Description, Causes and Risk Factors:
Diphallia is a medical condition in which a male infant is born with two penises. This is an extremely rare disorder with only approximately 100 cases of diphallia recorded since the first, reported by Johannes Jacob Wecker in 1609. Its occurrence is one in five and a half million men in the United States.
When diphallia is present, it is usually accompanied by other congenital anomalies such as renal, vertebral, hindgut or anorectal duplication. There is also a higher risk of spina bifida. 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.
Diphalia is believed to take place during the embryonic development of the penis around the 3rd to 6th week of gestation. Its development begins with the coalescence of the bilateral cloacal tubercle from the anterior and final parts in the cephalic portion of the urogenital sinus. The columns of the mesoderm that develop around the lateral margin of the cloacal plaque form the genital tubercle. The probable cause of diphalia is a longitudinal duplication of the cloacal membrane including more than 3 columns of the primitive mesoderm that migrated centrally around the 2 cloacal membranes forming 2 genital tubercles. Other related abnormalities in the bladder, colon, anus and spinal column are also produced. It has been suggested that diphalia could be due to a failed twin development.
Diphalia can be orthotopic or ectopic depending on whether the division of the penis is sagittal or frontal and symmetric or asymmetric. The Aleem classification is the most accepted one. It divides diphalia into true diphalia and forked phallus and subdivides it into partial and complete. Pseudodiphalia described by Villanova and Ranetos corresponds to partial diphalia.
Fewer than 100 cases have been reported so far in the medical literature. It is usually accompanied by other congenital alterations such as urogenital, gastrointestinal, cardiac and skeletal muscle abnormalities. Double bladder is a rarer manifestation.
Signs and symptoms of diphallia may vary on an individual basis for each patient. Only your doctor can provide adequate diagnosis of any signs or symptoms and whether they are indeed Diphallia symptoms.Generally, it is characterized with two or more penis, both are situated side by side and has equal size, urine passes through both penis, some patient in one penis only, other patient neither of the penis. Some patient is sterile or incapable to produce semen, but the penis will erect if stimulated.
Ultrasound is used for diagnosis. It detects the number of corpora cavernosa or corpora spongiosa and their accompanying abnormalities. Improved interpretation of anatomical structures has been made possible with the advent of magnetic resonance and better decisions can be made when carrying out surgical interventions.
Treatment will principally depend on the type of accompanying congenital abnormalities as well as preserving continence and erectile function, which means individualizing each case. A surgical removal of the supernumerary penis is the common surgery for the diphallic patient. But complex reconstruction is another management if severe malformations are associated.
NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
Related disease: Triphalangeal thumb
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