Triphallia (triple penis), the first reported case in human

Abstract

Introduction: Supernumerary penises is an extremely rare congenital anomaly which affects one in every 5-6 million live births. Affected patients may have only a rudimentary penis, supernumerary penile glances or complete duplication or triplication of penises. Some patients may have some other associated congenital anomalies.

Presentation of case: A 3-month-old child presented because of left side hydrocele. There were evidence of two supernumerary penises in the perineum, the first one was about 2 cm in length with a glans and was attached to the root of the penis, and the third one was about 1 cm and was below the scrotum. Hydrocelectomy was performed. The two supernumerary penises were extending to perineal region and were attached to original penis, both had corpora cavernosum and spongiosum with no urethra inside. Both supernumerary penises were excised and both corpora were sutured with a fine slowly absorbable suture material. The patient was discharged with no postoperative events and follow up was done for one years with no reported adverse events.

Conclusion: Triphallia (three penises) is unreported condition in human until now. Patients with supernumerary penises have unique presentation and no cases are identical. The position of the penis may be ectopic or orthotopic. Treatment is difficult because it poses medical, ethical, and cosmetic aspects. A combined multidisciplinary team is required for the management and long term follow up is required. Excision or reconstruction of the duplicate penis is required depending on the corporal development and anatomy of the urethra.

Keywords: Diphallia; Multiple penises; Supernumerary penises; Triphallia; Urogenital anomalies.