Mr Tarik Ibrahem Ali
Introduction: A congenital anomaly affecting the male penis is an extremely rare incident, especially when presented as a case of supernumerary penis (diphallus) with no other anomalies affecting the other systems or organs, as in our case. (Approximately 100 cases have been reported since the first case report by Wecker in 1609. There are broadly three types of diphallus, viz. true diphallus with two independent penises, bifid phallus that may be glandular or complete and pseudodiphallus having a rudimentary phallus in addition to the normal penis. Numerous associated genitourinary and gastrointestinal anomalies have been described with diphallus.) KK Sharma1 Reviewing medical literatures, nearly all reported cases of Diphallia were accompanied by at least one other congenital anomaly such as another urogenital, an imperforated anus, vertebral deformities or a gastrointestinal anomaly1, 2, 3, 4
Method: A 19 year-old man was presented to our surgical clinic in May 1979, complaining of dripping of urine from a small bud at the ventral surface of his mid- penile shaft. The problem, which he had had since birth, proved to be a small Supernumerary penis, originating from the ventral surface of the main penile shaft. On examination, the small bud on the ventral surface of the penile shaft was seen to resemble a tiny penis of 1.5cm length. It consisted of a small glans about 5mm in length and diameter with an external urethral opening and a small shaft measuring about 10mm in length with a retracted prepius or foreskin.
Result: Reconstructive surgical removal of the supernumerary penis was done. The post-operative course was uneventful and the patient was discharged home next day. The stitches were removed on the 7th post-operative day. The gross appearance of the surgical specimen was clearly a small penis of 1.5cm in length. No histopathological study of the surgical specimen was done at the time, but the specimen was preserved and saved and is still available for inspection.
Conclusion: Such a rare condition should be managed by an expert surgeon in the urogenital field. It should be born in mind that the most urgent and any possibly life threatening anomalies if present, should be treated first. The type of anomaly will determine the surgical treatment which will be needed.