What is a hidden/ buried/ concealed penis?
The term buried penis is interchangeable with the above terms and all refers to the same description. A buried penis is when the penis appears buried within the pubic area. The penis does not project through the relatively high pubic area and can appear flat or as a hole. Patients and parents often get worried as this is mainly noticeable after circumcision and is often but wrongly blamed on circumcision.
What causes buried penis?
It is definitely not due to the circumcision. Let me explain why. The penis starts of from the body wall and has a certain length in which it projects. If the pubic area is fatty or naturally higher in relation to the length of the penis, then the penis cannot project through this. So the cause of a buried penis is actually a fatty or high pubic area that is higher than the length of the penis. Now the severity of the buried penis depends on how high the pubic area which can actually also change. You will notice that if the legs are closed together, then the pubic area is higher and the penis is more buried. If you open the legs, then the pubic area will be spread and flatter and more of the penis shows, even though it is the same patient and the same length of penis.
So why does it look more buried after circumcision?
There are a lot of uncircumcised patients who have buried penis but are not aware of it. This is because they often mistake the foreskin projecting as the actual penis projecting, but if you often feel this skin, you will notice that is empty and the actual penis is buried in the pubic area. If you press down on the pubic area and cause the penis to project and then feel the foreskin, you will then notice and also see the outline of the penis.
So after circumcision, once the foreskin is gone, there is nothing projecting from the pubic area and people often think the buried penis is because of the circumcision. However, if they press on the pubic area and depress it down, they will see the full circumcised penis protrude.
Complications with buried penis
There should be no complications with patients who have buried penis as long as they maintain good personal hygiene. We often tell parents and patients to press down on the pubic area if they see the penis buried and then clean + dry it when it is fully projected. Failure to do this can cause infections and also encourage the skin to adhere to the head of the penis. Both of these are not real complications and can be dealt with easily but it is best to avoid it.
Treatment for buried penis
There is no treatment necessary for buried penis. If the patient has a buried penis to begin with, they will have it after the circumcision too. We aim for a low circumcision which means the inner skin which is often pink or lighter in colour to be as short as possible. This will minimise how much the head of the penis can be covered.
A patient may not have a buried penis to begin with and this often happens with new borns who are skinny and have a flat pubic area when circumcised, but later put on weight as they grow and end up having a fatty pubic area which will result in a buried penis. There is no necessary treatment apart from just maintaining good personal hygiene.
Summary
Any patient who has a high pubic area in relation to the length of the penis can have a buried penis and this is fairly common with no long term complications. They can be circumcised and there is no need to delay the circumcision. We often get referred patients who have buried penis from other clinics who do not carry out the circumcision on buried penis patients. If you would like to find out more information, please contact us on 0208 951 3794.