British doctors described a case of triphallia—a triple penis—during the autopsy of a 78-year-old man with normal external genitalia. However, two small additional penises were located one behind the other, posterior to the main penis. Each penis had its own corpora cavernosa and glans, and the main penis and the largest additional penis shared a common urethra. The case is described in the Journal of Medical Case Reports.
Congenital anomaly of the number of penises is an extremely rare condition, affecting approximately one in every 5-6 million live births. A total of 168 cases were recorded between 1606 and 2023, including diphallia (double penis), pseudodiphallia (vestigial additional atrophic penis), and, in one individual, triphallia (triple penis; we previously reported this case). In six cases of diphallia, the additional penis was located internally, under the skin.
A team of pathologists led by John Buchanan from the University of Birmingham Medical School described the world's second case of triphallia. During an autopsy of a 78-year-old man, doctors discovered internal triplication of the penis (his external genitalia appeared normal). A midline incision revealed three penises located next to each other, aligned in the midsagittal plane from front to back.
The largest penis was visible externally, while the other two appeared to be located near the scrotal introitus. The second penis was located directly within the main penis and had macroscopically distinguishable areas comparable to normal penile anatomy (the corpus spongiosum and urethra, the corpora cavernosa, and the glans penis).
The third penis was located deep in relation to the second penis, but lacked the obvious anatomical structures of the other penises, including the urethra. It was later discovered that the urethra of the main penis passes into the second penis, and then into the internal urethral sphincter.
Doctors suspect that this pelvic structure led to frequent urinary tract infections and erectile dysfunction. Furthermore, it's possible that the abnormal development could have been noted by doctors during life: the patient had a history of inguinal hernia surgery. Also, the tortuous nature of the urethra would have made it difficult to insert a urinary catheter. However, even if this defect had been noticed during life, it may have simply gone unnoticed due to the lack of symptoms and its benign nature.
We previously reported that urologists have begun to reclassify penile deformities.
