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ISSN: 2327-5146
General Medicine: Open Access
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Male Pygopagus Twins

Amin El-Gohary M*
Department of Pediatric Surgery, Burjeel hospital, Abu Dhabi, UAE
Corresponding Author : Amin El-Gohary M
FRCS, Professor of Pediatric surgery
Burjeel hospital, Abu Dhabi , UAE
Tel: 971506225532
E-mail: [email protected]
Received February 18, 2015; Accepted February 20, 2015; Published February 25, 2015
Citation: El-Gohary AM (2015) Male Pygopagus Twins. Gen Med (Los Angel) 3:i109. doi: 10.4172/2327-5146.1000i109
Copyright: ©2015 El-Gohary AM. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Figure 1: Male pygopagus twins.
A set of 2 male pygopagus twins were born at full term by normal vaginal delivery in a poor rural area in Sudan on April 2003, Their lower spines were fused and they shared a common anus and one penis. They were referred to Mafraq hospital at the age of 16 months for further management. Initial evaluation that they were joined at the sacrum and sharing a normal appearing phallus. Four normal testes were palpable in 4 separate hemi scrota. Sensation and motor function of the lower limbs were normal (Figure 1). CT and MRI showed a fused lower sacral region (S1-S3) with spinal cords sharing one continuous Dural tube. They were also found to share a common rectum on barium enema. The muscle complex around the common anus was found to split equally on the lateral side of the shared anus. Evaluation of the genitourinary tract showed 4 normal kidneys and ureters, separate bladders and a fused posterior urethra at the level of the membranous urethra extending to the external urethral meatus. A three-dimensional animation and a pelvic model were utilized during both the planning and operative phases of the separation and proved to be of great value in planning the separation. It clearly showed the anatomical fusion at the bony level and demonstrated the presence of 4 corporal bodies, which raised the hope of potential penile separation. Two tissue expander were used at the lower sacral area on both sides for 3 months and gradually inflated to obtain adequate tissue cover
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