Sikandar Ali Mughal, Sirajuddin Soomro, Jan Muhammad Shaikh.
Double Phallus.
J Coll Physicians Surg Pak Jan ;13(9):534-5.

A 2.8 kg newborn was brought to the hospital soon after birth because of absence of anal opening and duplication of penis. Examination of cardiovascular, central nervous system and respiratory system was normal. His abdomen was distended. Examination of perineum revealed absence of anal opening. His genital examination showed two penises with normal scrotum. One penis was larger, looking apparently abnormal. The other penis was smaller, normal in appearance and present to the right of large penis. Both penises had patent urethral meatuses. The scrotum contained both testes. X-ray invertogram showed an intermediate type of anorectal malformation. His Micturiting cystourethrogram (MCUG) showed pooling of contrast in accessory urethra. Initially a sigmoid colostomy was performed for anorectal malformation to relieve the intestinal obstruction and stabilize the clinical condition. After few days the accessory penis was also excised. Postoperative recovery was uneventful. Biopsy showed fibromuscular tissue surrounded by skin with a central cystic space lined by urethral mucosa. Vascular spaces and neural tissue also seen. Patient has been visiting our outpatient department every month for follow-up and for the management of his colostomy.

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