Surgical management of complete penile duplication accompanied by multiple anomalies

Abstract

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, hypogastric omphalocele and extrophic rectal duplication.

Penile duplication as genital abnormality in OEIS complex

“…The various genital abnormalities seen in males were small penis and epispadias, abnormal or absent scrotum, and cryptorchidism in 80, 60, and 60% cases in the series by Keppler-Noreuil (2001), but diphallus has not been reported in these series. Moreover, Karaca (2014) has reported a case as the first one of complete penile duplication with omphalocele.…”

True partial diphallia with associated penoscrotal transposition of two hemi-scrotums

“…Due to wide variability in presentation the management strategies differ [ [5] , [6] , [7] , 9 ]. Surgical correction is individualized with the aim of achieving proper urinary continence and erection with adequate cosmesis [ 10 , 11 ].…”

“…Due to low incidence and varied presentation, not much is known about the underlying pathophysiology, management options and outcomes [ 2 , [5] , [6] , [7] ]. Here, we report a case of diphallia with associated penoscrotal transposition of 2 hemiscrotums.…”

Complete Penile Duplication with Structurally Normal Penises: A Case Report

“…True diphallia is the less common variety and usually presents with a wider range of associated malformations such as bladder and urethral duplication, exstrophy vesica, renal anomalies, bifid scrotum, anorectal malformations, bowel duplication, and vertebral anomalies ( 8 , 9 ). Bifid phallus is usually associated with less severe malformations ( 8 ).…”

“…Penile duplication and multiple associated anomalies can be managed with multiple surgeries (treatment of the associated anomalies and genital reconstruction) ( 9 ). De Oliveira et al ( 2 ) reported an isolated true partial diphallia that was managed in a single surgery with right penectomy and end-to-side anastomosis between the right urethra and the remaining urethra.…”