Surgical Management of Buried Penis in Adults

Abstract

IntroductionBuried penis is a condition that causes the penis to become hidden beneath the skin. It has a significant impact on quality of life and can present in a variety of ways, with lower urinary tract symptoms and erectile dysfunction being common. Whilst there are several causes, obesity is the most common in adults. Due to the burden that obesity is increasingly presenting to healthcare, buried penis may become more common in the future.The purpose of this article is to provide an overview of the causes, presentation and surgical management of this condition in adults.Material and methodA literature review was conducted using urological and plastic surgery articles from PubMed, Embase and Medline. Eighteen studies, published between 1982 and 2016, were included.ResultsOriginal research trials discussed the treatment of buried penis in lymphoedema and balanitis xerotica obliterans (BXO), new techniques for fat removal, comparison of grafts and postoperative dressings. Several studies provided broad overviews, although focused on management rather than cause and presentation. Overall, studies suggest that, whilst some causes can only be treated with surgery, others can be modified by lifestyle changes and medical management.ConclusionsBuried penis is a complex condition that may take years to treat. Several surgical techniques are available, with patients likely requiring a combination of techniques to treat this problem. This review aims to provide a comprehensive overview of the causes, presentation and surgical management of this condition, in order to further the understanding of clinicians who may be faced with this problem more commonly in the future.

Adult Acquired Buried Penis: A Hidden Problem in Obese Men

“…It is a progressive and debilitating problem. Subsequently, the condition has been referred to as concealed, hidden, inconspicuous, trapped, and vanishing penis [1][2]5,6,8,16].…”

“…In addition to morbid obesity, some of the causes of buried penis are hidradenitis suppurativa, iatrogenic etiologies (such as the following circumcision or after aesthetic surgery including, but not limited to, penile and scrotal enlargement), infections (such as those resulting from bacterial and fungal organisms), lichen sclerosus, penoscrotal lymphedema (secondary to multiple etiologies including arteriobifemoral bypass grafting, inguinal lymphadenectomy for either penile cancer or melanoma, lymphatic filariasis--commonly known as elephantiasis--in men living in developing countries, and prostatectomy with accompanying pelvic lymph node dissection), and traumatic events. Wearing tight underwear can also potentially result in bacterial or fungal infection of the glans penis; the balanitis can promote the development of buried penis [1,3,5,6].…”

“…Indeed, 87% of the men who underwent surgical treatment for buried penis were obese. However, based on the increased prevalence of obesity, there seems to be a paucity of the literature on buried penis [1,5,6].…”

“…Indeed, a large portion of the population is overweight or obese. There are several obesity-associated medical conditions, such as diabetes mellitus and hypertension; in addition, adult acquired buried penis is a comorbid problem that may develop in obese men [1][2][3][4].…”

“…Buried penis can be a congenital condition or an acquired disorder; it occurs in children and adults who have either a normal or an elevated body mass index. There are multiple potential causes of acquired buried penis; however, obesity is the most common etiology in adult men [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”