Buried penis in children

What is a buried penis?

The penis is wrapped in a sheath of skin. Usually, the skin is evenly distributed around the entire penis, down to the scrotum. However, some boys are born with skin that unevenly covers the penis. There is less skin on the part of the penis closest to the scrotum. This is called a buried penis. It is also called a hidden or concealed penis. Buried penis can also happen when the penis hides within the fat inside the lower part of the body.

In most children, buried penis is a condition that will get better by itself.

Boys are born with a buried penis (congenital). There can be many causes, which include:

• problems with the skin and fat layers surrounding the penis of a developing fetus
  
• too much fat on top of the pubic bone, which is common in young babies
  
• the skin from the scrotum attaches towards the tip of the penis instead of at the base of the penis (scrotal "webbing")
  

Buried penis can also happen as a complication of circumcision.

Buried penis

At what age does buried penis occur?

Buried penis may be diagnosed at any age, but it is most commonly diagnosed in boys aged two years and younger.

What are the signs of buried penis in babies?

• The penis seems too small.
  
• The foreskin may puff out during urination, appearing like a balloon. Parents may notice a continuous dripple from the penis if this occurs during each void. Also, the child may have trouble directing their urine stream properly while toilet training.

Adolescents with buried penis are usually obese. An adolescent with a buried penis may experience:

• pain or difficulty urinating (dysuria) or inflammation of the foreskin (balanitis)
  
• trouble directing their urinary stream because of difficulty holding the penis
• embarrassment in the locker room
  
• difficulty with hygiene
  

Treatment for buried penis

If it does not improve on its own or is causing problems, your child should be referred to a urologist. Older children are usually referred for treatment because of cosmetic reasons.

If treatment is required, the buried penis can be successfully treated by:

• applying an anti-inflammatory medicine, such as betamethasone, to the area.

Many different surgical techniques can also help. Talk to your child's doctor to learn about possible treatment options for your child.

What are the possible surgical complications?

There are few complications. If they do occur, most are temporary.

• During the healing process, scar tissue inside the skin can sometimes stick together (adhesions), or extra connective tissue can build up (fibrosis). Both can pull the penis back in again and bury it.
• Swelling of the penis.
• Pain during an erection.
• Poor healing or complaints of decreased sensitivity.

Buried penis can cause emotional distress in older children and adolescents

Adolescents with buried penis are at risk for psychological and social distress. Obese boys with a buried penis may feel ashamed of their bodies. As a result, they may withdraw socially. Surgery may relieve anxiety and improve self-image. However, prior to surgical intervention, weight loss in obese boys is very important. Weight gain after surgery may cause buried penis to recur.