Penile agenesis (aphallia): A rare case report with associated congenital anomalies

Penile agenesis (aphallia) is an exceptionally rare congenital anomaly with an estimated incidence of one in 10 to 30 million live births. We report a full-term male neonate with complete penile agenesis, a normally developed scrotum with bilaterally palpable testes, and passage of urine through the anus. Investigations revealed a rectovesical fistula, horseshoe kidneys with mild pelvicalyceal dilatation, and aganglionic megacolon, a previously unreported triple association. Suprapubic cystostomy was performed at day seven. Male sex assignment was chosen based on 46,XY karyotype and Islamic ethical guidance, with staged phalloplasty planned.