Pakistani baby born with 2 penises, no anus; know about rare condition chances of having which is ‘one in six million’

“He had true diphallia with two separate uretheral orifices. Both phalluses were uncircumcised, phallus 1 was 2.5 cm in length while phallus 2 was 1.5 cm. Both phalluses had normal-shaped glans with uretheral openings located at the normal place. He had a single scrotum with two midline raphe and well-formed rouge. He was passing urine from both orifices. His ultrasonography of urological system showed two ureters and a single hemi bladder. He was admitted and operated upon and a sigmoid-divided colostomy was constructed. Per-operatively congenital pouch colon (type 4) was identified,” the study noted, adding that the doctors went on to create an opening via a colonoscopy so that the baby could pass stools.

All you need to know about diphallia (Source: Getty Images/Thinkstock)

Noting diphallia as a a rare congenital anomaly, which means two structurally and anatomically separate phalluses, the study noted that as diphallia presents with a spectrum of diseases, and as such, it requires a multidisciplinary approach.

“As in our case, the patient had diphallia with anorectal malformation. Hence, he was operated upon and a sigmoid colostomy was constructed,” the study read.

Dr Shrey Srivastav, MD (Internal Medicine), Sharda Hospital concurred and said that the cause of diphallia, also called penile duplication (PD), diphallic terata, or diphallasparatus, “is unknown”.

“Since its associated anomalies vary largely, it is impossible to give a simple, single explanation of its cause. But it is thought to have started from duplication of cloacal membrane in early embryonic development stages in the foetus, between third and sixth week of gestation,” Dr Srivastav told indianexpress.com.

But a thorough evaluation is needed to rule out associated abnormalities, stressed Dr Shrinivas R P, consultant – Urology, Manipal Hospital, Whitefield, Bangalore. “A double penis is frequently accompanied by a number of anomalies, including a double urinary tract, urethra, bladder, and digestive system. Since it’s also associated with a double and dilated colon, it needs to be evaluated and excised,” he said.

Dr Shrinivas also urged that while the double penis “might appear horrifying or frightful to the parents and the general public”,  as long as the child can urinate, it’s not an emergency.

Management

The study mentioned that the management of such cases should be individualised, depending upon the spectrum of disease.

Agreeing, Dr Srivastav said the treatment is initiated basis a case-by-case analysis “taking into account considerations for medical and ethical reasons, and involves surgical excision of the non-functioning penis”.

Once the child has gained some weight and is more stable after a few months, Dr Shrinivas said that doctors can perform a thorough evaluation to determine which urethra needs to be removed.

“We can also decide which bladder has to be excised because two bladders are mostly not compatible in the long run. Hence, one of the bladders and one of the urethra needs to be removed so that both kidneys join into the common bladder. That will restore the urinary tract to its regular state. In addition, the shorter, less developed penis must be taken out,” said Dr Shrinivas.

In the above case, as the baby’s post-operative recovery was uneventful, the study noted that the patient was discharged on second post-operative day and called for follow up.

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