Global InformationDiphallia information
| Diphallia | |
|---|---|
 | |
| The external male genitalia of a prepubescent male with a form of bifid diphallia |
Diphallia, penile duplication (PD), diphallic terata, or diphallasparatus is an extremely rare developmental abnormality in which a male is born with two penises.[1][2] The first reported case was by Johannes Jacob Wecker in 1609.[3][4] Its occurrence is 1 in 5.5 million boys in the United States.[5]
When diphallia is present, it is usually accompanied by renal, vertebral, hindgut, anorectal or other congenital anomalies. There is also a higher risk of spina bifida.[4] 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.[citation needed]
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.[citation needed]
The first case was reported by Wecker in Bologna, Italy, in 1609, and since then, about one hundred cases have been reported.[1][6] This condition has existed in humans since ancient times.[7] The two external genitalia may vary in size and shape,[8] either lying beside each other in a sagittal plane or one above the other in a frontal plane.[9]
According 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.[10] According to Vilanora and Raventos, in 1954, a fourth group called pseudodiphallia was added.[11]
The current widely accepted classification, introduced by Aleem in 1972, classifies double penis into two groups: true diphallia and bifid phallus.[8] True diphallia is caused by cleavage of pubic tubercle; bifid phallus is caused by separation of pubic tubercle.[8][12] Each of these two groups is further subdivided into partial or complete.[8] True diphallia is where each phallus has two corpora cavernosa and a single corpus spongiosum containing a urethra.[8][12] 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.[8] In bifid phallus, each phallus has only one corpus cavernosum and one corpus spongiosum containing a urethra.[8][12] Separation of penises down to the base of the penile shaft is complete bifid, whereas to glans is partial bifid.[8] 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.[13] In partial bifid phallus, the duplication of urethra, corpora cavernosa 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.[14]
- ^ a b Tirtayasa, Pande (2013). "Diphallia with Associated Anomalies: A Case Report and Literature Review". Case Reports in Urology. 2013: 192960. doi:10.1155/2013/192960. PMC 3870645. PMID 24383036.
- ^ Aparicio-Rodríguez, J (2010). "Disorders of sexual development in genetic pediatrics: Three different ambiguous genitalia cases report from hospital para el Nino Poblano, Mexico". International Journal of Genetics and Molecular Biology. 2 (10): 207–216.
- ^ Sharma KK, Jain R, Jain SK, Purohit A (2000). "Concealed diphallus :a Case report and review of the literature". Journal of Indian Association of Pediatric Surgeons. 5 (1): 18–21.
- ^ a b Mirshemirani, AR; Sadeghyian, N; Mohajerzadeh, L; Molayee, H; Ghaffari, P (2010). "Diphallus: Report on six cases and review of the literature". Iranian Journal of Pediatrics. 20 (3): 353–7. PMC 3446048. PMID 23056729.
- ^ "Indian man wants op to remove extra organ". Reuters. 19 August 2006. Archived from the original on 22 January 2007. Retrieved 18 August 2006.
- ^ Mirshemirani, Ali-Reza (2010). "Diphallus: Report on Six Cases and Review of the Literature". Iranian Journal of Pediatrics. 20 (3): 353–357. PMC 3446048. PMID 23056729.
- ^ Karabagli, Murat (2017). "Bifid phallus with complete duplication and a separate scrotum in a German shepherd dog: a case report". Veterinarni Medicina. 62 (4): 226–230. doi:10.17221/16/2017-VETMED.
- ^ a b c d e f g h Gyftopoulos, Kostis (2002). "Clinical and embryologic aspects of penile duplication and associated anomalies". Urology. 60 (4): 675–679. doi:10.1016/S0090-4295(02)01874-5. PMID 12385932.
- ^ Wojewski, A (1964). "Total diphallia: A case of plastic repair". Plastic and Reconstructive Surgery. 34 (1): 84–6. doi:10.1097/00006534-196407000-00032. PMID 14104422.
- ^ Aboodi, M.d M (2005). "Accessory Pseudophallus With Accessory Pseudoscrotum Detected During Antenatal Sonographic Scanning". Journal of Ultrasound in Medicine. 24 (8): 1163–1166. doi:10.7863/jum.2005.24.8.1163. PMID 16040834. S2CID 42171596.
- ^ Kundal, Vijay (2013). "A rare case of isolated complete diphallia and review of the literature". BMJ Case Reports. 2013: bcr2012008117. doi:10.1136/bcr-2012-008117. PMC 3603707. PMID 23413289.
- ^ a b c deVries, Catherine (2013). "Congenital anomalies in children" (PDF). Retrieved 18 April 2018.
- ^ Rossete-Cervantes, H (2016). "Diphallia: a case report". Revista Médica del Instituto Mexicano del Seguro Social. 54 (3): 401–3. PMID 27100989 – via PubMed.
- ^ Karagöz, Yeşim (2014). "Isolated penile duplication: case report and literature review". Causapedia. 3: 762. S2CID 35108939.