An extraordinary case of a man with three penises was just described in the scientific literature. It's only the second time, and the particulars of this example are one of a kind.
The unique anatomical quirk was found by accident in a White male, who died at the age of 78 and who may not have known about his congenital anomaly in life.
The man donated his body to science, and only upon post-mortem examination by researchers from the University of Birmingham in the UK were two extra penile shafts discovered hiding underneath the man's skin, near his main external sex organ.
Of all the reports of multiple penises published in scientific literature between 1606 and 2023, researchers could find just 112 case studies that describe complete 'diphallia' or a double penis. Only one other report describes a triple penis or 'triphallia', and this previous case was obvious from the outset.
In 2020, researchers in Iraq described the anatomy of a 3-month-old male child, who had a 2-centimeter-long (just under 0.8 inches) glans attached to the root of their main penis beneath the perineum, as well as a third glans roughly a centimeter in size just below their scrotum. Both external appendages were surgically removed.
The more recent case of triphallia is quite different. Externally, the genitalia appeared normal, but upon postmortem analysis, two interior and inferior penises were discovered "concealed within the scrotal sac", above the hanging part of the scrotum and at the base of the main penile shaft.
"Without any symptoms and additional medical needs, concealed internal penises may not present themselves, preventing diagnosis," explain the authors of the report, led by final-year medical student John Buchanan at the University of Birmingham.
"Hence, polyphallia may be more prevalent than currently understood."
The authors are calling for a simple and uniform classification system by which to describe polyphallia, as it may be important to know about during medical interventions.
The presence of a hidden, additional penis, for instance, can create issues when it comes to inserting a catheter, imaging the urethra, or doing surgery in the area.
At the moment, polyphallia is thought to occur in one in every 5 to 6 million live births. But internal cases can potentially remain hidden for the entire length of a person's life, resulting in unexplainable symptoms related to urination, erections, or male fertility.
Among previously published cases of diphallia, researchers at Birmingham found six reports of internal penis formation, where the extra shaft is concealed within the skin. When discovered, however, these anomalies are usually left alone if asymptomatic.
In the most recent case of triphallia, the identity of the donor was kept anonymous, so it's unknown if the man reported any related symptoms during his life.
Based on his anatomy, however, researchers say it is possible he may have experienced difficult or painful erections, due to the potential for his internal penises to become enlarged with blood.
The man's internal, secondary penis actually had "macroscopically discernible and distinct regions" that are usually seen in a typical penis, such as a glans, a urethra, and the spongy tissue that swells with blood during an erection.
In fact, the same urethra in the primary penis was found to take a "meandering course" through this secondary penis first.
Researchers can't be sure how that tortuous path came about, but during typical male development, a form of testosterone prompts growth from a 'genital tubercle'. In this case, that tubercle might have accidentally tripled.
If the urethra started developing in the secondary penis, it could have jumped over to the primary penis when the continued growth of the internal penis failed.
"Due to the tortuous nature of the urethra, a urinary catheter would have proved challenging to pass," the authors write.
"If the defect had been noticed during his life it may have simply been left untouched due to the apparent lack of symptoms and its benign nature."
The study was published in the Journal of Medical Case Reports.
