A bifid penis (also known as diphallia) is a rare congenital malformation, present at birth, in which the penis is partially or completely duplicated (Medical News Today).

While many men may have concerns about their anatomy, a bifid penis is a rare, specific, and medically defined congenital condition that is distinct from normal anatomical variation. This guide provides a clinical explanation of what a bifid penis is. We will cover the official diagnostic criteria, the underlying causes of bifid penis, and how it is identified.

What Causes a Bifid Penis to Develop?

A bifid penis is caused by a disruption of embryological development between the 3rd and 6th week of gestation, which prevents the proper fusion of the genital tubercle (ScienceDirect).

How Embryological Development Causes a Bifid Penis

A bifid penis forms when the genital tubercle, a single structure that normally develops into the penis, is disturbed or duplicated, causing two separate genital buds to form. The genital tubercle is the primordial tissue in an embryo that develops into the penis in males or the clitoris in females.

This disruption, which occurs very early in pregnancy, is related to a disturbance of the cloacal membrane (PMC – review of literature). This prevents the two sides from merging into a single structure, resulting in a bifid penis or complete diphallia.

Are There Known Risk Factors for a Bifid Penis?

The exact risk factors for a bifid penis are unknown; the condition is considered a random, sporadic event and is not linked to any specific actions taken during pregnancy.

Bifid penis, or diphallia, is an extremely rare anomaly. The estimated incidence is only 1 in every 5-6 million live male births, as noted in case studies published in sources like the Journal of Pediatric Urology (PMC – Case Study).

While this type of penile duplication is sometimes associated with other genetic syndromes, it is most often a random, non-hereditary event during fetal development.

What Are the Symptoms and Variations of a Bifid Penis?

The primary symptom of a bifid penis is the visible duplication of the structure, which is classified into variations ranging from a split glans to two complete, separate shafts (diphallia).

How a Bifid Penis Is Visibly Identified

A bifid penis is visibly identified and classified at birth based on the degree of duplication (Radiopaedia).

• Glans Duplication: The shaft is single, but the glans (head) is split in two.
• Bifid Phallus: The penis is partially split, often appearing as two shafts that are fused at the base.
• Complete Diphallia: Two separate, complete penile shafts are present, which may be side-by-side or one above the other.

How a Bifid Penis Affects Function

The functional impact of a bifid penis depends entirely on the underlying anatomy, specifically whether each shaft contains erectile tissue (corpora cavernosa) and a functional urethra.

• Urination: Function depends on the urethra. One or both of the duplicated penises may have a functional urethra, or the urethra may open in an abnormal location (a condition known as hypospadias or epispadias).
• Sexual Function: One or both penises may be capable of erection, depending on the presence of corpora cavernosa in each.

Why a Bifid Penis Requires Evaluation for Other Conditions

A bifid penis requires a comprehensive evaluation for other conditions because it is rarely an isolated defect and is frequently associated with other severe congenital anomalies, especially of the urogenital and gastrointestinal tracts. The bifid penis itself is often the external sign of more serious internal issues.

The Link Between a Bifid Penis and Urogenital Anomalies

A bifid penis is most strongly linked to other urogenital anomalies, including scrotal abnormalities, bladder exstrophy, and kidney malformations (Radiopaedia).

• Scrotal Abnormalities: A bifid (split) or ectopic (misplaced) scrotum is very common.
• Bladder Issues: Bladder exstrophy (where the bladder develops outside the body) or bladder duplication (Urology Care Foundation).
• Urethral Duplication: The presence of two urethral tubes (Medscape).
• Kidney Malformations: Such as abnormal kidney position or function.

These associations are well-documented in medical imaging literature.

The Link Between a Bifid Penis and Gastrointestinal Anomalies

Gastrointestinal anomalies, particularly imperforate anus (a blocked or missing anus) and colorectal duplication, are also commonly associated with a bifid penis (ScienceDirect).

• Imperforate Anus: A condition where the anus is missing or blocked.
• Colorectal Duplication: The large intestine may also be duplicated.

Other Anomalies Associated with a Bifid Penis

Other anomalies often associated with a bifid penis involve the skeletal system, such as a separation of the pubic bones or defects in the spine (vertebral defects).

What Is the Treatment for a Bifid Penis?

The “treatment for a bifid penis” is almost always surgical, involving a complex reconstruction (phalloplasty) and the correction of its associated urogenital and gastrointestinal anomalies.

How Doctors Diagnose a Bifid Penis and Related Issues

Doctors diagnose a bifid penis at birth via physical examination, which is immediately followed by imaging tests like an ultrasound or MRI to map the extensive, associated internal anomalies.

• Physical Examination: The condition is typically identified at birth by a pediatrician.
• Imaging Tests: An ultrasound or MRI is essential. This is done to create a “map” of the internal anatomy, checking the kidneys, bladder, and rectum.
• Specialist Consultation: A pediatric urologist and pediatric surgeon will lead the evaluation to plan the complex treatment.

What Surgical Treatment for a Bifid Penis Involves

Surgical “treatment for a bifid penis” is a complex, often staged process of phalloplasty (penile reconstruction) designed to create a single, functional penis and correct life-threatening associated conditions (JIAPS). Phalloplasty is the surgical construction or reconstruction of a penis.

• Primary Goal: To create a single, functional, and cosmetically normal-appearing penis.
• Surgical Approach: The surgeon will typically remove the less-functional or smaller penis and reconstruct the remaining tissues. If both are small, tissues may be combined.
• Urethral Reconstruction: Creating a single, functional urethral channel to the tip of the new penis.
• Staged Surgeries: Treatment is often done in multiple stages to manage associated conditions (like bladder or anal repair) first, followed by the penile reconstruction.

Conclusion

In conclusion, a bifid penis is a rare, medically defined congenital malformation that is critical to identify at birth, not because of the duplication itself, but because it is a strong indicator of other serious internal anomalies.

This condition, also known as diphallia, results from an event early in embryological development. The primary medical concern is the high frequency of associated urogenital, gastrointestinal, and skeletal defects, which require immediate and thorough investigation by a specialized medical team.

Understanding that this is a known, though rare, medical condition is the first step toward a comprehensive and effective surgical treatment plan. At [Our Brand/Clinic], we believe in providing clear, clinical information to help parents and patients understand complex medical conditions.

Glossary of Clinical Terms

To ensure full clarity, this glossary defines the key clinical and scientific terms used throughout this guide on bifid penis.