Diphallia Research Articles

A man with two penises: A rare case report

Abstract Diphallia, commonly referred to as penile duplication, is a relatively rare congenital anomaly. It affects one out of every 5.5 million live infants. The degree of penile duplication and the number of associated anomalies varies greatly, ranging from a double glans from a penis without an accompanying aberration up to total penile duplication linked with multiple anomalies. In this case, a 65-year-old man is seen with a cleft scrotum and complete bifid diphallia.

A Two-Year-Old Boy with Diphallia and Multiple Congenital Anomalies

Diphallia is a rare urogenital defect and varies from a small accessory penis or duplication of the glans to complete penile duplication. Its incidence is 1 in 5.5 million live births. Only 100 cases were reported from 1609 until 2021. A two-year-old boy with diphallia and multiple congenital anomalies had an uncircumcised penis with two glans penis and two complete urethral orifices, accompanied by scrotum bifidum, asymmetric right buttock, with normal anorectal position. Spina bifida with lipomyelocele, tethered cord at the level of vertebra lumbar 3-4, scrotum bifidum, and left mild hydronephrosis were observed using Magnetic Resonance Imaging (MRI). Urethrocystoscopy of both complete urethra revealed meatal stenosis and bulbar urethral stricture, normal posterior urethral, and no verumontanum in the right urethral orifice and did dilatation. Whereas normal urethral orifice, anterior urethra, posterior urethra and verumontanum were found in the left side. Management for diphallia must consider associated anomalies and the goal of patient satisfaction. In this case, conservative treatment is the best choice.

Penile duplication or diphallia: case report of a very rare disease

Diphallia or penile duplication is an extremely rare congenital malformation. The presentation of penile duplication and the number of other associated anomalies, range from a double glans from a penis with no associated anomaly up to complete penile duplication associated with multiple anomalies.

Complete diphallia: How to proceed?

Diphallia is a rare anomaly. It has a range of appearances from a small accessory penile to complete duplication. We present a 2 year-old boy with complete penile duplication. The left penile was the largest. NMR (Nuclear Magnetic Resonance) suggested one corporal body for each penile and VCUG (Voiding Cystourethrogram) showed a normal urethra in the right penile and stricture at glandular and mid penile urethra of the left penis. A Y confluence to bulbar urethra was observed confirming only one prostate and bladder. The cystoscopy through the right penile identified the urethral confluence in the bulbar area. We performed a meatotomy in the left penile to insert the cystoscope and confirmed the blind ending urethra. We decided to remove this penile. The penile was degloved entirely and clamped and took out the corpora at the base. Diphallia can have three presentations: only glans duplication, bifid diphallia and complete diphallia (two corpora cavernosa and a corpus spongiosum for each penile). In our case, each penile presented only one corpora cavernosa and the decision taken was based on urethral patency. The treatment should always be planned individually whereas associated anomalies with the goal of attaining satisfactory functional and cosmetic results.

A case report on penile duplication: A rare congenital anomaly

Introduction: Penile duplication or penile diphallia is a rare congenital anomaly that is mainly associated with renal, anorectal or vertebral anomalies, that is, spina bifida. This condition was first described by Johannes Jacob Wecker in 1609 in Italy. Problem: Its incidence is extremely rare, about one in millions. The aetiology of this condition is unknown up till now; however, it is considered that defect of genital tubercle leads to the formation of diphallia. Methods: The condition is diagnosed clinically, and management depends on the appearance of genitalia and the associated anomalies as well as after taking into account the social and ethical considerations. Most of the time, management involves surgical incision of the non-functioning penis. Results: In this case report, a child of age 10 years presented with double penis since childhood. The child was evaluated clinically and radiologically for any other associated abnormalities, and his non-functional urethra was surgically removed. Level of evidence: Level IV

A Rare Case of Diphallia associated with Anorectal and Vertebral Malformations

Diphallia is a rare urogenital tract malformation characterized by complete or partial penile duplication with an estimated incidence of 1 per 5 to 6 million live births. First case was published in 1609 and till now only around 100 cases have been reported worldwide.

Pseudoexstrophy associated with penile duplication and hypospadias: A case report and literature review

Bladder exstrophy is a rare developmental anomaly. Four principle variants of bladder exstrophy have been described and they themselves are rarer than the bladder exstrophy. Authors describe the management of a case of pseudoexstrophy type of variant in a 9 month old male child with penile duplication with torsion and coronal hypospadias. The rectal fascial defect was repaired without osteotomy as the distance between two pubic bones was <4 cm (3.1 cm). Genital reconstruction with excision of duplicate atrophic penile shaft and repair of coronal hypospadias with detorsion of the functional penile shaft could be accomplished. The patient had good outcome in terms of cosmesis and urinary stream. Total of 18 cases of the pseudoexstrophy have been described till date. Pseudoexstrophy of bladder is a very rare condition and can simultaneously present with other defects like omphalocele, anorectal malformations, pouch colon, multiple or solitary urogenital anomalies. The principles of correction though remain same with correction of abdominal wall defect with or without osteotomy depending upon severity of pubic diastasis. Other anomalies can undergo treatment as per standard protocol.

Тотальная эписпадия удвоенной уретры у мальчиков

The article reports on two cases of the total epispadias of duplicated urethra with and without penile duplication. The authors describe the clinical presentation, diagnosis, and treatment. Duplicated urethra with epispadias both with and without penile duplication must be removed. At the same time, it is necessary to restore the patency of the lower duplicated urethra.

Bifid phallus with complete duplication and a separate scrotum in a German shepherd dog: a case report

Diphallia or penile duplication is a rare congenital abnormality thought to result from duplication of the cloacal membrane in the early developmental stages in the uterus. The present case concerned a 4-year old intact male German shepherd dog. The patient presented with a complaint of paraphimosis. Clinical, laboratory, radiological and ultrasonographic examinations were carried out. Semen samples collected prior to surgery were examined. Following amputation, the penis with paraphimosis was sent for histopathological investigation. Karyotype analysis of the patient was also performed. As well as the first report of this abnormality in Turkey, this case report represents the first report of this condition in a German shepherd dog.

Penile Duplication: A Case Report

Penile duplication or diphallia is a rare congenital anomaly. The authors report of diphallia in a 54 year old man who was received in consultation for the management of inguinal hernia. A review of the literature describes the clinical presentations and associated malformations and the therapeutic options ranging from a simple excision of the supernumerary penis to a complex reconstruction when associated with severe malformations. This case report did not undergo plastic surgery.

Surgical management of complete penile duplication accompanied by multiple anomalies

Diphallus (penile duplication) is very rare and seen once every 5.5 million births. It can be isolated, but is usually accompanied by other congenital anomalies. Previous studies have reported many concurrent anomalies, such as bladder extrophy, cloacal extrophy, duplicated bladder, scrotal abnormalities, hypospadias, separated symphysis pubis, intestinal anomalies and imperforate anus; no penile duplication case accompanied by omphalocele has been reported. We present the surgical management of a patient with multiple anomalies, including complete penile duplication, hypo-gastric omphalocele and extrophic rectal duplication.

Urinary reconstruction in vertebral, anorectal, cardiac, trachea‐esophageal, renal abnormalities and limb defects association with chronic renal failure and penile duplication

Various urological complications in VATER association require careful management. A 15-year-old boy with VATER association, including a hypoplastic lower urinary tract and diphallia, presented with chronic kidney disease and incontinence after a right loop ureterostomy. In order to acquire urinary continence without renal function impairment, an ileocecal reservoir with umbilical catheterizable stoma was created as a urinary reconstruction. The ectopic posterior penis was resected for cosmetic reasons, and the stump of the hypoplastic urethra was opened at the perineal skin. Clean intermittent self-catheterization through the umbilicus using disabled bilateral limbs was then achieved. This report describes the management of VATER association in a patient with complicated urological anomalies.

Penile duplication without removal of corporal tissue: Step by step of an excellent cosmetic result

Penile duplication without removal of corporal tissue: Step by step of an excellent cosmetic result

Diphallia with Associated Anomalies: A Case Report and Literature Review

Diphallia or penile duplication is an extremely rare congenital anomaly. It occurs once in every 5.5 million live births. The extent of penile duplication and the number of associated anomalies vary greatly, ranging from a double glans from a penis with no associated anomaly up to complete penile duplication associated with multiple anomalies. Here, we report a 12-year-old boy with complete bifid diphallia associated with bifid scrotum, epispadia, and pubic symphysis diastasis along with a review of the articles pertaining to this anomaly.

Anterior urethral fusion for treatment of complete penile diphallia: a case report and literature review

Objective To evaluate the efficacy,safety and clinical value of anterior urethral fusion to treat diphallia. Methods A 17-year-old male patient with complete penile diphallia was treated in March 2011.The physical examination showed two completely separated mature penis; urethrography,and urethroscope showed the two urethras were completely separated and entered the bladder respectively.Two anterior urethras were incised respectively at ventral sides ( from the meatus to bulbar urethra) and then two incised anterior urethras were splintered by a continuous suture with 4-0 polyglactin sutures in side and side.Two penises were splintered into one.The nocturnal penile tumescence test and the penis vibration thresholds were assessed before,and after surgery.. Results The patient was followed up for 12 months.There was no hematoma,urinary fistula,urinary incontinence and other complications postoperatively.The penis was recovered with normal appearance; urination and morning erection of penile were normal.6 months after surgery,there was no significant difference in the nocturnal penile tumescence and penis vibration thresholds detection ( P ＞ 0.05). Conclusion The operation of anterior urethral fusion is a safe and efficient surgical treatment to treat partial complete penile diphallia with less complication and no worse effect on urination and erection of penile. Key words: Diphallia; Urethral fusion; Treatment

Penile Duplication in Newborn with Multiple Anomalies

We present a case of male, premature born child with multiple anomalies. The physical status was dominated by penile duplication, with additional, abortion scrotum in the median line, without palpable content and omphalocele with semi septum of the anus. By ultrasound examination of internal organs, we found a complex congenital heart anomaly, multiple anomalies in abdomen and micro calcifications in the central nervous system. General condition of the child required a prolonged mechanical ventilation and intensive care, so with clinical picture of liver failure at the age of 45 days occurred fetal outcome.

Penile duplication: Is it necessary to excise one of the penises?

A 37-day-old boy presented with a duplicated penis. Examination revealed presence of two penises, one dorsally located and one ventrally, a large left inguinal hernia and absent right thumb. Abdominal ultrasound and micturating cystourethrogram showed normal kidneys, a single urinary bladder, and partial urethral duplication with no vesicoureteric reflux. The patient was subjected to a new technique, reconstructing the penis without removal of corporal tissue, and therefore not compromising its size. A satisfactory result was achieved. The case is being reported due to its rarity and different surgical approach, in contrast to previous reports of management of diphallia involving excision of one of the penises.

Disorders of sexual development in genetic pediatrics: Three different ambiguous genitalia cases report from Hospital Para el Nino Poblano, Mexico

Five pediatric patients with three different disorders of sexual development are reported in this study; the first three male patients (16 years, 4 years and 2 months old, respectively) were diagnosed as having diphallia. These 3 patients had real diphallia, well developed penises, urinarious meatus, and both testicles and one of the case, vessel duplication was reported by urology. All the patients have normal cytogenetic analysis, 46XY. The fourth patient was 2 years old, with hyperplasic clitoris, hyperpigmented tissue similar to labia major (large lips) and internal female organs identified as vagina, uterus and both ovaries. A chimera with two different cells lines [46,XX (48%) and 46,XY (52%)] by cytogenetic studies was reported. And the last child was 2 years 8 months old patient with chromosome translocation, between chromosome Y and 7 chromosomes t(7;Y). Hypospadias pene-escrotal, unilateral cryptorchidism, urinary meatus stenosis and malformed scrotum were diagnosed together with vessel duplication. Key words: Ambiguous genitalia, diphallia, hypospadias, cryptorchidism, chromosome translocation and chimera.

Surgical treatment of penile duplication

Penile duplication is a rare anomaly with an incidence of 1 in 5,500,000. It is normally associated with other malformations, such as double bladder, presence of the cloaca, imperforate anus, duplication of the rectosigmoid and vertebral deformities. Presented here is the surgical technique used to resolve a rare case of complete penile duplication in a 5-year-old child, without any other malformation. A male Caucasian patient presented with a rare diagnosis of complete penile duplication, without any associated systemic malformation. At 5 years of age, he was successfully submitted to surgical treatment. The procedure included the following steps: penile dissection up to the point of ischial-pubic insertion; dissection of the hypoplastic urethra; amputation of the less developed penis; termino-lateral urethral anastomosis and phalloplasty. Three years after surgery, penile morphology was normal, with a normal urinary flow according to age. Treatment should always be individualized. The malformations that are potentially life-threatening should be solved first. Fortunately, this patient had only penile duplication, successfully corrected after surgical treatment.

Tratamiento quirúrgico de duplicidad peneana completa

Penile duplication is a rare anomaly with an incidence of 1 in 5,500,000. It is almost associated with other malformations like double bladder, presence of the cloaca, imperforate anus, duplication of the recto sigmoid and vertebral deformities.The authors present the surgical technique to resolve a rare case of complete penile duplication in a 4 years old child, without any other malformation.