Incomplete diphallus: correction in one stage

Abstract

We report a patient with an anorectal malformation and an abnormal penis with an isolated prepuce, double glans, and two corpora cavernosa. A right main urethra opened into the bladder neck; the right meatus was hypospadiac. The proximal end of the left accessory urethra opened into the right prostatic urethra and the left meatus was orthotopic. Severe chordee and normal urinary flow through both meatuses were present. At the age of 4 years, the diphallus was corrected. Both corpora cavernosa were dissected and the urethra was reconstructed, lengthening the right urethra with a 2.5-cm fragment of left urethra as a free graft excised from the emergence point and joined to the main urethra pasteriorly. The right urethra, whose meatus was hypospadiac and lateral, was dissected until a medial course was obtained. The glans was reconstructed using the lateral aspect of each glans; both medial aspects were extirpated. To correct the urethral trajectory, the urethra was fixed to the tip of the glans. A penis with two corpora cavernosa, a single glans, and a complete urethra with a meatus at the tip of the glans was obtained. The prepuce was reconstructed from the dorsal redundant aspect. The postoperative course was satisfactory.