Types of Buried Penis and An Overview of Surgical Techniques

Dr Clarence Lei Chang Moh, FRCS Urol, FEBU,

Consultant Urologist,

Adjunct Professor,Universiti Malaysia Sarawak, 

 Honorary Consultant Urologist to HKL, SGH, SHC

 c/o Kidnay & Urology Centre, Normah Hospital, Kuching.

Introduction: A buried penis refers to the penis which is partially or completely buried or concealed under prepubic skin and/or fat.  The corporeal length of penile shaft is normal.Presentation in adulthood is rare. This is different from “micropenis”, a condition feared by most mothers.  A buried penis is of normal size. When the penis is erect or when the fat is reduced, the mother may sometimes be reassured.  The patient may have some hygienic problems with urination as the urinary stream may spray. If the patient  somehow undergoes an over-zealous circumcision, the penis may become more buried.   

Methods: If the penis erects or with the pubic fat depressed, a ruler can be used to measure the length and girth of the penis, as a record and also to indicate to the mother that his true penis is not microsized.  Literature research as well as the author’s personal series are used to illustrate various surgical techniques used to treat buried penis.  If there is  phimosis, a judicious circumcision will allow the penis to project outwards.  In cases where the penis still remains “small”, local application of testosterone gel may be used when the child undergoes puberty. In the meantime, the patient should also be given advice to reduce childhood obesity.  When the penile skin is lax, the penile skin can be tagged down with a suture (egPDS) to the lateral aspect of the corpora cavernosa to reduce the risk of penile retraction.  

In adults, dissection of the penile corpora, releasing down to the suspensory ligament and scrotum can be achieved by the urologist. Excision of  the suprapubic fat pad,  liposuction,  excision of abdominal apron or skin graft are better done in collaboration with a plastic surgeon. Cosmesis and sexual function are multifactorial and patient expectations have to be realistic.

Conclusion: The buried penis usually does not give rise to significant sexual dysfunction in adulthood. The judicious use of surgery may sometimes be necessary. Reconstructive surgery is better done in specialized units.