Baby Born with Double Penis

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Double penis
Image showing double penis, a double scrotum, and two natal clefts with absent anal orifice.

A 6-hour-old baby diagnosed with caudal duplication syndrome presenting with a double penis, two scrotum, two urethra, and two natal clefts

A mother delivered a male neonate 6 hours earlier. The baby weighed 2.6 kg. The mother had an uneventful prenatal course with no history of prenatal exposure. The baby was shifted to the neonatal intensive care unit. On examination, he had a double penis (diphalus), double scrotum, and dual urethral opening.

The baby was urinating normally from both the urethrae. The double scrotum contained one palpable testis in each. Examination also revealed two separated natal clefts. However, there was no anal orifice (imperforate anus).

The doctors made a working diagnosis of Caudal Duplication Syndrome (CDS) with anorectal malformation.

The Invertogram showed a high variety of anorectal malformation. Moreover, ultrasonogram revealed hydronephrosis of the left kidney. Echocardiography was normal and did not reveal any cardiac abnormalities.

With consent, the baby underwent a low descending colostomy that revealed a duplicated colon (4 stomas). Postoperatively, the baby was able to tolerate oral feed and to pass regularly from the colostomy (The two proximal ends).

Distal Loopgram showed duplicated colon down to the rectum. It did not reveal any fistulae with the urinary tracts.

Magnetic Resonance Imaging (MRI) showed:

  • Left moderate hydronephrosis.
  • Left congenital PUJ (pelvi-ureteric junction) stenosis.
  • Duplicated urinary bladder.
  • Tethered cord with no duplication of the vertebral column.

The doctors discharged the patient 3 days postoperatively for follow up and subsequent planning for a staged repair.

Reference:

Maher A, Sabra TA, Ibrahim H, Mostafa M, Newborn with complete double penis and two separate scrotums: Int Journal of Surgery Case Reports; 2020; 77:490-497, ISSN 2210-2612, https://doi.org/10.1016/j.ijscr.2020.11.002.

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Dr. Arsia Hanif has been a meritorious Healthcare professional with a proven track record throughout her academic life securing first position in her MCAT examination and then, in 2017, she successfully completed her Bachelors of Medicine and Surgery from Dow University of Health Sciences. She has had the opportunity to apply her theoretical knowledge to the real-life scenarios, as a House Officer (HO) serving at Civil Hospital. Whilst working at the Civil Hospital, she discovered that nothing satisfies her more than helping other humans in need and since then has made a commitment to implement her expertise in the field of medicine to cure the sick and regain the state of health and well-being. Being a Doctor is exactly what you’d think it’s like. She is the colleague at work that everyone wants to know but nobody wants to be. If you want to get something done, you approach her – everyone knows that! She is currently studying with Medical Council of Canada and aspires to be a leading Neurologist someday. Alongside, she has taken up medical writing to exercise her skills of delivering comprehensible version of the otherwise difficult medical literature. Her breaks comprise either of swimming, volunteering services at a Medical Camp or spending time with family.

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