A buried penis is a medical condition where the penis is concealed beneath surrounding skin, fat, or scar tissue, making it appear shorter or even absent. This condition can affect individuals across all age groups, from infants and children to adults. While the penis itself is typically of normal size, its hidden nature can lead to various complications.
What is a Buried Penis?
A buried penis occurs when the penile shaft is obscured by excess surrounding tissue, such as abdominal fat, fatty tissue around the penis (mons pubis), or tissue in the upper thighs or scrotum. This makes the shaft challenging to visualize or access. Unlike a micropenis, which is an abnormally small penis, a buried penis has a normal underlying size but is simply hidden.
This condition can lead to several functional implications. Individuals may experience difficulties with urination, including dribbling or soiling clothing, or an inability to urinate while standing. Maintaining proper hygiene can also become a challenge, increasing the risk of skin rashes, infections, and unpleasant odors. Additionally, some individuals may face difficulties with sexual intercourse, such as painful erections or an inability to achieve penetration.
Causes in Infants and Children
In infants and children, a buried penis can stem from both congenital and acquired causes. Congenital factors include underdeveloped suspensory ligaments or abnormal dartos fascia attachment. The dartos fascia is a layer of tissue beneath the skin of the penis; its inelasticity or improper attachment can cause the penis to retract or “telescope” into surrounding tissue.
Excess suprapubic fat due to childhood obesity is another contributing factor. A large fat pad covering the pubic region can obscure the penis. While some cases in infants may resolve naturally as the child grows and loses baby fat, obesity can persist as a cause. Scar tissue from circumcision can also lead to an acquired buried penis if the suture line constricts or if too much or too little foreskin is removed, creating scarring that tethers the penis inward.
Causes in Adults
In adults, a buried penis is primarily an acquired condition, with several contributing factors. Obesity plays a role, as weight gain leads to accumulation of excess suprapubic fat that can envelop the penis. This increased fat can create a moist environment, predisposing individuals to chronic infections and inflammation, which exacerbates the condition.
Lymphedema, characterized by fluid retention and swelling in the pubic and scrotal areas, can also cause the penis to become buried. This occurs when the lymphatic system is damaged or blocked, leading to a buildup of lymph fluid that engulfs the penis. Scar tissue from previous surgeries, such as prostatectomy or hernia repair, or from trauma to the genital area, can tether and retract the penis. Other contributing factors include lichen sclerosus, a chronic inflammatory skin condition, or complications from adult circumcision that result in scarring and retraction.
Diagnosis and Treatment
Diagnosis of a buried penis involves a physical examination by a healthcare provider, who assesses the extent of concealment and differentiates it from other conditions like micropenis. The examination may include attempting to expose the penis by gently pressing on surrounding tissues. This helps identify underlying contributing conditions.
Treatment approaches vary depending on the underlying cause and the individual’s age. In some mild cases in young children, the condition may improve without intervention as they grow. For cases related to obesity in both children and adults, weight loss is a supportive measure, though it may not always fully resolve the condition. Surgical intervention is often recommended for correction. Surgical goals involve releasing the penis from surrounding tissue, removing excess fat or scar tissue, and re-anchoring the penile skin to deeper structures to ensure proper exposure and function.