INTRODUCTION: Triphallia, a rare congenital anomaly describing the presence of three distinct penile shafts, has been reported only once in the literature. This case report, based on an extensive literature review, describes the serendipitous discovery during cadaveric dissection of the second reported human case of triphallia, distinctly morphologically different from the previous case.
CASE PRESENTATION: Despite the normal appearance of external genitalia on examination, the dissection of a 78-year-old white male revealed a remarkable anatomical variation: two small supernumerary penises stacked in a sagittal orientation posteroinferiorly to the primary penis. Each penile shaft displayed its own corpora cavernosa and glans penis. The primary penis and largest and most superficial of the supernumerary penises shared a single urethra, which coursed through the secondary penis prior to its passage through the primary penis. A urethra-like structure was absent from the smallest supernumerary penis.
CONCLUSION: This case report provides a comprehensive description of the anatomical features of triphallia in a cadaver, shedding light on the morphology, embryology, and clinical implications of this anomaly. Without dissection, this anatomical variation would have remained undiscovered, suggesting the prevalence of polyphallia may be greater than expected. The single tortuous urethra present in this case, as well as the supernumerary and blind ending urethras present in many cases of penile duplication, may pose significant risk of infection, sexual dysfunction, subfertility, and traumatic catheterization.
SIGNIFICANCE: These findings underscore the importance of meticulous anatomical dissections and may act as a resource for anatomists and those studying genitourinary anomalies. Although we can only speculate as to which functional implications this patient may have experienced, understanding such anatomical variations contributes to both knowledge of human anatomy and clinical management should the condition be encountered in living individuals.
the dissection of a 78-year-old white male revealed a remarkable anatomical variation: two small supernumerary penises stacked in a sagittal orientation posteroinferiorly to the primary penis.
gross dissection documents the structures without histologic corroboration or systematic exclusion of alternative interpretations
The primary penis and largest and most superficial of the supernumerary penises shared a single urethra, which coursed through the secondary penis prior to its passage through the primary penis.
probe tracing and sagittal dissection directly establish the continuous urethral course in this specimen
Without dissection, this anatomical variation would have remained undiscovered, suggesting the prevalence of polyphallia may be greater than expected.
one incidental cadaveric observation cannot establish prevalence or exclude recognition during life
The single tortuous urethra present in this case, as well as the supernumerary and blind ending urethras present in many cases of penile duplication, may pose significant risk of infection, sexual dysfunction, subfertility, and traumatic catheterization.
no clinical outcomes were observed, and the Discussion states that UTI risk was not likely increased in this case
Derived from the full evaluation — not a separate score.
Strengths
The report documents internally concealed accessory structures and a urethral arrangement distinct from the previously reported triphallia phenotype.
↳ Background; Abstract—Case Presentation; Cadaveric Findings
The examination describes sagittal sectioning, further exploration, and probe tracing of the continuous urethral course. Figures, a schematic, defined measurements, and negative findings support the gross description.
↳ Cadaveric Findings; Figs. 1–3; Table 1
The Discussion explains why existing systems do not readily accommodate the phenotype and acknowledges uncertainty in nomenclature.
↳ Discussion, classification paragraph; Conclusion
Limitations
The anatomical interpretation rests on gross dissection without reported histologic corroboration or systematic exclusion of alternative interpretations.
↳ Cadaveric Findings; Figs. 1–2
No lifetime clinical outcomes are available, yet the abstract links this case to significant potential complications. Its infection-risk framing also conflicts with the Discussion's statement that UTI risk is not likely increased.
↳ Abstract—Conclusion; Discussion, second paragraph
The paper reports a substantial case count but does not describe the search method sufficiently for reproduction. Comparison with the closest triphallia report remains brief.
↳ Background; Discussion
The report's principal value lies in its detailed description of concealed triphallia and the directly traced shared urethral course. Defined measurements, negative findings, and anatomical illustrations support the descriptive contribution, but gross identification lacks confirmatory characterization and systematic treatment of alternative interpretations. The broader prevalence and clinical-risk statements exceed what this single cadaver can establish, with opposing infection-risk wording in the Abstract and Discussion. Discussion of competing classifications provides useful context, although the literature-search method and closest-case comparison are limited. Ethics approval and donor-consent procedures are not reported in the supplied text, creating a transparency concern without establishing that either was absent.
Nabu’s assessment, alongside the field’s view.
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Sound3.5
Confidence mediumThe concealed triphallia phenotype and shared urethral anatomy add a distinct observation to a sparse descriptive record. The contribution is anatomical and hypothesis-generating rather than evidence of prevalence or clinical consequences.
Sectioning, urethral probing, measurements, and negative findings make the gross examination reconstructable. Absent histologic corroboration and systematic consideration of alternative interpretations reduce the score from the gross-documentation merit assessment.
The structure and anatomical terminology make the descriptive findings followable. The abstract's clinical-risk statement conflicts with the Discussion's case-specific UTI assessment, and developmental reconstruction sometimes uses excessive certainty.
The paper situates the case among reported polyphallia phenotypes and explains competing classification systems. The closest-case comparison is brief, and the literature-search method and limitations are not developed systematically.
Caveats4 of 4 checks
The reported numbers and statistics are consistent with the stated results.
The supplied text explains donor-information restrictions but does not report ethics approval or a donor-consent process. This is a transparency omission, not evidence that approval or consent was absent.
Ethics approval: not stated
27 references in manuscript 26 of 27 checkable references found in an index
References not verified automatically are resolved manually within 24 hours.
No retraction or expression of concern found in Crossref (includes Retraction Watch).
Sources: Crossref (incl. Retraction Watch) ✓
Where this paper’s evidence sits on the path from initial observation to real-world use.
The work is an initial anatomical observation rather than a validated diagnostic or management approach. Proposed clinical consequences are not supported by observed patient outcomes.
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