https://orcid.org/0000-0002-4320-9619
Dear editor
We read with interest the article entitled “An extremely rare case report of aphallia with horseshoe kidney and ureterohydronephrosis” by Daniel and Abera.Citation1 This case is special because of its rarity. However, we have some comments on this case report. Our observations mainly concern the discussion section, which is practically non-existent, because the authors repeat the same information as in the introduction and have not properly addressed it. They argue that there are three anatomical classifications of the urethral opening: post-sphincteric, pre-sphincteric, and urethral atresia. However, the latter is not a urethral opening, but is defined as the congenital absence of the urethral orifice. Perhaps the authors were referring to the types of aphallia according to the location of the urethral meatus.Citation2 They also say that “the isolated aphallia were less likely to be identified”, which makes no sense since this anomaly, if present, is easily detected at birth. Furthermore, only one reference is included to comment on the ureterohydronephrosis found in this case. However, this association is not rare, as ureterohydronephrosis is due to the obstruction of urinary outflow and subsequent accumulation of urine, which is common in these patients.Citation3,Citation4 Finally, the authors state that aphallia has not been reported in association with horseshoe kidney, which is incorrect, as this association, like other renal anomalies, is well documented.Citation5–7
In conclusion, we believe that these observations are important because this type of article is read by students who may receive inaccurate information.
Disclosure
The authors have no conflict of interest to declare in this communication.
References
- Daniel T, Abera Y. An extremely rare case report of aphallia with horseshoe kidney and ureterohydronephrosis. Int Med Case Rep J. 2023;16:779–781. doi:10.2147/IMCRJ.S441943
- Skoog SJ, Belman AB. Aphallia: its classification and management. J Urol. 1989;141(3):589–592. doi:10.1016/s0022-5347(17)40903-7
- Pal D, Pal DK. Agenesis of penis. Urol Ann. 2020;12(4):379–381. doi:10.4103/UA.UA_29_20
- Sen S, Arunachalam P, Sam CJ. Urethral reconstruction in aphallia using transpubic exposure and colonic monti neo-urethra - An addition to the De Castro reconstruction. J Pediatr Urol. 2021;17(1):83.e1–83.e7. doi:10.1016/j.jpurol.2020.10.023
- Willihnganz-Lawson KH, Malaeb BS, Shukla AR. De Castro technique used to create neophallus: a case of aphallia. Urology. 2012;79(5):1149–1151. doi:10.1016/j.urology.2011.10.004
- Shilpa K, Rajan J, Arati R. A rare case report of aphallia with horse-shoe kidney. J Clin Neonatol. 2016;5(1):55–57. doi:10.4103/2249-4847.173277
- Krishnamoorthy K, Sethuraman G, Devi U. Aphallia in a neonate with VACTERL malformation: report of a rare association. Clin Dysmorphol. 2023;32(2):74–76. doi:10.1097/MCD.0000000000000445