University of Birmingham Medical School, Edgbaston, Birmingham, West Midlands, B15 2TT, UK.
J Med Case Rep. 2024 Oct 9;18(1):490. doi: 10.1186/s13256-024-04751-5.
Triphallia, a rare congenital anomaly describing the presence of three distinct penile shafts, has been reported only once in the literature. This case report, based on an extensive literature review, describes the serendipitous discovery during cadaveric dissection of the second reported human case of triphallia, distinctly morphologically different from the previous case.
Despite the normal appearance of external genitalia on examination, the dissection of a 78-year-old white male revealed a remarkable anatomical variation: two small supernumerary penises stacked in a sagittal orientation posteroinferiorly to the primary penis. Each penile shaft displayed its own corpora cavernosa and glans penis. The primary penis and largest and most superficial of the supernumerary penises shared a single urethra, which coursed through the secondary penis prior to its passage through the primary penis. A urethra-like structure was absent from the smallest supernumerary penis.
This case report provides a comprehensive description of the anatomical features of triphallia in a cadaver, shedding light on the morphology, embryology, and clinical implications of this anomaly. Without dissection, this anatomical variation would have remained undiscovered, suggesting the prevalence of polyphallia may be greater than expected. The single tortuous urethra present in this case, as well as the supernumerary and blind ending urethras present in many cases of penile duplication, may pose significant risk of infection, sexual dysfunction, subfertility, and traumatic catheterization.
These findings underscore the importance of meticulous anatomical dissections and may act as a resource for anatomists and those studying genitourinary anomalies. Although we can only speculate as to which functional implications this patient may have experienced, understanding such anatomical variations contributes to both knowledge of human anatomy and clinical management should the condition be encountered in living individuals.
三阴茎畸形,一种罕见的先天性异常,描述了三个不同的阴茎干的存在,仅在文献中报道过一次。本病例报告基于广泛的文献回顾,描述了在尸体解剖中意外发现的第二例三阴茎畸形,其形态明显不同于前一例。
尽管外部生殖器检查外观正常,但对一名 78 岁白人男性的解剖显示出显著的解剖变异:两个小的额外阴茎以矢状位从前向后堆积在主阴茎的下方。每个阴茎干都有自己的海绵体和龟头。主阴茎和最大、最浅表的额外阴茎共用一个尿道,该尿道穿过次级阴茎,然后穿过主阴茎。最小的额外阴茎没有尿道样结构。
本病例报告提供了三阴茎畸形在尸体中的全面解剖特征描述,阐明了该异常的形态、胚胎发生和临床意义。如果不进行解剖,这种解剖变异将无法发现,这表明多阴茎的发生率可能高于预期。本例中存在单一的迂曲尿道,以及许多阴茎重复畸形中存在的额外和盲端尿道,可能会导致严重的感染、性功能障碍、不育和外伤性导尿风险。
这些发现强调了细致解剖的重要性,并可能成为解剖学家和研究泌尿生殖系统异常的人的资源。虽然我们只能推测该患者可能经历了哪些功能影响,但了解这些解剖变异有助于增加对人体解剖的认识,并有助于在遇到活体患者时进行临床管理。