this young man will have to take anti-rejection drugs for the rest of his life.

Doctors expected full function of the penis—both urinary and reproductive—to take about two years, but were surprised to find that it happened far sooner than expected. Professor Frank Graewe, head of plastic reconstructive surgery at Stellenbosch University and a member of the surgical team, said in a press release that the surgery marked a “massive breakthrough.”

“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,” Graewe said.

André Van De Merwe, who led the team of surgeons during the transplant, said in a press release that these techniques could be useful throughout the country.

“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,” he said. “This is a very serious situation. 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.”

Some experts warn that we should proceed with cautious optimism. A 2006 attempt at a penile transplant by doctors in China ended with the new organ being removed when the patient suffered severe psychological stress. John Robinson, professor of psychiatry and surgery at Howard University, told CNN, “The anxiety of waiting for a transplant creates a lot of anxiety and tension. Once you get the transplant, the anxiety of rejection keeps people pretty nervous.”

Anthony Atala, director of the Wake Forest Institute for Regenerative Medicine, told CNN that while helping men regain their function is a good thing, “it’ll be important to have a follow-up to ensure that we don’t have what happened in China.”

The doctors in South Africa are planning to give nine more men—all of whom lost their penises after botched ritual circumcisions—transplanted penises as part of this initial feasibility study. They believe that one day this surgery could help men who have lost their penises to cancer or even those who have severe erectile dysfunction.

Netwerk24 in Capetown reports that since the news broke of this success, the doctors have been inundated with requests.