Diphallia is an unusual congenital anomaly where a child is born with two penises. This condition appears in about one in five million patients, and treatment depends on the specific presentation and any other medical issues the patient may have. Typically, the malformation of the penis is accompanied with anomalies in other parts of the body, and these may take precedence in treatment because of their severity.
This condition is not a genetic mutation and cannot be inherited. It occurs because of errors during fetal development, like the incomplete migration of penile cells as the penis grows. This may be random or the result of exposure to chemicals in utero. Prenatal ultrasound may allow for a diagnosis before the baby is born, along with an evaluation of other body systems like the renal and colorectal tracts to check for other birth defects. Patients with diphallia may have other deformities like imperforate anus, where the anal opening fails to form.
When a baby is born with this condition, a medical professional will usually recommend a thorough evaluation to check for other birth defects and collect as much information about the anomaly as possible. Sometimes, one of the penises is not fully formed or doesn't connect to other parts of the urinary and reproductive tracts, while in others, the two penises may be complete and fully functional. The anatomy of a specific case can be a cause for concern when developing a treatment plan.
One treatment option is surgical reconstruction. A surgeon will evaluate the patient, remove the supernumerary penis, and perform any additional procedures such as relocating the remaining penis to place it in an anatomically correct position. At the same time, the surgeon may address other aspects of the patient's case, such as malformations in the gut that may lead to medical complications in the future.
A surgeon may recommend waiting on treatment since newborn infants are fragile and surgery can be dangerous. If the procedure is purely cosmetic in nature, it may be better to let the infant grow and develop before addressing the issue. The surgeon may also want to address serious birth defects first, treating the diphallia at a later juncture.
Patients with this condition may be infertile. If fertility is a concern, a patient can request specific testing and discuss options for managing infertility with a doctor. These can include using donor sperm or seeing if it is possible to harvest viable sperm for in vitro fertilization.
