What is diphallia? Boy born in Pakistan with rare phenomenon

ISLAMABAD: A boy in the federal capital has been born with an extraordinarily rare congenital anomaly called diphallia, a condition in which a person is born with two penises, The News reported on Tuesday.

According to reports, only 100 cases of diphallia — is an extremely rare developmental abnormality in which a mammal is born with two penises — have been recorded in medical literature, so far. However, it is believed that one in five to six million live births may witness this rare phenomenon. 

Surgeons in federal capital revealed that interestingly, the baby boy is able to pass urine "from both orifices".

A specialist doctor on the condition of anonymity told The News that the surgery is the only treatment for diphallia. 

“Treatment is not always necessary; however, a surgeon will usually perform this surgery at birth or soon after. The procedure will vary based on how much duplication there is and the presence of other birth irregularities," the doctor said.

The primary concerns are making sure the male is able to urinate normally and has erections, reducing the potential risk of infectious and reducing structural irregularities. 

The medical expert said the timing of surgery would be an important factor due to the male’s likely age. As doctors often diagnose diphallia at birth, several surgeries may be needed over time. 

Scans revealed that the boy had a single bladder attached to two urethras, which meant he could pass urine from both penises.

It was learnt that the boy also had no anus; however, the doctors did create an opening via a colonoscopy so that he could pass stools. 

The surgeons diverted one end of his colon through an opening in the lower left side of the abdomen to allow him to defecate. The boy was monitored for two days following the surgery. He was then discharged and a follow-up appointment arranged.

What is diphallia?

It is unclear how diphallia occurs, and there is no known single risk factor, but it’s thought to have happened by chance when genitalia develops in the womb. 

Patients can either have complete diphallia, when both penises are well developed, or partial diphallia, when one penis is smaller or deformed.

Males with diphallia are often able to urinate through one or both penises. They may also be able to have erections and ejaculate with one or both penises. 

Depending on the individual situation, males with this condition may be able to have a normal sex life and children. However, there tends to be an increased risk of poorly functioning kidney and colorectal systems. For this reason, infants with diphallia may have a higher risk of death due to infections. 

This may not be the case when diphallia is not associated with other irregularities.

Writing in the International Journal of Surgery Case Reports, the team claimed that the chances of having diphallia as it is known medically is one in six million. 

Only 100 such cases have been recorded in medical literature, with the first dating back to 1609. This rare condition was first written about in a report by Swiss doctor Johannes Jacob Wecker when he encountered a cadaver exhibiting the condition in 1609.

'Boy has no family history of any birth defects'

The doctors who treated the boy in Islamabad said 1% of the sufferers also had a defect which affected their anus or rectum.

The boy, born after 36 weeks, was treated at the Children’s Hospital at the Pakistan Institute of Medical Sciences. His parents, who took him to the Emergency Department straight after he was born, have no family history of any birth defects. 

The doctors examining him spotted that he had no anal opening and two "well-formed phalluses", one of which was 1.5cm, while the other 2.5cm. Scans revealed that he had a single bladder attached to two urethras, which meant he passed urine from both penises.

In a first in medical history, a boy was born with three penises, a team of doctors revealed, according to a foreign media report on April 3, 2021.

According to the doctors, he was the first human to be born with such an affliction. This condition is called triphallia. It was reported in Duhok. 

A team, led by Dr Shakir Saleem Jabali, wrote in the journal: “Triphallia (three penises) is an unreported condition in humans until now. Patients with supernumerary penises have unique presentation and no cases are identical. 

"Treatment is difficult because it poses medical, ethical and cosmetic aspects. A combined multidisciplinary team is required for the management and a 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.”