Radiologic imaging of true diphallia with imperforate anus: A case report

Diphallia, also known as penile duplication, represents a highly unusual congenital abnormality of sex development, occurring in 1 in every 5 million to 1 in thirty million live births. Wecker, in Bologna, Italy, noted the first instance of diphallia in 1609. Meanwhile, no sufficient report has meticulously described the incidence in Indonesia. Generally, this condition is accompanied by duplication or malformation of other organs, such as the urinary tract, anorectal, or vertebrae, whether uncomplicated or complex; therefore, appropriate imaging is paramount to identify the related anatomical structures in order to provide prompt and pertinent management. A wide variety of imaging modalities can be conducted to elucidate this malformation, from the conventional procedure, namely urethrography ultrasound to assess the vessels, to advanced examination, such as magnetic resonance imaging (MRI), to capture the anatomy around the lesion distinctly. Comprehensive imaging enables the surgeon to evaluate and understand the complexity of the anatomical builds. This case report will illustrate diphallia from conventional and advanced perspectives concomitantly of a boy presenting with a hereditary anomaly of 2 penises, each conveying a functional urethra, 2 anal dimples, with a presacral mass between them.