A guide for parents of children with a buried penis
What is a buried penis?
Although the penis is of normal size, it is seen as small when viewed from the outside, because it is hidden by the surrounding skin. Buried penis is also called hidden, concealed penis. It is often confused with the small penis. In a buried penis, the penis is not small, it is completely normal in size. Your penis is hidden inside the body due to anatomical reasons (figure 1) or excessive fat tissue in the groin area.
In childhood, there is a buried penis in most of the doctor's visits due to the concern of the small penis. Its frequency is increasing every year with the change in eating habits and the increase in obesity.
Buried penis can sometimes be seen in children circumcised with an improper technique or due to abnormal healing after circumcision. These cases are called trapped penis.
Another condition that can be confused with a buried penis is the webbed penis. Here, there is a congenital adhesion between the penis and the scrotum.
What are the symptoms?
In infancy, the family usually complains that the child's penis is small, that he cannot urinate forward and that his hygiene is not easy. In adolescence, psychosocial problems come to the fore as well as similar complaints. In both cases, the penis appears with a slight downward stretching of the skin around the penis, and it is observed to be of normal size.
What are the surgical requirements?
Recurrent foreskin inflammations in young children, followed by the development of stenosis (phimosis) at the tip of the foreskin, skin adhesions, urination problems, and inability to control the child's penis during urination are surgical requirements. In older children, cosmetic discomfort and psychological problems caused by this situation, lack of self-confidence, and the thought of treating this situation due to the families' concerns about the child's future sexual life are other requirements.
When is the surgical procedure performed?
If the problem is the adhesion of the penis to the lower tissues, this should be corrected surgically. Cases with buried penis with excess adipose tissue in the pubic region due to overweight can be followed up to puberty. When the child reaches puberty, this excess fat layer will disappear, so no additional treatment is needed. If a resistant adipose tissue persists after puberty due to obesity, it is treated with surgical removal of adipose tissue and plastic corrective operations to the abdominal wall region.
How is the surgical procedure performed?
There are many different surgical techniques described for the buried penis. In these techniques, the aim is simply to correct the angles between the penis and the pubic bone, and between the penis and the scrotum, and bring them back to normal. The penis is completely freed from the surrounding abnormal adhesions and bands, and the loose tissues are sutured to the underlying tissues to create upper and lower angles, and the foreskin is treated by covering the underside of the penis, which has emerged and regained its normal size and visibility.