An extraordinary case of a man with three penises was described in scientific literature. This is only the second time around and the details in this example are unique. A unique anatomical oddity was accidentally discovered in a white man who died at the age of 78 and was unaware of his congenital anomaly during his life.

The man donated his body to science, and only after an autopsy by researchers at the University of Birmingham in the United Kingdom were two additional penis shafts discovered hiding under the man’s skin, near his main external genitalia.

Of all the reports of multiple penises published in the scientific literature between 1606 and 2023, researchers were only able to find 112 examples that described the entire penis.diphalium» or double penis. Only one report mentioned threesomes or “triphala” and this previous situation was evident from the beginning.

In 2020, researchers in Iraq described the anatomy of a 3-month-old baby boy with a head 2 centimeters (just under 0.8 inches) long and a third head about a centimeter long, attached to the root of the penis below the perineum. It is just below the scrotum. Both external appendages were surgically removed.

A recent case of triphalia is quite different. Externally, the genitals appeared normal, but postmortem examination revealed two inner and lower penises “hidden in the scrotal sac” above the flaccid part of the scrotum and at the base of the main penis.

“Without any symptoms or additional medical need, hidden internal penises may go undetected, making diagnosis difficult,” explain the report’s authors, led by University of Birmingham medical student John Buchanan.

“Therefore, polyphagia may be more common than currently believed.”

The authors call for a simple and unified classification system to define polyphany, as it may be important to know during medical interventions. For example, having a hidden extra penis can cause problems when it comes to inserting a catheter, imaging the urethra, or performing surgery in that area.

It is currently believed that polyphany occurs in every 5-6 million live births. But internal cases can potentially remain latent throughout a person’s life, leading to unexplained symptoms related to urination, erection or male fertility.

Among previously published cases of diphalia, Birmingham researchers found six reports of the formation of an internal penis, in which the extra penis is hidden in the skin. However, when detected, these abnormalities often remain symptomless. In the second triphalia case, the donor’s identity was kept secret, so it is unknown whether the man reported similar symptoms during his lifetime.

But based on his anatomy, researchers say he may have had difficult or painful erections because his internal penises were swollen with blood. The man’s internal secondary penis had “macroscopically visible and distinct areas” normally seen in a typical penis, such as the glans, urethra, and spongy tissue that swells with blood during erection.

In fact, the same urethra in the primary penis has been found to first take a “detour” through this secondary penis. Researchers aren’t sure how this circuitous route arises, but during typical male development a certain type of testosterone stimulates the growth of the “pubic tubercle.” In this case, this bump may accidentally triple in size.

If the urethra begins to develop in the secondary penis, it may progress into the primary penis when further growth of the internal penis fails.

“Due to the tortuous structure of the urethra, it will be difficult for the urinary catheter to pass,” the authors write. “Had the defect been discovered during his lifetime, it could have been left untouched due to its apparent lack of symptoms and benign nature.” The study was published on: Journal of Medical Case Reports.