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Complete Penile Duplication with Structurally Normal Penises: A Case Report

Ahsen Karagözlü Akgül1, Murat Uçar2, Fatih Çelik3

  • 1Clinic of Pediatric Urology, University of Health Sciences, Van Training and Research Hospital, Van, Turkey

Balkan Medical Journal
|March 29, 2018
PubMed
Summary
This summary is machine-generated.

Diphallia, a rare congenital anomaly, presents unique surgical challenges. This case highlights successful management of complete penile duplication with associated anomalies using end-to-side urethra-urethrostomy.

Keywords:
Congenital anomaly, diphallia, penile duplication, reconstructive surgery

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Area of Science:

  • Urology
  • Pediatric Surgery
  • Medical Genetics

Background:

  • Diphallia, characterized by penile duplication, is an exceedingly rare congenital anomaly, occurring in approximately 1 in 5.5 million live births.
  • True diphallia with anatomically normal penile structures is exceptionally uncommon.
  • Surgical intervention for complete penile duplication, especially without concurrent penile or urethral pathology, poses significant challenges.

Observation:

  • A 4-year-old male patient presented with diphallia, exhibiting complete penile duplication.
  • Clinical examination revealed urine excretion from both penises, meconium discharge from the right urethra, and anal atresia.
  • Further investigations identified a duplicated colon and rectum, double bladder, and a significant rectovesical fistula.

Findings:

  • Histological examination of each penile body revealed two corpora cavernosa and one corpus spongiosum.
  • The surgical strategy involved a right total penectomy and an end-to-side urethra-urethrostomy.
  • The patient experienced no postoperative complications, and normal voiding function was maintained during an 18-month follow-up period.

Implications:

  • Penile duplication necessitates individualized surgical approaches due to its variable presentation.
  • End-to-side urethra-urethrostomy offers a viable alternative to posterior urethral resection, potentially preserving prostatic and sphincter integrity.
  • This surgical technique may reduce the risk of damage to critical pelvic structures during the management of complex penile duplication anomalies.