Complete Penile Duplication with Structurally Normal Penises: A Case Report

Year 2018, Volume: 35 Issue: 4, 340 - 342, 01.07.2018

Ahsen Karagözlü Akgül Murat Uçar Fatih Çelik İrfan Kırıştıoğlu Nizamettin Kılıç

Abstract

Background: Diphallia is a very rare anomaly and seen once in every
5.5 million live births. True diphallia with normal penile structures is
extremely rare. Surgical management for patients with complete penile
duplication without any penile or urethral pathology is challenging.
Case Report: A 4-year-old boy presented with diphallia. Initial
physical examination revealed first physical examination revealed
complete penile duplication, urine flow from both penises, meconium
flow from right urethra, and anal atresia. Further evaluations showed
double colon and rectum, double bladder, and large recto-vesical
fistula. Two cavernous bodies and one spongious body were detected
in each penile body. Surgical treatment plan consisted of right total
penectomy and end-to-side urethra-urethrostomy. No postoperative
complications and no voiding dysfunction were detected during the
18 months follow-up.
Conclusion: Penile duplication is a rare anomaly, which presents
differently in each patient. Because of this, the treatment should
be individualized and end-to-side urethra-urethrostomy may be an
alternative to removing posterior urethra. This approach eliminates
the risk of damaging prostate gland and sphincter

Keywords

Congenital anomaly, diphallia, penile duplication, reconstructive surgery

References

• 1. Tirtayasa PM, Prasetyo RB, Rodjani A. Diphallia with Associated Anomalies: A Case Report and Literature Review. Case Rep Urol 2013;2013:192960.
• 2. De Oliveira MC, Ramires R, Soares J, Carvalho AP, Marcelo F. Surgical treatment of penile duplication. J Pediatr Urol 2010;6:257.
• 3. Bhat HS, Sukumar S, Nair TB, Saheed CS. Successful surgical correction of true diphallia, scrotal duplication, and associated hypospadias. J Pediatr Surg 2006;41:13- 4.
• 4. Mirshemirani A, Roshanzamir F, Shayeghi S, Mohajerzadeh L, Hasas-Yeganeh S. Diphallus with Imperforate Anus and Complete Duplication of Recto Sigmoid Colon and Lower Urinary Tract. Iran J Pediatr 2010;20:229-32.
• 5. Elsawy M, Pippi Salle JL, Abdulsalam M, Alsaid AN. Penile duplication: Is it necessary to excise one of the penises? J Pediatr Urol 2012;8:434-6.
• 6. 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.
• 7. Muramatsu M, Shishido S, Nihei H, Hamasaki Y, Hyodo Y, Kawamura T, et al. Urinary reconstruction in vertebral, anorectal, cardiac, trachea-esophageal, renal abnormalities and limb defects association with chronic renal failure and penile duplication. Int J Urol 2015;22:125-7.
• 8. Gyftopoulos K, Wolffenbuttel KP, Nıjman RJ. Clinical and embryologic aspects of penile duplication and associated anomalies. Urology 2002;60:675-9.
• 9. Karaca I, Turk E, Ucan AB, Yayla D, Itirli G, Ercal D. Surgical management of complete penile duplication accompanied by multiple anomalies. Can Urol Assoc J 2014;8:741-3.