• Anatomy
• Cadaveric dissection
• Case report
• Triphallia

• Aged
• Humans
• Male
• Cadaver
• Penis/abnormalities
• Urethra/abnormalities

Diphallia occurs once in 5–6 million births, with no two patients presenting with the same anatomical variation. Here we discuss a review of diphallia case reports, as well as present a new surgical classification system based on the soft tissue composition of the two phalluses, the anatomy of the urethra present within the most normal phallus and the bladder configuration.

Eighty‐seven diphallia case reports were collected and analysed, excluding those presented in animals and articles that were non‐English, with the results compiled to provide an in‐depth reference of the specific anatomy found in diphallia patients and the associated abnormalities.

Our proposed classification system was then applied to each patient and the most common configuration base on our classification system presented, along with commonly seen associated anomalies.

The reviewed cases represent a subset of the most unique diphallia patients; thus, several cases may be left unreported. Future reports can then be categorized, aiding as a reference, and potentially building on the classification, should the patient not fit into a specific group, leading to an expansion of the classification system.

• classification
• congenital anomaly
• diphallia
• duplicate penis
• urethral duplication

Diphallia is a highly uncommon congenital urogenital abnormality and a few connected reports have been published. However, no case of intraabdominal heterotopic diphallus has been documented to date. In the present study, we present a rare case of intraperitoneal ectopic bipenis.

A 49-year-old man was hospitalized with the chief complaint of hydronephrosis of both kidneys, which was discovered three days earlier through regular physical examination performed using urological ultrasound without significant lumbar or abdominal pain or bladder irritation. Physical examination showed normal external penile development, bilateral testes located on the left side of the scrotum, and a fused epididymis. Urological plain and enhanced computed tomography suggested bilateral hydronephrosis, bilateral ureters opened to the left side of the bladder wall; an intrapelvic soft tissue shadow on the left side of the bladder was considered a germline malformation called bipenis (hidden penis in the abdominal cavity). Based on the urological plain and enhanced computed tomography results, a 49-year-old man was diagnosed with bipenis (one hidden in the abdominal cavity). Ectopic penile compression produced bilateral ureteral dilatation and hydronephrosis. The ectopic penis was amputated and partially removed during surgery, and bilateral ureteral replantation was successfully performed. At a 2-mo follow-up, the patient was very satisfied with the operation, there was no significant hydronephrosis in both kidneys, and urination and erectile function were normal.

To our knowledge, this is the first report of diphallia with an intraperitoneal ectopic penis. Computed tomography or magnetic resonance imaging can be used to assess the associated internal anomalies before surgery. Postoperative pathological findings are the gold standard for the diagnosis.

• Diphallia
• Penis duplication
• Intraperitoneal ectopic penis
• Ureteral reimplantation
• Case report

Diphallia is a highly uncommon congenital urogenital abnormality and a few connected reports have been published. However, no case of intraabdominal heterotopic diphallus has been documented to date. In the present study, we present a rare case of intraperitoneal ectopic bipenis.

A 49-year-old man was hospitalized with the chief complaint of hydronephrosis of both kidneys, which was discovered three days earlier through regular physical examination performed using urological ultrasound without significant lumbar or abdominal pain or bladder irritation. Physical examination showed normal external penile development, bilateral testes located on the left side of the scrotum, and a fused epididymis. Urological plain and enhanced computed tomography suggested bilateral hydronephrosis, bilateral ureters opened to the left side of the bladder wall; an intrapelvic soft tissue shadow on the left side of the bladder was considered a germline malformation called bipenis (hidden penis in the abdominal cavity). Based on the urological plain and enhanced computed tomography results, a 49-year-old man was diagnosed with bipenis (one hidden in the abdominal cavity). Ectopic penile compression produced bilateral ureteral dilatation and hydronephrosis. The ectopic penis was amputated and partially removed during surgery, and bilateral ureteral replantation was successfully performed. At a 2-mo follow-up, the patient was very satisfied with the operation, there was no significant hydronephrosis in both kidneys, and urination and erectile function were normal.

To our knowledge, this is the first report of diphallia with an intraperitoneal ectopic penis. Computed tomography or magnetic resonance imaging can be used to assess the associated internal anomalies before surgery. Postoperative pathological findings are the gold standard for the diagnosis.

• Diphallia
• Penis duplication
• Intraperitoneal ectopic penis
• Ureteral reimplantation
• Case report

Diphallia is an extremely rare congenital anomaly. Bifid phallus is a type of diphallia and is rarely recorded in published studies. According to the degree of separation of the penises at the base of the shaft or just at the glans, bifid phallus is further classified into complete or partial forms. Bifid phallus is often associated with hypospadias or part of the exstrophy–epispadias complex. We are really lucky to have successfully treated a 2-year-old patient with penoscrotal hypospadias combined with partial bifid phallus in the shaft. After the surgery, the patient had no issues with penile function.

• Bifid phallus
• Diphallia
• Hypospadias