A man grew old not knowing he might have three penises

Do you really know what you look like on the inside? Most people don’t, and it usually requires surgery or medical imaging to take a look while we’re still alive.

A case study in the Journal of Medical Case Reports was published last week in which researchers made the rare discovery of a man with “triphallia”. Most people would say the man had three penises. But anatomists, like myself, who teach health professionals about the structure of the human body, prefer the term penes (plural of penis).

This finding emerged from the dissection of the body of a 78-year-old man who had donated his body to science. It’s a case that has left many anatomists scratching their heads and sparking debates about typical human anatomy and anatomical variation.

I also have an extra organ – an extra spleen – plus other anatomical variations involving two muscles. It is very likely that you also have anatomical variations, but you don’t necessarily know it.

Back to this case

According to the latest study, only one penis was visible externally. But when his body was dissected, there were two additional, smaller penises in the scrotum.

The main penis was 77mm long and 24mm wide, while the smaller ones were about half that size. However, the images in the study do not appear to match the written descriptions in all places. The study therefore needs clarification.

Intriguingly, researchers identified a single urethra: the hollow tube of the bladder through which urine (and sperm from the testes) can leave the body. This urethra ran from the bladder through part of one of the smaller penises and along the length of the main penis, completely omitting the third penis.

Was there a misunderstanding in identifying these anatomical structures? Could the second penis simply be a misidentified part of the main one? Is this actually a case of diphallia – two penises? In both cases, the man’s anatomy was different from what you would normally see in anatomy books.

The study suggests that all three penises contain erectile tissue capable of engorgement. But it remains unclear whether they worked independently or together. Unfortunately, the authors did not confirm the structures by examining them under the microscope, or report on tracing the nerves or blood vessels, to shed more light.

There was a previous case in a baby

A special case of someone with three penises documented in 2020involving a three-month-old baby.

In this case, the main penis was in the typical position, but you could see the extra penis on the perineum (between the anus and scrotum in men).

None of the extra penises had a urethra, which prevented them from functioning normally. Ultimately, these non-functional penises were safely removed.

Such cases are rare, with only these two examples listed in medical databases.

So how does this happen? The answer could lie in the way embryos develop.

Early in development

The penis begins to develop early in the first trimester of a 40-week pregnancy, a time when a woman may not know she is pregnant.

During this critical period the embryo can be exposed to various influences. This involve toxins that are transported through the bloodstream when the mother becomes ill, takes certain medications during pregnancy, or is exposed to certain chemicals. There are also genetic factors that determine how organs develop.

By the fifth week of pregnancy, the cells migrate to the midline of the embryo, where they help form the precursor to the penis.

Problems in this migration process, abnormalities in a developmental gene (called “sonic hedgehog”), or fluctuations in testosterone levels or receptors during early fetal development can potentially lead to the formation of extra penises.

People are varied

While the appearance of triphallia can be startling, these rare cases highlight a broader point: our anatomy can vary significantly. Just as individuals differ in their appearance, so do our internal anatomy.

For example, there are anatomical variations in blood vessels, organs, muscles, nerves and even bones that may not be immediately visible.

Incidental findings during my own medical examinations have revealed that I have a supernumerary (or extra) spleen called a splenunculus, an extra flexor digitorum longus muscle (in my leg), and that I am missing both palmaris longus muscles (in my forearms). ).

Although my anatomical variations are internal, extra nipples are a common example of a visible external anatomical variation. These can be mistaken for moles and can also be the result of developmental problems in the early weeks of pregnancy.

Why is this important?

Cases like the man who reportedly had three penises are important reminders of the complexity of human anatomy and the many factors that can influence our bodies from the very beginning of development.

Exploring these rare findings highlights the importance of continued research in the fields of anatomy and embryology.

These findings also highlight the importance of a healthy lifestyle for people who are planning to become pregnant and are already pregnant. This is so that growing embryos have the best chance of developing typical anatomy.

This article is republished from The conversation under a Creative Commons license. Read the original article.