A rare case report of aphallia with hypoplastic kidney and vesicorectal fistula

Aphallia - congenital absence of the penis: a systematic review

“…The most cases were reported in the USA which were 31% (n:13) of all cases [ 2 , 7 , 8 , 12 , 16 , 30 , 32 – 34 ], followed by India with 21% (n:9) [ 14 , 18 , 19 , 21 , 25 , 29 , 34 ] Iran with 12% (n:5) [ 5 , 13 , 17 ], China with 7.3% [ 1 , 6 , 23 ], Turkey with 4% (n:2) [ 15 , 31 ], France with 4% (n:2) [ 23 , 27 ], Japan with 4% (n:2) [ 26 , 27 ], Morocco with 4% (n:2) [ 9 , 10 ], Mexico with 2% (n:1) [ 3 ], UK with 2% (n:1) [ 11 ], and Senegal with 2% (n:1) [ 22 ].…”

“…The majority of cases involve males with 97% (n:40) of all cases (1–3,7–29), and 2% (n:1) was female [ 2 ]. Of the 35 cases, the majority with 48% (n:20) cases were term neonates [ 2 , 3 , 8 – 12 , 14 , 17 , 18 , 21 , 22 , 25 , 28 , 30 , 33 ], while 19% (n:8) were preterm neonates [ 2 , 13 , 24 , 26 , 32 , 34 ], 9% (n:4) were infants [ 1 , 16 , 25 , 34 ], 9% (n:4) were under five [ 5 , 7 , 19 , 27 ],and 12% (n:5) were over 5 years old [ 6 , 15 , 23 , 29 , 31 ]. The patient with the lowest gestational age was 31 weeks [ 13 ], with the oldest patient ‘s age was 31 years old [ 23 ].…”

“…On physical examination, as many as 95% (n:39) cases reported scrotum development, and 2% (n:1) case reported well-formed labia major [ 2 ]. From 39 cases, 85% (n:35) cases reported normal scrotum development [ 1 – 3 , 5 – 19 , 22 – 25 , 27 – 31 , 33 , 34 ], and 9% (n:4) reported bifid scrotum [ 13 , 21 , 26 , 32 ]. Almost all male cases reported testicular development (with 39 of the 40), with 82% (n:34) with descending testis [ 1 – 3 , 5 – 7 , 9 – 23 , 25 – 30 , 32 – 34 ] and 12% (n:5) with undescendent testes [ 8 , 24 , 25 , 31 ].…”

“…The majority of the patients’ anus was in a normal position in 78% (n:32) cases [ 1 – 3 , 5 – 7 , 9 – 13 , 15 – 20 , 22 , 27 – 33 ], with 2% (n:1) an anteriorly displaced anus [ 2 ], 17% (n:7) with imperforated anus [ 8 , 14 , 21 , 22 , 24 – 26 ], and 2% (n:1) with funnel anus [ 11 ]. As many as 22% (n:8) of the cases were found to have skin tags in the perineal area (2,21,27,29).…”

“…Most cases used postnatal ultrasound in 75% (n: 31) cases [ 1 – 3 , 5 – 19 , 23 , 25 – 30 , 33 , 34 ] followed by 46% (n:19) using cystography [ 2 , 10 , 13 , 15 , 16 , 22 , 23 , 25 – 28 , 30 , 31 , 33 ], 22% (n:9) using urography [ 2 , 7 , 15 , 19 , 23 , 27 , 29 , 31 , 33 ], 22% (n:9) using magnetic resonance imaging (MRI) [ 7 , 8 , 11 , 12 , 15 , 16 , 19 , 23 , 28 ], 17% (n:7) using nuclear imaging [ 2 , 15 , 16 , 19 , 33 , 34 ], 17% (n:7) of cases using prenatal ultrasound [ 8 , 12 , 16 , 24 , 26 , 28 , 32 ], 14% (n:6) used computerized tomography (CT) scan [ 1 , 1 , 3 , 5 , 6 , 15 , 22 ], and 12% (N5) used endoscopy [ 2 , 12 , 27 , 33 ].…”