Purpose or Case Report: A 6-month-old full-term infant presented to the urology clinic for management of diphallia. No reported relevant past medical history. Physical examination demonstrated 2 completely developed penis with normal looking meatus, both penises covered at the mid-part of the shaft with one penile skin shaft, penoscrotal malposition, right side scrotal skin tag, sacral dimple, and undescended testes. Both of them have urine flow from the urethras. Amniotic karyotype was 46 XY.
Methods & Materials: Ultrasound of the penis and scrotum demonstrated well-developed right penis, with normal corpora spongiosum and normal separate corpora cavernosa each supplied by separate cavernosal artery. Left penis demonstrated normal corpora spongiosum, and 2 separate corpora cavernosa supplied by 1 cavernosal artery. Vesicocystourethrogram demonstrates normal flow during voiding phase in the well-developed right penile urethra. The left penile urethra was relatively smaller in caliber (but patent) and proximally it terminated in the right prostatic urethra. The imaging findings were consistent with true partial diphallia.
Results: Approximately 100 cases of diphalia have been reported in the literature with varied presentations. These cases are associated with other urogenital and anorectal malformations, such as hypospadias, epispadias, exstrophy bladder, duplication of bladder, renal agenesis, caudal duplication syndrome, imperforate anus, duplication, and triplication of the colon. Underlying mechanism is unclear.

Gyftopoulos et al proposed classification where cases can be divided into 2 broad categories: True diphallia and bifid phallus. Both can be subclassified into partial or complete duplication. True complete diphallia will have 2 well-developed penis (with 2 corpora cavernosa and 1 corpora spongiosum). True partial diphallia will have smaller or rudimentary duplicate penis (with complete structures that is 2 corpora cavernosa and 1 corpora spongiosum). If the duplicate penis does not have all the structures, for example one corpora cavernosum they are classified as bifid phallus. Depending on the degree of separation, bifid phallus is further subclassified into complete and partial. Complete bifid phallus has separation at the base whereas, partial bifid phallus has separation at the glans.
Conclusions: Due to wide variability in presentation the management strategies differ. Surgical correction is individualized with the aim of achieving proper urinary continence and erection with adequate cosmesis.