Figure 2. Loss of penis after a ritual circumcision complication and a ventilated critically ill patient with a septic penis after ritual circumcision. (Own pictures) The current treatment for total penile loss is surgical total penile reconstruction (TPR), also called total phallus reconstruction. The goal of TPR is to create a cosmetically acceptable, sensate penis, functional urethra that extends up to the distal glans which permits voiding in a standing position, and providing enough bulk to allow the insertion of a penile prosthesis for sexual intercourse. In addition, the donor-site should cause minimal morbidity and should be easy to conceal. The above goals are difficult to obtain in South African state patients, as penile prostheses are not available due to their high cost (about ZAR 80 000 per inflatable prosthesis).