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Agbara KS, Ehua AM, Thomas HA, Akproh RC, Konan JM, Kouame YGS, Ouattara, Oyewola AS, Moulot MO, Bankole RS. Ventral partial diphallia associated with hypospadias: A case report. Urol Case Rep 2024; 52:102644. [PMID: 38259954 PMCID: PMC10801320 DOI: 10.1016/j.eucr.2023.102644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/14/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
Diphallia, or penile duplication, is a rare congenital urological malformation. It may be associated with other congenital malformations. The objective of present paper is to report the case of a two-year boy with ventral duplication of the penis associated with proximal hypospadias. The ventral penis was amputated, and Duckett urethroplasty was done. There were no reported postoperative complications in the follow-up.
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Affiliation(s)
| | | | | | | | | | | | - Ouattara
- Teaching Hospital of Treichville, Abidjan
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2
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Mishra AK, Anand V, Kale R. Congenital Pseudo diphallia -A Rare Case Presentation. J Indian Assoc Pediatr Surg 2023; 28:537-540. [PMID: 38173637 PMCID: PMC10760616 DOI: 10.4103/jiaps.jiaps_30_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 01/05/2024] Open
Abstract
Diphallia (penile duplication) is a rare congenital malformation with an incidence of about 1 per 5-6 million newborns. The severity of diphallia varies from a small accessory penile-like tissue to complete true penile duplication with other deformities, usually involving the urogenital, gastrointestinal, and musculoskeletal systems. Pseudodiphallia, as a rare kind of diphallia, is characterized by a small accessory penile-like tissue without a normal penile anatomy structure. A 5.5-year-old male child was brought to the pediatric surgery outpatient department by the parents with complaint of difficulty in retracting the prepucial foreskin and the presence of some growth near the glans. There were no other complaints in specific. Clinical examination revealed foreskin retractable with difficulty and small conical lump smaller than the original glans approximately size ~1 cm diameter at the base attached horizontally at the left side of the original glans at the coronal sulcus and visible incomplete clefting in between the 2 glans visible from the aerial view. After approval from anesthetist, the patient was operated under general anesthesia by excision of pseudodiphallia. Urethral catheterization and circumcision of the penis after taking informed parental consent. Postoperatively, the period was uneventful. The patient responded well to the symptomatic treatment and was orally allowed on the same day evening. Urinary catheter was removed on 5th postoperative day. The patient was discharged on oral symptomatic medication and was advice for follow-up.
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Affiliation(s)
- Amit Kumar Mishra
- Department of General Surgery, School of Medical Sciences and Research, Sharda Hospital, Greater Noida, Uttar Pradesh, India
| | - Vijay Anand
- Department of General Surgery, School of Medical Sciences and Research, Sharda Hospital, Greater Noida, Uttar Pradesh, India
| | - Ravi Kale
- Department of General Surgery, School of Medical Sciences and Research, Sharda Hospital, Greater Noida, Uttar Pradesh, India
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Habib M, Bajwa HF, Abbas M, Chaudhary MA. A very rare case of diphallia with anorectal malformation. Int J Surg Case Rep 2023; 105:107980. [PMID: 36933406 PMCID: PMC10031018 DOI: 10.1016/j.ijscr.2023.107980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/01/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Diphallia is extremely rare urological anomaly with reported incidence of 1 in 5-6 million live births. It can present as complete or incomplete diphallia. In most of the cases it is associated with complex urological, gastrointestinal or anorectal malformations. CASE PRESENTATION We report here case of a newborn who was presented to us at 1st day of life with diphallia and anorectal malformation. He had true diphallia with two separate uretheral orifices. Both phalluses were uncircumcised, phallus 1 was 2.5 cm in length while phallus 2 was 1.5 cm. Both phalluses had normal shaped glans with uretheral opening located at the normal place He had a single scrotum with two midline raphe and well-formed rouge. He was passing urine from both orifices. His ultrasonography of urological system showed two ureters and a single hemi bladder. He was admitted and operated upon and a sigmoid divided colostomy was constructed. Per-operatively congenital pouch colon (type 4) was identified. His post-operative recovery was uneventful. The patient was discharged on second post-operative day and called for follow up. CLINICAL DISCUSSION Diphallia is a rare congenital anomaly, which means two structurally and anatomically separate phalluses. Complete Duplication in Diphallia presents the kind of Diphallia in which both the phalluses have two corpus cavernosum and only one corpus spongiosum. As diphallia presents with a spectrum of diseases; therefore, it requires a multidisciplinary approach. A case of Diphallia may well present with complex urogenital, gastrointestinal or anorectal malformations. As in our case the patient had Diphallia with anorectal malformation. Hence he was operated upon and a sigmoid colostomy was constructed. CONCLUSION Diphallia is a very rare congenital anomaly which can occur in association with anorectal malformations. Management of such cases should be individualized depending upon the spectrum of disease.
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Affiliation(s)
- Murad Habib
- Department of Paediatric Surgery, The Children's Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.
| | | | - Muhammad Abbas
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Islamabad, Pakistan
| | - Muhammad Amjad Chaudhary
- Department of Paediatric Surgery, The Children's Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
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Macedo A, Ottoni SL, Camilato PCB, Ganchozo HSC, Garrone G, Marcondes RDM, Leal da Cruz M. Complete diphallia: How to proceed? J Pediatr Urol 2022; 18:399-400. [PMID: 35346592 DOI: 10.1016/j.jpurol.2022.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/02/2022] [Accepted: 02/25/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Diphallia is a rare anomaly. It has a range of appearances from a small accessory penile to complete duplication. METHODS 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. RESULTS 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. DISCUSSION 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. CONCLUSION The treatment should always be planned individually whereas associated anomalies with the goal of attaining satisfactory functional and cosmetic results.
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Affiliation(s)
- Antonio Macedo
- Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil; Department of Urology, CACAU-NUPEP, São Paulo, Brazil
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Vafaei H, Roozmeh S, Bahador A, Khafri MZ, Ghiasi M. Prenatal diagnosis of diphallia in association with bladder exstrophy: a case report. BMC Pregnancy Childbirth 2022; 22:435. [PMID: 35610593 PMCID: PMC9131630 DOI: 10.1186/s12884-022-04746-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 05/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Penile duplication or diphallia is a rare congenital anomaly with unclear pathophysiological cause. Most cases of diphallia are reported postnatally; however, today with the use of a high-resolution ultrasound device, in-uterine diagnosis of many congenital anomalies is possible. Case presentation Herein we report a multiparous mother at 25 weeks of gestation who referred due to an abnormal cystic structure protruding from a large abdominal wall defect located below the umbilicus that was noted during a routine exam. Target scan revealed two penile-like protrusions with an empty scrotal sac and double bladder in an otherwise normal fetus, which was confirmed postnatally. Neonatal microarray study and karyotype were normal. Conclusion Diphallia could be detected prenatally as an isolated anomaly, associated with caudal duplication syndrome, or as an exstrophy-epispadias complex. As this is a rare congenital anomaly, all sonographers should be familiar with prenatal ultrasound features and associated anomalies, an important issue in prenatal counseling with parents, delivery planning, psychological support of the family, and postnatal management.
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Affiliation(s)
- Homeira Vafaei
- Maternal-fetal medicine Research Center, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shohreh Roozmeh
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ali Bahador
- Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Zare Khafri
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhde Ghiasi
- Dr vafaei perinatology center, Shiraz University of Medical Sciences, Shiraz, Iran
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Jia YT, Shi BL, Zhang J, Li YY, Zhu J. Bilateral ureteral reimplantation in a patient with an intraperitoneal ectopic bipenis: A case report. World J Clin Cases 2022; 10:2876-2880. [DOI: 10.12998/wjcc.v10.i9.2876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Diphallia is a highly uncommon congenital urogenital abnormality and a few connected reports have been published. However, no case of intraabdominal heterotopic diphallus has been documented to date. In the present study, we present a rare case of intraperitoneal ectopic bipenis.
CASE SUMMARY A 49-year-old man was hospitalized with the chief complaint of hydronephrosis of both kidneys, which was discovered three days earlier through regular physical examination performed using urological ultrasound without significant lumbar or abdominal pain or bladder irritation. Physical examination showed normal external penile development, bilateral testes located on the left side of the scrotum, and a fused epididymis. Urological plain and enhanced computed tomography suggested bilateral hydronephrosis, bilateral ureters opened to the left side of the bladder wall; an intrapelvic soft tissue shadow on the left side of the bladder was considered a germline malformation called bipenis (hidden penis in the abdominal cavity). Based on the urological plain and enhanced computed tomography results, a 49-year-old man was diagnosed with bipenis (one hidden in the abdominal cavity). Ectopic penile compression produced bilateral ureteral dilatation and hydronephrosis. The ectopic penis was amputated and partially removed during surgery, and bilateral ureteral replantation was successfully performed. At a 2-mo follow-up, the patient was very satisfied with the operation, there was no significant hydronephrosis in both kidneys, and urination and erectile function were normal.
CONCLUSION To our knowledge, this is the first report of diphallia with an intraperitoneal ectopic penis. Computed tomography or magnetic resonance imaging can be used to assess the associated internal anomalies before surgery. Postoperative pathological findings are the gold standard for the diagnosis.
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Affiliation(s)
- Ya-Tao Jia
- Department of Urology, Baoji People's Hospital, Baoji 721000, Shannxi Province, China
| | - Bao-Lei Shi
- Department of Urology, Baoji People's Hospital, Baoji 721000, Shannxi Province, China
| | - Jie Zhang
- Department of Urology, Baoji People's Hospital, Baoji 721000, Shannxi Province, China
| | - Ying-Yi Li
- Department of Urology, Baoji People's Hospital, Baoji 721000, Shannxi Province, China
| | - Jiang Zhu
- Department of Urology, Baoji People's Hospital, Baoji 721000, Shannxi Province, China
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Jia YT, Shi BL, Zhang J, Li YY, Zhu J. Bilateral ureteral reimplantation in a patient with an intraperitoneal ectopic bipenis: A case report. World J Clin Cases 2022; 10:2878-2882. [PMID: 35434100 PMCID: PMC8968799 DOI: 10.12998/wjcc.v10.i9.2878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/22/2021] [Accepted: 02/13/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Diphallia is a highly uncommon congenital urogenital abnormality and a few connected reports have been published. However, no case of intraabdominal heterotopic diphallus has been documented to date. In the present study, we present a rare case of intraperitoneal ectopic bipenis.
CASE SUMMARY A 49-year-old man was hospitalized with the chief complaint of hydronephrosis of both kidneys, which was discovered three days earlier through regular physical examination performed using urological ultrasound without significant lumbar or abdominal pain or bladder irritation. Physical examination showed normal external penile development, bilateral testes located on the left side of the scrotum, and a fused epididymis. Urological plain and enhanced computed tomography suggested bilateral hydronephrosis, bilateral ureters opened to the left side of the bladder wall; an intrapelvic soft tissue shadow on the left side of the bladder was considered a germline malformation called bipenis (hidden penis in the abdominal cavity). Based on the urological plain and enhanced computed tomography results, a 49-year-old man was diagnosed with bipenis (one hidden in the abdominal cavity). Ectopic penile compression produced bilateral ureteral dilatation and hydronephrosis. The ectopic penis was amputated and partially removed during surgery, and bilateral ureteral replantation was successfully performed. At a 2-mo follow-up, the patient was very satisfied with the operation, there was no significant hydronephrosis in both kidneys, and urination and erectile function were normal.
CONCLUSION To our knowledge, this is the first report of diphallia with an intraperitoneal ectopic penis. Computed tomography or magnetic resonance imaging can be used to assess the associated internal anomalies before surgery. Postoperative pathological findings are the gold standard for the diagnosis.
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Affiliation(s)
- Ya-Tao Jia
- Department of Urology, Baoji People's Hospital, Baoji 721000, Shannxi Province, China
| | - Bao-Lei Shi
- Department of Urology, Baoji People's Hospital, Baoji 721000, Shannxi Province, China
| | - Jie Zhang
- Department of Urology, Baoji People's Hospital, Baoji 721000, Shannxi Province, China
| | - Ying-Yi Li
- Department of Urology, Baoji People's Hospital, Baoji 721000, Shannxi Province, China
| | - Jiang Zhu
- Department of Urology, Baoji People's Hospital, Baoji 721000, Shannxi Province, China
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Agzamkhodjayev S, Ergashev K, Abdullayev Z, Soliyev A, Batrutdinov R. Complete duplication of the penis - A case report. Urol Case Rep 2021; 40:101892. [PMID: 34745893 PMCID: PMC8551595 DOI: 10.1016/j.eucr.2021.101892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/05/2021] [Accepted: 10/11/2021] [Indexed: 11/27/2022] Open
Abstract
Penile duplication is a very rare urological entity. It may be associated with other congenital conditions such as urogenital, GI tract and musculoskeletal anomalies. Properly classifying the condition may dictate the final treatment options. Our current case is the complete true duplication in which we performed side-to-side urethra-urethral anastomosis. We spared the posterior urethra as it may end up with postoperative urinary incontinence.
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Affiliation(s)
- Saidanvar Agzamkhodjayev
- Department of Urology, National Children's Medical Center, Tashkent, Uzbekistan.,Department of Urology, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
| | - Kobiljon Ergashev
- Department of Urology, National Children's Medical Center, Tashkent, Uzbekistan
| | - Zafar Abdullayev
- Department of Urology, National Children's Medical Center, Tashkent, Uzbekistan.,Department of Urology, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
| | - Asqar Soliyev
- Department of Urology, National Children's Medical Center, Tashkent, Uzbekistan
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9
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Viet Nguyen H, Hong Vu T, Quy Hong Q, Quang Pham H, Bich Nguyen N. Hypospadias associated with partial bifid phallus: A case report. Urol Case Rep 2021; 39:101840. [PMID: 34557380 PMCID: PMC8445837 DOI: 10.1016/j.eucr.2021.101840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/05/2021] [Accepted: 09/08/2021] [Indexed: 11/24/2022] Open
Abstract
Diphallia is an extremely rare congenital anomaly. Bifid phallus is a type of diphallia and is rarely recorded in published studies. According to the degree of separation of the penises at the base of the shaft or just at the glans, bifid phallus is further classified into complete or partial forms. Bifid phallus is often associated with hypospadias or part of the exstrophy–epispadias complex. We are really lucky to have successfully treated a 2-year-old patient with penoscrotal hypospadias combined with partial bifid phallus in the shaft. After the surgery, the patient had no issues with penile function.
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Affiliation(s)
- Hoa Viet Nguyen
- Department of Pediatric Surgery, Vietnam Germany Hospital, 40 TrangThi, Hoankiem, Hanoi, Viet Nam
| | - Tuan Hong Vu
- Department of Pediatric Surgery, Vietnam Germany Hospital, 40 TrangThi, Hoankiem, Hanoi, Viet Nam.,Department of General Surgery, Hanoi Medical University, Viet Nam
| | - Quan Quy Hong
- Department of Pediatric Surgery, Vietnam Germany Hospital, 40 TrangThi, Hoankiem, Hanoi, Viet Nam
| | - Hung Quang Pham
- Department of Pediatric Surgery, Vietnam Germany Hospital, 40 TrangThi, Hoankiem, Hanoi, Viet Nam.,Department of General Surgery, Hanoi Medical University, Viet Nam
| | - Ngoc Bich Nguyen
- Department of Pediatric Surgery, Vietnam Germany Hospital, 40 TrangThi, Hoankiem, Hanoi, Viet Nam
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10
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Lakhani DA, Cannon M, Balar AB, Hernandez GV, Katyal S, Al-Omar O, Hailemichael E. True partial diphallia with associated penoscrotal transposition of two hemi-scrotums. Radiol Case Rep 2021; 16:760-763. [PMID: 33537104 PMCID: PMC7841225 DOI: 10.1016/j.radcr.2020.12.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/09/2020] [Indexed: 11/28/2022] Open
Abstract
Diphallia or duplication of penis is extremely rare condition with a reported incidence of 1 in 5-6 million live births. Approximately around 100 cases of diphallia have been described in literature, each case have a unique presentation from associated anomalies. Clinically these patients can be classified into complete (true diphallia) or partial duplication. In true diphallia, each penis has 2 corpora cavernosa and 1 corpus spongiosum. If the duplicate penis is smaller or rudimentary with complete structure, it is described as true partial diphallia. The term bifid phallus is used if there is only one corpus cavernosum in each penis. Due to low incidence and varied presentation, not much is known about the underlying pathophysiology, management options, and outcomes. Here, we report a case of partial diphallia with associated penoscrotal transposition of 2 hemi-scrotums.
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Affiliation(s)
- Dhairya A. Lakhani
- Department of Radiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Mary Cannon
- Section of Pediatric Radiology, Department of Radiology, West Virginia University School of Medicine, 1 Medical Center Drive, Morgantown, 26506 WV, USA
| | - Aneri B Balar
- Department of Radiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Gabriela V Hernandez
- Department of Radiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Sanjeev Katyal
- Department of Radiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Osama Al-Omar
- Division of Pediatric Urology, Department of Urology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Eyassu Hailemichael
- Section of Pediatric Radiology, Department of Radiology, West Virginia University School of Medicine, 1 Medical Center Drive, Morgantown, 26506 WV, USA,Corresponding author.
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Jabali SS, Mohammed AA. Triphallia (triple penis), the first reported case in human. Int J Surg Case Rep 2020; 77:198-200. [PMID: 33166819 PMCID: PMC7652711 DOI: 10.1016/j.ijscr.2020.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/31/2020] [Accepted: 11/01/2020] [Indexed: 01/16/2023] Open
Abstract
Supernumerary penises is an extremely rare congenital anomaly. It affects one in every 5–6 million live births. Each case has a unique presentation and no cases are identical. Around 100 cases of diphallia are reported till now. No cases of Triphallia is reported before.
Introduction Supernumerary penises is an extremely rare congenital anomaly which affects one in every 5–6 million live births. Affected patients may have only a rudimentary penis, supernumerary penile glances or complete duplication or triplication of penises. Some patients may have some other associated congenital anomalies. Presentation of case A 3-month-old child presented because of left side hydrocele. There were evidence of two supernumerary penises in the perineum, the first one was about 2 cm in length with a glans and was attached to the root of the penis, and the third one was about 1 cm and was below the scrotum. Hydrocelectomy was performed. The two supernumerary penises were extending to perineal region and were attached to original penis, both had corpora cavernosum and spongiosum with no urethra inside. Both supernumerary penises were excised and both corpora were sutured with a fine slowly absorbable suture material. The patient was discharged with no postoperative events and follow up was done for one years with no reported adverse events. Conclusion Triphallia (three penises) is unreported condition in human until now. Patients with supernumerary penises have unique presentation and no cases are identical. The position of the penis may be ectopic or orthotopic. Treatment is difficult because it poses medical, ethical, and cosmetic aspects. A combined multidisciplinary team is required for the management and long term follow up is required. Excision or reconstruction of the duplicate penis is required depending on the corporal development and anatomy of the urethra.
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Affiliation(s)
- Shakir Saleem Jabali
- Department of Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq
| | - Ayad Ahmad Mohammed
- Department of Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq.
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12
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Deshpande V. Complete Diphallia - Our Technique to Avoid Complications. J Indian Assoc Pediatr Surg 2020; 25:182-183. [PMID: 32581449 PMCID: PMC7302456 DOI: 10.4103/jiaps.jiaps_76_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/08/2019] [Accepted: 10/26/2019] [Indexed: 11/04/2022] Open
Abstract
Diphallia is a rare congenital anomaly with the incidence of 1 in 5-6 million live births. We are reporting a case of complete diphallia associated with accessory scrotum and undescended testis in a 2-year-old boy. We did amputation of the left phallus, urethral end-to-side anastomosis between the spatulated end of proximal left penile urethra and side of proximal part of right penile urethra, excision of accessory scrotum, and left-sided orchidopexy. Avoiding dissection in the posterior urethra leads to an acceptable outcome.
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Affiliation(s)
- Vidyanand Deshpande
- Department of Pediatric Surgery, MGM Medical College and Hospital, Aurangabad, Maharashtra, India
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13
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Jesus LE, Dekermacher S, Lopes E, Bacon AP. Glans duplication: In-depth review and proposal of a new classification. J Pediatr Urol 2017; 13:172-176. [PMID: 28161406 DOI: 10.1016/j.jpurol.2016.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 12/13/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Diphallia is a very uncommon malformation, and glans duplication (GD) is its rarest form. In this last group, patients normally present with esthetic/sexual complaints or obstructed voiding late in life after pubertal genital development. Associated malformations are uncommon and relatively mild in those cases. METHODS After a case presented, we present herein an extensive review of GD, as the disease is rare, and there is very little about its treatment and there are diverse approaches to address the condition. RESULTS After an extensive review of the available literature, we carefully analyzed each published case to describe specific aspects of their clinical presentation (age, main complaint, voiding/urethral problems, and individual anatomy) and treatment. CONCLUSION This review allowed us to propose a new classification for diphallia into four groups (true diphallia, hemiphallus, pseudodiphallia, and partial duplication), considering embryological, anatomical, clinical, and therapeutic implications (see Fig. 1). Glans duplications present as esthetic/sexual cases or show abnormal voiding patterns caused by urethral associated abnormalities. Reconstructive techniques may be simple (resection of a hypoplastic accessory glans + urethra) or relatively complex (glans and/or urethral reconstruction).
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Affiliation(s)
- Lisieux E Jesus
- Department of Pediatric Surgery and Urology, Servidores do Estado Hospital, Ministry of Health, Rio de Janeiro, Brazil.
| | - Samuel Dekermacher
- Department of Pediatric Surgery and Urology, Servidores do Estado Hospital, Ministry of Health, Rio de Janeiro, Brazil
| | - Erica Lopes
- Department of Pediatric Surgery and Urology, Servidores do Estado Hospital, Ministry of Health, Rio de Janeiro, Brazil
| | - Andreia P Bacon
- Department of Pediatric Surgery and Urology, Servidores do Estado Hospital, Ministry of Health, Rio de Janeiro, Brazil
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Corrêa Leite MT, Fachin CG, de Albuquerque Maranhão RF, Francisco Shida ME, Martins JL. Penile duplication without removal of corporal tissue: step by step of an excellent cosmetic result. J Pediatr Urol 2014; 10:567-70. [PMID: 24508357 DOI: 10.1016/j.jpurol.2013.12.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 12/18/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | - Camila Girardi Fachin
- Department of Pediatric Surgery, Federal University of São Paulo, São Paulo, Brazil.
| | | | | | - José Luiz Martins
- Department of Pediatric Surgery, Federal University of São Paulo, São Paulo, Brazil.
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Bakheet MAAM, Refaei M. Penile duplication and two anal openings; report of a very rare case. Iran J Pediatr 2012; 22:133-6. [PMID: 23056874 PMCID: PMC3448231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 06/13/2011] [Accepted: 07/20/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND Penile duplication (diphallus) is an extremely rare disorder. It is almost always associated with other malformations like double bladder, exstrophy of the cloacae, imperforate anus, duplication of the rectosigmoid and vertebral deformities. Meanwhile anal canal duplication, the most distal and least common duplication of the digestive tube and is a very rare congenital malformation. CASE PRESENTATION A 21 days old Egyptian neonate is reported with complete penile duplication and two scrotums with each one carrying two palpable testes. Both penises have normal shaft with normally located meatus. Clear urine voids from both meati spontaneously. The child had also a fold of redundant skin about 4×5 cm at the anal region in which two separate anal openings are present. In rectal examination we found two normal anuses passing stool spontaneously. Ascending (voiding) cystourethrography revealed two penises with two separate meatuses and one bladder from which the two urethras go out separately. Intravenous pyelogram (IVP) revealed two normal kidneys and ureters. Barium study revealed duplication of rectum and colon, otherwise normal GIT. CONCLUSION In our review of the literature, we did not come across any other case of this variety of the penile duplication and congenital presence of two anuses. Unfortunately the patient expired before any surgical correction.
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Affiliation(s)
- Mohamed Abdel Al M. Bakheet
- Pediatrics, Sohag University Hospital, Sohag Faculty of medicine, Upper Egypt,Corresponding Author:Address: Pediatric Department, Egypt-Sohag-Sohag University Hospital, Postal Code: 82524, Egypt. E-mail:
| | - Mohammad Refaei
- Pediatric Surgery Division, Arar Central Hospital, Kingdom of Saudi Arabia
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