Concealed penis (also known as buried or hidden penis) is a condition in which the penis is partially or fully covered by the skin of the abdomen, thighs, or scrotum and does not fully protrude from the body. Unlike micropenis, a concealed penis is typically average in length but hidden under skin. It is an uncommon condition that can be congenital (present at birth) or acquired later in life.
What causes concealed penis?
Congenital concealed penis can be caused by abnormalities in the penile structure at birth. The ligaments that attach the penis to the body may be weaker than normal, or abnormal fibrous bands can develop and trap the penis against the body. Alternatively, excess fat in the suprapubic area (the lower abdomen) may envelop the penis. Often, patients with congenital concealed penis experience a combination of these factors.
Adult-acquired concealed penis can be brought on by a few causes, including:
- Morbid obesity: excessive fat can engulf the penis so that it becomes hidden. This is the most common cause of concealed penis.
- Circumcision complications: overly aggressive circumcision can cause scarring and constriction, pulling the penis back into the remaining skin around it.
- Lymphedema: a buildup of lymph fluid that cannot drain properly can cause the scrotum and surrounding area to swell and bury the penis.
What are the problems or complications?
Several physical and psychological problems often accompany concealed penis, such as:
- Low self-esteem or distortion of self-image
- Erectile dysfunction or painful erections
- Painful or difficult intercourse
- Difficulty with urination while standing
- Urinary incontinence or dribbling
- Frequent urinary tract infections
- Hygiene challenges that can lead to fungal and bacterial infections
How is it diagnosed?
Adult patients can usually identify concealed penis on their own and a provider can confirm the diagnosis through a visual examination.
How is it treated?
For infants and children, concealed penis can be self-correcting and sometimes goes away on its own. For adults, it can be treated with weight loss in mild cases, while surgery is usually required for more severe cases (even if successful weight loss is achieved).
Providers approach surgery for concealed penis in a variety of ways, depending on the underlying root of the problem. They may remove scar tissue, excess fat, or excess skin from the lower abdomen and area surrounding the penis. Alternatively (or in addition), they may correct or detach the ligaments that connect the penis to the body. Sometimes, they will address damaged skin with skin grafts. Generally, providers will also advise weight loss for patients whose cases are caused by obesity.
Concealed penis is a challenging condition, but it is treatable. Consult your healthcare provider if you are struggling with concealed penis.
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Cavayero, C.T., Cooper, M.A., & Harlin, S.L. (2015). Adult-Acquired Hidden Penis in Obese Patients: A Critical Survey of the Literature. The Journal of the American Osteopathic Association, 115(3), 150-156. https://jaoa.org/article.aspx?articleid=2211854
Rybak, J., Larsen, S., Yu, M., & Levine, L.A. (2014). Single Center Outcomes after Reconstructive Surgical Correction of Adult Acquired Buried Penis: Measurements of Erectile Function, Depression, and Quality of Life. The Journal of Sexual Medicine, 11(4), 1086-1091. https://www.jsm.jsexmed.org/article/S1743-6095(15)30731-1/fulltext
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What is Buried Penis? (n.d.). Urology Austin. Retrieved January 27, 2021, from https://urologyaustin.com/male-urology/buried-penis/