![]() ![]() This structure had no communication with any other structures. A bowel loop-like structure was over the pubis region. He had bifid scrotum, one testicle on each side of the scrotum. He had two separate penises, similar in size and shape, each penis had an epispadia urethral meatus. The secondary penis had glans but without urinary meatus.Ĭomplete bifid diphallia with associated anomalies Ī 12-year-old boy, associated with bifid scrotum, epispadia and pubic symphysis diastasis. The small, immature and nonfunctional penis protruded on one side of the large, normal penis. This rare case was reported, based on the age of the 83-year-old man when diphallia was only detected then when he was hospitalised, and also because of the absence of other anatomical malformations. It is independent of the normal penis and can be removed surgically without problem. Pseudodiphallia is formed from erectile tissue only, undifferentiated and non-functional. Partial true diphallia corresponds to pseudodiphallia. Partial true diphallia or pseudodiphallia, without associated anomalies ![]() He had imperforated anus, hypospadias, bifid scrotum, meatuses on both glandes, two bladders and two colons, and had normal testes, kidneys and ureters. Complete true diphallia with associated anomalies Ī two-day-old male newborn, associated with complex genitourinary and ano-rectal malformation. Infants born with diphallia have higher death rate due to infections associated with anomalies. True diphallia is more likely accompanied with associated anomalies and malformations compared with bifid phallus. The meatus may be normal at tip of glans, hypospadiac, or epispadiac the scrotum may be normal or bifid. Penile duplication also varies from a single penis with double glans to complete double penises. Notable clinical cases ĭiphallia is usually accompanied by systemic anomalies their extent varies, ranging from no associated anomaly to multiple anomalies including urogenital, gastrointestinal and musculoskeletal systems. In partial bifid phallus, the duplication of urethra, corpora cavernous and corpus spongiosum in one penis is incomplete, and there is only a corpus cavernosum and a spongiosum surrounding the functioning urethra in the other penis. For complete bifid phallus associated with anomalies, the anterior urethra is absent from each penis and the prostatic urethra is situated in the skin between the two penises. Separation of penises down to the base of the penile shaft is complete bifid, whereas to glans is partial bifid. In bifid phallus, each phallus has only one corpus cavernosum and one corpus spongiosum containing a urethra. True diphallia can be either complete with both penises similar in size, or partial when one of the phallia is smaller in size or immature, though structurally same as the larger phallus. True diphallia is where each phallus has two corpora cavernosa and a single corpus spongiosum containing a urethra. Each of these two groups is further subdivided into partial or complete. True diphallia is caused by cleavage of pubic tubercle bifid phallus is caused by separation of pubic tubercle. ![]() The current widely accepted classification, introduced by Aleem in 1972, classifies double penis into two groups: true diphallia and bifid phallus. According to Vilanora and Raventos, in 1954, a fourth group called pseudodiphallia was added. Īccording to Schneider classification in 1928, double penis is classified into three groups: (a) glans diphallia, (b) bifid diphallia and (c) complete diphallia or double penis. The two external genitalia may vary in size and shape, either lying beside each other in a sagittal plane or one above the other in a frontal plane. This condition has existed in humans since ancient times. The first case was reported by Wecker in Bologna, Italy, in 1609, and since then, about one hundred cases have been reported. It is generally believed diphallia occurs in the fetus between the 23rd and 25th days of gestation when an injury, chemical stress, or malfunctioning homeobox genes hamper proper function of the caudal cell mass of the fetal mesoderm as the urogenital sinus separates from the genital tubercle and rectum to form the penis. Infants born with diphallia and its related conditions have a higher death rate from various infections associated with their more complex renal or colorectal systems. There is also a higher risk of spina bifida. When diphallia is present, it is usually accompanied by renal, vertebral, hindgut, anorectal or other congenital anomalies. Its occurrence is 1 in 5.5 million boys in the United States. The first reported case was by Johannes Jacob Wecker in 1609. The external male genitalia of a prepubescent male with a form of bifid diphalliaĭiphallia, penile duplication ( PD), diphallic terata, or diphallasparatus, is an extremely rare developmental abnormality in which a male is born with two penises. ![]()
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