Health and Medicine
PUBLISHED
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In 2024, members of the University of Birmingham Medical School in Edgbaston, Birmingham, were dissecting the cadaver of a 79-year-old man, when they found an incredibly rare surprise in the genital area. Doing a quick count of the penises attached to the male body, they found three instead of the usual one.
Congenital supernumerary penile formation – or the formation of an extra penis from birth – is an incredibly rare condition, affecting just 1 in every 5-6 million people. The team noted that only 168 scientific papers from between 1606 and 2023 CE have documented polyphallia, or the presence of more than one penis. Of these, only one reported the presence of triphallia, or three penises.
"Almost all surgeons decided to remove an additional external penis, often the non-functional or smaller of the two," the team noted in their report. "However, typically no action was taken with regard to internal penis formation, as they are usually asymptomatic."
Due to local policies, not much is known about the man's medical history prior to his death and delivery of his cadaver to the researchers, beyond what was found during examination at the University of Birmingham Medical School.
"This white male, in his late 70s, was around 6 feet tall and of a medium–large build," the team wrote. "The most notable finding, as previously discussed, was the presence of internal penile triplication." They added that the man may not have been aware of the abnormalities, as the accessory penises were "internal", or concealed within the skin.
"Despite the majority of external penile duplication being associated with other congenital abnormalities, including midline structure duplication and vertebrae, anus, heart, trachea, esophagus, kidney, and limbs (VACTERYL) association, internal penile duplication often presents later in life as an incidental finding," the team wrote.
"However, he may have lived with functional deficits due to the abnormal anatomy of the region, which may include urinary tract infections, erectile dysfunction, or fertility issues, as later described," they added.
According to the team, the two "extra" penises were found inside the scrotal sac, and so they may have gone unnoticed until after the man's death. However, the team found signs that the man underwent inguinal hernia repair that may have required a catheter, which would have been difficult to pass through his urethra. If the extra penises were noticed during this stage of the man's life, they were left alone by his medical team.
Given the lack of symptoms in people who have more than one penis, and the discovery of extra penises on cadavers, the team suggests it may be more prevalent than we realized.
"The penis develops from the genital tubercle and is controlled by DHT [dihydrotestosterone]. Genetic abnormalities affecting the expression of androgen receptors may cause morphological genital abnormalities," the team explained.
"In this case, there may have been triplication of the genital tubercle. The urethra originally developed in the secondary penis, however, when this penis failed to develop, the urethra diverted its course and developed in the primary penis instead. The tertiary penis is a remnant of the triplicated genital tubercle."
The team noted that in this man's case, he likely did not suffer from infections as there was no "blind-ending" urethra, or a urethra which ends in a closed pouch. However, he may have experienced pain surrounding sexual intercourse "due to the potential erection of the secondary and tertiary penises".
The authors suggested that a better classification system is needed for additional penises, recognizing their clinical differences and medical needs.
