Man with three penises discovered in ultra-rare condition, a 1st in adults

During the examination, the researchers observed that the patient, a white man approximately six feet tall, had normal external genitalia. 

However, further investigation revealed the presence of “two small extra penises concealed within the scrotal sac.”

 The main and secondary penis both shared a urethra, which passed through the secondary penis before going through the main penis. 

The smallest supernumerary penis did not have a urethra-like structure, according to the authors. Genital development begins in the womb at four to seven weeks gestation. 

The penis develops from the genital tubercule and is controlled by dihydrotestosterone (DHT). 

Abnormalities in genes that affect the androgen receptors can lead to physical abnormalities in the genitals. 

In this case, the genital tubercle may have been triplicated, resulting in the urethra developing in the secondary penis. 

When this penis did not develop, the urethra changed course and developed in the primary penis instead. The tertiary penis is a remnant of the triplicated genital tubercle. 

Researchers observed that the differences in physical characteristics of extra penises reported in medical literature varied greatly, possibly due to a wide range of underlying causes. In most cases of external penile duplication, which is usually linked with other congenital issues, surgeons opt to remove the extra penis. 

Penile duplication inside the body is usually identified later in life, causing issues such as sexual dysfunction, obstructive urinary symptoms, and urinary incontinence in adulthood. 

“We cannot be sure if the defect was unnoticed in this case, as the person had a history of having surgery to repair an inguinal hernia,” the researchers wrote. 

The urethra’s twisted nature would have made it difficult to pass a urinary catheter. If the defect had been noticed while he was alive, it may have been left alone due to the lack of symptoms and its harmless nature. 

Given the discovery’s accidental nature, the researchers suggested that internal penile duplication may be more common than previously thought. 

Internal penises that are hidden and do not show any symptoms or additional medical needs may not be detected, making diagnosis difficult. 

Healthcare providers need to know about polyphagia to diagnose patients with urological symptoms and provide appropriate care, such as catheter insertion, urological imaging, and surgery. 

Polyphallia may be more common than we currently realize, so awareness of this condition is crucial for effective healthcare interventions.