Science

Baby is born with three penises, for the first time in the world

This child born in Iraq last year has attracted the attention of the medical profession. And for good reason: he came into the world with an extremely rare congenital urogenital anomaly, namely three separate penises. Duplication of the penis, called diphallia, affects about one in 5 to 6 million births!

This baby has therefore truly gone down in history: it is the first ever recorded case of a human born with three penises. This is why it is the subject of an article in the journal International Journal of Surgery Case Reports. Supernumerary penises are an extremely rare urogenital anomaly, first reported in 1609 by Wecker. After that, only about a hundred cases of diphallia have been reported in the literature.

The extent of this anomaly and other associated anomalies vary greatly from patient to patient. In the most common form, affected patients present with a rudimentary additional penis; there are other cases where only the glans is duplicated, or even cases of duplication, or even complete triplication of the penis. Quite often, people with the disease have other associated birth defects (such as bladder and urethral duplication, bladder exstrophy, anorectal malformation, colon duplication, etc.), which are fine. more problematic.

An aspect that is at the same time medical, ethical and aesthetic

The child in question was brought to the attention of surgeons at the age of 3 months, after parents noticed swelling in his scrotum, alongside strange protrusions that looked like small penises. A close examination revealed a hydrocele – an accumulation of fluid in a “pocket” surrounding the testicle, as well as two additional protuberances. One, two centimeters long, extended from the root of the original penis and had an acorn, while the other, about one centimeter, was located below the scrotum.

In a case like this, it is important to take into account not only the health of the patient, but also ethical and aesthetic aspects. Having multiple penises is in itself more troublesome than dangerous, but diphallia is often associated with other congenital problems, including problems with the digestive system and urinary tract. On the advice of various health experts, the child therefore underwent surgery to remove the hydrocele and the two additional penises. The operation was a success and the child does not present any adverse effects to date, after one year of follow-up.

Infants with associated birth defects tend to live shorter lives, but this child born with three penises does not appear to have any other abnormalities in the abdomen, kidneys and bladder; it therefore seems extremely likely that he will live a completely normal life. The medical team in charge of his case still plans to do further tests once he reaches puberty.

A cause still unknown

In the majority of cases of penile duplication, each organ has only one cavernous body, this is called a bifid penis. If each has two cavernous bodies and one spongy body, it is a true diphallia (complete duplication). The term pseudo-diphallia is, on the other hand, used to describe the presence of an additional, smaller or rudimentary penis. The urethra of the penis can have a wide range of associated abnormalities: it can be completely normal and functional, or on the contrary, completely absent.

Distribution of the different anatomoclinical forms of the digital anomalies of the penis listed so far. © French Association of Urology

Only an ultrasound or an MRI can detect the presence or absence of corpora cavernosa and spongy bodies, and to identify any other associated abnormalities. An essential examination to make an appropriate surgical decision. This first reported case of triphallia will undoubtedly enrich the literature on the subject.

What is the origin of this strange malformation? The causes are still poorly understood today. This condition occurs during the embryonic development of the penis between the 3rd and 6th week of gestation. According to some experts, it can also occur during the process of ventral migration and fusion of the mesodermal anlagen at the 15th week of gestation. Environmental factors such as drugs or infections may affect the fetal caudal mass of the mesoderm during this period, suggesting that the epigenetic mechanism may play a role in the pathogenesis of diphallia. In the case of triphallia described here, the child was not exposed to drugs during the pregnancy. The doctors also found no family history of genetic abnormalities or any relevant psychosocial history.

This malformation did not in any case prevent a user of Reddit, nicknamed “Double Dick Dude” to live his life fully, with two fully functional penises. A few years ago he started a session Ask Me Anything to tell the whole world about his extraordinary life. His original position also gave him the opportunity to write a book on the subject.

International Journal of Surgery Case Reports, SS Jabali and AA Mohammed

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