SPU Main Site  |  Past and Future Meetings
Society For Pediatric Urology

Back to 2019 Abstracts


Penile Fusion Technique for Correction of Diphallia
Allison Sih, MD1, Gregory Dean, MD, FAAP, FACS2.
1Temple University Hospital, Philadelphia, PA, USA, 2St Christopher's Hospital for Children, Philadelphia, PA, USA.

BACKGROUND: Diphallia is a rare congenital anomaly with approximately a hundred cases reported in the literature. We present a case of an adolescent with penile and urethral duplication who desires surgical reconstruction.
METHODS:
The patient is a 16-year-old male who presents with penile and urethral duplication. He has a history of bladder exstrophy closure and imperforate anus repair in Ecuador. He was able to void from both meatuses. Physical exam showed a single shaft with two separate glans and meatuses. MRI evaluation showed four corporal bodies with a fused corpora spongiosum. Cystourethroscopy showed two parallel, but separate urethras which entered the bladder. The surgical strategy centered on maximally preserving glans tissue and creation of a single meatus. A circumferential incision was made and the shaft was degloved. The glans were separated using electrocautery and the urethras were incised sharply. A side-to-side anastomosis of each urethra using 5-0 Monocryl facilitated voiding from a single meatus. A small portion of the ventral and dorsal glans skin was excised to create a two layer closer, forming a single glans. The penile skin was reapproximated to give a circumcised appearance. RESULTS: Total operative time was approximately 180 minutes. Estimated blood loss was 10 ccs. The patient did well post-operatively. The catheters were removed after two weeks. At three month follow-up, the patient is doing well and is happy with his cosmetic result.
CONCLUSIONS: Diphallia is a rare congenital anomaly. We present a case of an adolescent with diphallia who had two separate glans and meatuses with a single penile shaft. Surgical reconstruction consisted of maximal glans preservation and formation of a single meatus. The patient is pleased with his cosmetic result.


Back to 2019 Abstracts