Buried Penis

What is a buried penis?

Buried penis is a condition in which your penis is typical in size and shape, but body tissues and folds of skin hide it. These tissues can include:

• Abdominal (lower belly) fat.
• Fatty tissue surrounding your penis (mons pubis).
• Fatty tissue in your upper thighs.
• Fatty tissue in your scrotum (the sac behind your penis that normally holds your testicles).
• Inverted penis skin attachments.

Buried penis can affect anyone with a penis. It may be present at birth (congenital) or develop later in life (adult-acquired buried penis). The majority of babies/children who have buried penises at birth will have improvement in their penises’s appearance as they get older.

Other names for buried penis include:

• Buried penile syndrome.
• Hidden penis.
• Concealed penis.

Who does a buried penis affect?

Buried penis can affect anyone with a penis at any age. However, it’s most common in infants and toddlers.

How common is buried penis?

Buried penis isn’t common. Healthcare providers and medical researchers don’t know how common it is in adults, though there appears to be a connection between buried penis and increasing rates of a body mass index (BMI) greater than 30 (has obesity).

One study reported that it affects about 4% of newborns in Japan.

What are the symptoms of buried penis?

Buried penis doesn’t typically cause any symptoms.

The primary issue with buried penis is that your penis doesn’t “stick out” and seems “tucked in” to the tissues around it. This can sometimes lead to difficulty with peeing or keeping your penis clean. You can expose your buried penis by pressing the tissue/skin around the penis down to “push it out.”

A lot of inflammation or scar tissue that forms around the surrounding tissues can “trap” a buried penis, so you can’t expose it at all. This can lead to:

• Pain.
• Odor.
• Infections.

What causes buried penis?

Buried penis causes may relate to:

• Congenital differences. The skin at the base of your penis attaches in a different way. At rest, this causes it to invert rather than be exposed.
• BMI greater than 40 (class III obesity). Excess weight around your abdomen and genital area can hide your penis.
• Genital lymphedema. Lymphedema occurs when something affects your lymphatic system and causes swelling around your scrotum area. The collection of lymph fluid in the surrounding tissue may bury your penis.
• Circumcision problems. Circumcision is a procedure that removes the foreskin that covers the head of your penis. If a healthcare provider removes too much or not enough foreskin, the penis may drop back into the fatty area that surrounds it.
• Hydradenitis suppurativa. Hydradenitis suppurative is inflammation in your sweat (apocrine) glands. It may lead to the development of pockets of pus (abscesses) or an abnormal passage between body parts (fistula), which can cause buried penis.

What are the complications of buried penis?

Buried penis complications may include:

• Trouble urinating (peeing). You may inadvertently dribble pee on your scrotum, thighs or clothes. It can be difficult to pee at all because scar tissue blocks your penis. In some cases, you may not be able to pee while standing up.
• Difficulty cleaning your penis. It can be challenging to clean and thoroughly dry the area. This can cause skin rash, skin infections and urinary tract infections (UTIs).
• Difficulty with sexual intercourse. You may be unable to get an erection. If you do get an erection, you may not be able to penetrate.
• Pain and irritation. You may have a persistent ache or pain, or pain may occur when you get an erection. There’s also an association between lichen sclerosus and buried penis. Lichen sclerosus causes the skin on your penis and surrounding areas to become thin, discolored and/or irritated.

Buried penis can also impact your mental health. It can affect how other people influence your thoughts and emotions (psychosocial) and how you think about yourself or behave (psychological). A buried penis may cause you to experience:

• Low self-esteem.
• Anxiety.
• Depression.
• Stress.

How is buried penis diagnosed?

In most cases, a healthcare provider can diagnose a buried penis by reviewing your medical history and conducting a physical examination.

How is buried penis treated?

Buried penis can be difficult to treat, and the treatment depends on the underlying cause. In infants and children, it often goes away on its own without treatment. First-line treatments may include:

• Medications. A healthcare provider may prescribe antibiotics to treat an infection in your genital region.
• Weight loss. A provider will usually encourage weight loss and nutritional counseling before surgery. Weight loss alone may cure buried penis. If it doesn’t completely fix buried penis, it can reduce the chances of complications during treatment.
• Psychological counseling. Psychotherapy (counseling or talk therapy) can help address depression, sexual dysfunction and low self-esteem.

In severe cases, a provider may recommend surgery. They may:

• Remove scar tissue.
• Detach the ligament that attaches the base of your penis to your pubic bone.
• Attach internal sutures (stitches) under the skin of your penis to the base of your penis.

Other surgical techniques may include:

• Suction lipectomy. Suction lipectomy involves removing fat tissue above your penis or scrotum. A surgeon will make tiny cuts (incisions) in the area and use surgical suction catheters to remove fat cells.
• Abdominoplasty (tummy tuck). This procedure removes excess fat and skin from your abdominal area.
• Pannulectomy. A surgeon removes the apron of excess skin (pannus) that hangs below your belly button (navel).
• Escutcheonectomy. During an escutcheonectomy, a surgeon removes the fat pad above your pubic area.
• Skin grafts. Skin grafts cover areas of your penis where skin coverage is lacking.
• Circumcision revision. If a circumcision causes the penis to drop back into the fatty surrounding area, a circumcision revision can correct it.

Most babies and children don’t need any treatment for buried penis. Surgery is a last resort if there are health-related problems.

Does buried penis surgery make the penis bigger?

No, surgery for buried penis doesn’t make your penis larger or longer.

How soon after treatment will I feel better?

It depends on what type of treatment you receive. A healthcare provider can give you a better idea of what to expect.

Can a buried penis be prevented?

There’s no known way to prevent a buried penis that’s present at birth. Most babies don’t require any treatment. If a healthcare provider notes buried penis at birth, you may need to delay circumcision. A pediatric urologist may also need to perform the circumcision.

You can help prevent adult-acquired buried penis by maintaining a healthy weight for you. This may include:

• Being physically active. In general, you should aim for at least 150 minutes of moderate-intensity aerobic exercise each week (about 30 minutes of exercise five days a week) and two strength-training sessions. Aerobic exercise may include walking, jogging, bicycling or dancing. Weight-training activities may include free weights, weight machines, resistance bands or bodyweight exercises, such as pushups.
• Eating a heart-healthy diet. A heart-healthy eatin plan includes lots of fruits and vegetables, whole grains, lean meats and low- or nonfat dairy products. It’s also a good idea to consume alcohol and sweets in moderation.
• Managing stress. You can help reduce stress by being physically active, talking about your feelings to trusted friends or family members, keeping a journal and practicing yoga, meditation or deep-breathing exercises.
• Getting healthy amounts of sleep. In general, adults 18 and older should aim for seven to nine hours of sleep each night.

Talk to a healthcare provider or a registered dietitian to learn more about how you can safely adopt or maintain an active lifestyle.

What can I expect if I have buried penis?

With proper treatment, the outlook for a buried penis is good. For infants and children, surgery has a high success rate. The recovery time is usually just a few weeks, and buried penis symptoms are unlikely to come back. If you have an adult-acquired buried penis, it’s important to maintain a healthy weight for you after treatment.

When should I see a healthcare provider?

Talk to a healthcare provider if you have a buried penis, especially if it:

• Prevents you from comfortably peeing.
• Affects your ability to clean or dry the area.
• Causes UTIs.
• Affects sexual functioning.

What questions should I ask a healthcare provider?

Questions you may want to ask your healthcare provider include:

• How will you diagnose a buried penis?
• How do I make myself comfortable if I have a buried penis?
• What treatment do you recommend?
• What’s the recovery time?
• When can I expect to see the results from your recommended treatment?
• Can you recommend a counselor or dietitian?
• Are there any other resources or support groups available for people who have buried penis?