Buried penis is a condition in which the penis is completely or partially concealed inside folds of skin, tissue, or fat. It is primarily caused by morbid obesity. Buried penis causes urinary and sexual dysfunction and can affect a person’s mental health. It can be treated with surgery and lifestyle changes.
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What Is Buried Penis?
Buried penis is a condition where a person’s penis becomes totally or partially hidden inside folds of skin, tissue, or fat in the belly, thighs, or scrotum.
It's sometimes present at birth, but can happen at any age. Some babies are born with a buried penis. The ligaments that attach the penis to other structures may have weakened. In children, it often goes away on its own.
In adults, buried penis often occurs in men who are morbidly obese. Although a normal-sized penis, a buried penis gets hidden under skin or fat. Sometimes, the tip of the penis is still visible; other times, the entire penis is hidden.
A buried penis can cause problems with peeing, sex, and self-esteem.
With rising rates of obesity, buried penis is becoming an increasingly common condition. While weight loss can improve symptoms of buried penis, the most effective way to treat a buried penis is with surgery.
How common is buried penis?
Not much research is available on the prevalence of the buried penis, but the condition is not common. Most cases are seen in childhood, with one study in Japan finding it occurred in 3.7% of male newborns.
Even less research is available about its prevalence in adults. Researchers note that the primary cause of buried penis in adults – extreme obesity – is increasing, so more adults may develop the condition later in life. However, many adults with buried penises may not seek medical care unless it causes problems.
What causes buried penis?
The most common cause of buried penis is morbid obesity, in which a large degree of excess fat is present around the belly and genitals, covering the penis in folds of fat or skin.
Other causes of buried penis include:
- Congenital factors — Occasionally, some babies are born with buried penis, though it tends to resolve itself as they grow up.
- Dysgenic dartos — Underdeveloped muscle and tissue beneath the skin of the scrotum is inadequately connected to the penis, causing it to telescope inward.
- Genital lymphedema — Lymph fluid may cause swelling around the scrotum, hiding the penis.
- Hidradenitis — Lumps may form on the thighs and belly where the skin rubs together, hiding the penis.
- Scars — From prior surgeries (such as circumcision or penile enlargement) can hide the penis.
- Trauma — Blunt force trauma to the genital area (such as in a car accident) may cause swelling and scarring.
Buried penis risk factors
The main risk factor for a buried penis in adulthood is being morbidly obese. A 2012 study found that 87% of men receiving surgery for buried penis were obese.
Other risk factors include:
- Balanitis xerotica obliterans (BXO).
- Complications from penile enlargement surgery, circumcision, or genital trauma.
- Fournier’s gangrene.
- Penoscrotal lymphedema.
- Persistent infection.
Buried penis complications
Left untreated, a buried penis can lead to complications, such as:
- Anxiety.
- Chronic pain.
- Depression.
- Erectile dysfunction.
- Infertility.
- Low quality of life.
- Pain during intercourse.
- Penile cancer.
- Phimosis — an inability to retract the foreskin in uncircumcised males.
- Poor hygiene.
- Sexual dysfunction, especially difficulty having penetrative sex.
- Skin infections.
- Urinary blockage.
- Urinary tract infections (UTIs).
Sometimes a buried penis prevents the urethral opening of the penis from being visible, making it difficult to diagnose a urethral disease called balanitis xerotica obliterans (BXO). BXO is a subset of the autoimmune disorder lichen sclerosis (LS).
Additionally, the skin that hangs over the penis may create an environment where bacteria and fungus can thrive. Being obese and having diabetes increases the chances of infection in some people with buried penis. These infections can cause constricted skin and scarring, which can actually worsen buried penis.
How can I prevent buried penis?
There is no way to prevent being born with buried penis or having a baby who is born with the condition. Most cases of childhood buried penis resolve on their own, however.
The best way to prevent developing buried penis as an adult is to maintain a healthy weight or lose weight if you are obese.
What Are the Signs and Symptoms of Buried Penis?
Symptoms of buried penis include:
- Being unable to urinate standing up.
- Dribbling urine or urinary incontinence.
- Feelings of doubt or low self-esteem.
- Inability to get an erection or difficulty having sex.
- Only the tip of the penis is visible.
- Painful erections.
- Penis is no longer able to be seen.
- UTIs.
When should I see a doctor about buried penis?
You should see a doctor if you think you have a buried penis. A reconstructive urologist is a surgical specialist who will help to treat your buried penis.
How Do You Diagnose Buried Penis?
Your doctor will first ask about your health history. They will be able to diagnose a buried penis with a physical exam. You won't need any tests to confirm the diagnosis.
How Do You Treat Buried Penis?
A buried penis is highly treatable with surgery. Surgeons remove excess skin, fat, or scar tissue to free the penis.
Successful treatment will:
- Improve a person's quality of life.
- Improve the way the penis looks.
- Restore urinary and sexual function.
The surgical procedure, extent of surgery, and recovery time to treat buried penis depends on the cause(s) and your overall health condition.
Possible techniques include:
- Abdominoplasty — Removes fat and skin from the belly, also known as a "tummy tuck."
- Escutcheonectomy — Removes fat pad above the pubic area.
- Panniculectomy — Removes the pannus, or the excess skin and fatty tissue that hangs down over the genitals and/or thighs.
- Suprapubic lipectomy — Helps elongate the penis and remove fat in cases where a large amount of fat remains above the pubic bone in people who have tried to lose weight.
Doctors may also do a skin graft if the penis loses skin when they separate it from surrounding tissues or has a significant amount of diseased skin. In cases of scrotal lymphedema and genital hidradenitis, however, there may not be enough unaffected skin to perform a skin graft.
How effective is buried penis treatment?
Even after surgery, buried penis can recur, especially if the person remains obese. Certain lifestyle changes may help to treat and prevent the recurrence of buried penis.
Your doctor may recommend:
- Mental health counseling.
- Nutrition and diet counseling.
- Weight loss.
Weight loss alone is often not enough to treat buried penis as many people will still have a significant amount of fat or skin remaining in the escutcheon, or the fat above the pubic bone.
In some cases of extreme obesity, a doctor may recommend bariatric surgery, such as gastric bypass, to help you lose weight before performing surgery to free a buried penis.
