Buried penis occurs when the penis is hidden by surrounding tissue. Obesity is the most common cause of buried penis in adult men. Excess fat causes tissue around the penis to extend beyond the head of the penis. Other causes include inflammation of the genital tissue (lichen sclerosis), genital lymphedema, complications from penile/scrotal surgery, and/or prior genital infection.
What are symptoms of a buried penis?
Symptoms of buried penis include unusual or undesirable appearance, hygiene concerns, bothersome urinary symptoms (spraying, dribbling, leakage), skin breakdown, erectile dysfunction, pain when trying to expose the head of the penis, pain with erection/ejaculation, urinary tract infections, and/or infections of the head of the penis.
Benefits of buried penis repair include exposure to the penis to help with urination, sexual function, and hygiene.
Conservative options include weight loss and application of topical medicine to the genital tissue.
While conservative treatments can help, surgery may also be needed. There are many different types of surgery to treat buried penis and surgical recommendations depend on the shape of your body and the health of the skin that covers your penis.
Surgical options under general anesthesia include:
Panniculectomy: The pannus is the tissue from the abdomen that can sometimes hang over the penis. For most buried penis repairs, this tissue will be left in place. Removing that tissue will require a plastic surgeon.
Escutcheonectomy: The escutcheon is also called the mons pubis. It is the tissue just above the penis and below the pannus. This tissue is often removed during buried penis repair.
Scrotectomy/scrotoplasty: If the scrotum is enlarged and is burying the penis, some of the scrotal tissue will need to be removed.
Split-thickness skin graft: Once the penis has been exposed, your surgeon will determine if enough healthy skin is still on the penis.
Sometimes unhealthy tissue will need to be removed and then covered with skin from other areas of the body. In most cases, this skin can come from the tissue already being removed on the abdomen. Other times, the skin will come from the leg.
Depending on your work, you may need to take several weeks off following your surgery. You will also need someone to drive you home from surgery.
Recovery after surgery depends on surgical procedure performed. You may go home the same day or be discharged home up to 5 days after surgery if a skin graft is required. You will likely go home with a drain(s) which will be removed 1-2 weeks after surgery in the office. A temporary catheter to drain your bladder may be necessary in some cases.
Follow up will depend on surgical procedure performed.
Dr. Pearlman is fellowship-trained in genital reconstruction, including buried penis repair. She believes in providing comprehensive care when it comes to the treatment of male genital health concerns. As a result, she will discuss all treatment options with you prior to consideration of buried penis repair so that she can help you come up with a treatment plan to best meet your quality of life goals.
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