Buried penis

A buried penis is a condition in which a normal sized penis is entrapped partially or completely by the surrounding subcutaneous fat and soft tissues of the scrotum, thighs, or hypogastrium.

Pathology

Etiology
Congenital
  • congenital poor fixation of the penile skin at its base
Acquired
  • obesity: it's the primary cause of an acquired buried penis
  • scrotal and suprapubic lymphedema
  • scrotal elephantiasis
  • balanitis xerotica obliterans
  • penile trauma (e.g. post-circumcision) 
  • dysgenic dartos

Radiographic features

The penis is partially or entirely concealed under excessive scrotal skin or pubic soft tissues.

Treatment and prognosis

Management of a buried penis is based on a surgical treatment associating :

  • exposure of the penile shaft
  • adipose tissue excision
  • removal of redundant skin, adhesions, and phimosis
  • lipectomy and scrotoplasty
  • coverage of the penile shaft with a graft
Complications
  • chronic inflammation: moisture and lack of hygiene under the overlying tissue may lead to bacterial and fungal infection
  • phimosis and glandular adhesions: due to chronic inflammation
  • erectile dysfunction with cavernosal fibrosis
  • lower urinary tract symptoms
  • urinary infections
  • depression and low self-esteem
  • squamous cell carcinoma of the penis 

History and etymology

The condition was first reported by Keyes in 1919 .

Differential diagnosis

  • micropenis
  • webbed penis
  • concealed penis
  • trapped penis