A case report of penis agenesis (Aphallia)

A neonate was admitted on the second day of birth in the pediatric ward of Kerman medical sciences university No. 1 hospital, because of abdominal distention and the absence of penis. Physical findings were lethargia, infancy hyporeflexia, abdominal distention without any organomegally, absence of penis, two touchable masses in the scrotum and a hole on scrotum for urine discharge. CBC and electrolytes were normal. Urea and creatinin were higher than normal rate but decreased to normal rate on the 4th day of birth. Urine analysis showed a lot of white and red cells and bacteria, but urine culture and blood culture were negative. Abdominal radiography revealed intestinal lobes full of gas, but there was no gas in the rectum. Barium enema was normal. Vertebral radiograph and echocardiograph were normal. Abdominal sonography showed pyelocalisil distention in both kidneys, but more in the left kidney, right scrotum and a hypoplastic penis in scrotum. In CT scan, perfusion and function of right kidney were normal while no perfusion and function were observed in the left kidney. The karyotype was 46XY. Abdominal distention was relieved after the washing of rectum with normal salin and discharge of gas and meconium. Urea and creatinin levels decreased to normal rate and oral feeding was started. The neonate was discharged because of parents’ discontent for genital repair, but readmitted on the 41st day of birth due to urinary retention and visiculotomy was performed. Genital repair was not done due to parents’ discontent.