Traditional circumcision ceremonies in South Africa's Eastern Cape province, where the rite-of-passage practice is common, has left 14 boys dead and 141 injured this year, local authorities said on Sunday.
Many of the injured teens suffered from "dehydration, wounds, pneumonia, aseptic penis and gangrene", Sizwe Kupelo, spokesperson from the health ministry in the Eastern Cape province told AFP.
"Fourteen died and 141 are in various hospitals," he said.
Nine patients are waiting for a penis transplant -- a procedure requested more and more after the first successful transplant was performed in the country last year on another botched circumcision victim.
The rite of passage into adulthood, which usually follows a bush retreat of two to four weeks, is also a show of physical endurance.
For the ceremony, the teens gamble their lives. Each year, teenaged boys die or are mutilated during the initiation.
"A death is always one too many," said Mamkeli Ngam, spokesperson for cooperative governance and traditional affairs minister in Eastern Cape, the home province of Nelson Mandela.
Ngam also said that several initiation schools had already been shut down.
According to media reports, 41,000 young men of the Eastern Cape -- one of the most affected provinces in South Africa -- completed the initiation last year.
Circumcision in the country can be lucrative, bringing in around 1,500 rand (110 euros, $120) per initiation, but the boys do not benefit from the profit. They are often treated harshly and receive little or no food.
In June, South African police rescued 11 teenage boys from forced circumcision after their parents reported that they had been taken from the street to participate in the initiation.