A case of penile duplication with neonatal teratoma and bladder neck incompetence

An 8-year-old boy presented with a duplicated penis and urinary incontinence. He had a history of a perineal teratoma which was removed during his first week of life. Examination revealed a large prepuce, 90-degree counter clockwise rotation of the penis, an orthotopic megalomeatus and an additional smaller glans dorsally. Cystourethroscopy and artificial erection showed a wide-open bladder neck and deviation of the penis(es) to the right. There were two cavernosae in the orthotopic penis and one in the duplicated rudimentary penis. The patient was subjected to Young-Dees bladder neck reconstruction and two years later, excision of the rudimentary penis. A satisfactory cosmetic result was achieved, the patient is voiding normally, and urinary incontinence improved. Penile duplication is a rare anomaly, which presents differently in each patient. Therefore, treatment should be individualized, and the goal of surgery being to achieve as a near normal cosmetic and functional result as possible.