British doctors described a case of triphallia — a triple penis — in an autopsy of a 78-year-old man with normal external genitalia. However, two small additional penises were located one behind the other behind 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 pathology, affecting approximately one newborn in 5-6 million live births. In total, 168 cases were recorded from 1606 to 2023, including diphallia (double penis), pseudo-diphallia (vestigial additional atrophic penis) and, in one person, triphallia (triple penis; we reported this case earlier). In six cases of diphallia, the extra penis was located inside the body, 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. At postmortem examination of the 78-year-old man, doctors found an 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, and the other two appeared to be located near the entrance to the scrotum. The second penis was located just inside the main penis and had macroscopically distinguishable areas comparable to normal penile anatomy (corpus spongiosum and urethra, corpora cavernosa, and glans penis).
The third penis was located deep in relation to the second penis, but did not have the same obvious anatomical structures as 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 sphincter of the urethra.
Doctors assume that such a structure of the pelvic organs led to frequent urinary tract infections, as well as erectile dysfunction. In addition, it is possible that the developmental anomaly could have been noted by doctors during life: the patient's medical history includes an operation to remove an inguinal hernia. Also, due to the tortuous nature of the urethra, it would have been difficult to install a urinary catheter. However, if this defect was noticed during life, it may have simply been overlooked due to the lack of symptoms and benign nature.
Earlier we reported that urologists began to classify penile deformities in a new way.