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It may be disheartening for some people when they look down and can’t see their full penis. This can happen when skin and fat tissue fold over the penis, causing what’s known as a buried penis. But why does this happen, and is there anything you can do about it? There are many possible causes, some of which are easily treatable. Keep reading to learn more.
What is a buried penis?
Buried penis (also known as inverted penis, hidden penis, or retracted penis) is a condition in which the penis is covered by excess skin and fat tissue from the surrounding structures like the abdomen, scrotum, or public area.
Some people are born with a buried penis (congenital buried penis), and in others, it begins in adulthood. It’s different from a micropenis, in which the penis is smaller than two inches long. A buried penis is an average size but appears smaller because it’s covered by skin.
What causes an inverted penis?
While someone can be born with a buried penis, it’s considered “acquired” when it happens in adulthood, usually related to another health condition. No matter the cause, it can have a big impact on quality of life. Luckily, treatments are often available. Some causes of an acquired buried penis include:
Excessive fat tissue
In adults, the most common cause of a buried penis is obesity (Cohen, 2021). People with obesity can have excess fat tissue in the area above the penis (the suprapubic fat pad). This fat pad can envelop the penile shaft and make it look shorter than it is. Weight loss often helps to resolve the condition.
When too much of the foreskin is removed during circumcision—often called “radical circumcision”—the penis can be pushed upward into the pubis (Pestana, 2009). This is also known as a “trapped penis.” If not enough foreskin is removed, the penis might retract into the remaining foreskin and cause a buried penis (Zimmerman, 2011).
Other injuries that may lead to a buried penis include trauma to the penis from infection or burns. Some common penis enlargement procedures (surgeries or injecting chemicals into the penis) can have complications like retraction or scarring that can shorten the visible part of the penis (Pestana, 2009; Ho, 2018).
Conditions that cause inflammation of the genital skin may also cause a buried penis. For example, the glans (head) of the penis may be chronically inflamed by a skin condition called balanitis xerotica obliterans. This causes the glans to tunnel under the penile skin—ultimately leading to the appearance of a buried penis. It can sometimes be treated with a prescription steroid cream, but surgery may be necessary (Hartley, 2011).
Some health conditions can cause fluid to build up in the scrotum (a condition called lymphedema), causing it to swell and bury the penis (Ho, 2018).
Congenital causes of buried penis syndrome
Some congenital causes (causes you’re born with) of buried penis include:
Weak penile ligaments
Some people are born with a condition called dysgenic dartos, in which the skin of the penis isn’t properly attached to the ligaments that support it. This can cause the penis to slide like a telescope into the scrotum, creating a buried penis (Anandan, 2018).
Webbed penis is a condition in which the skin of the scrotum attaches to the skin of the penile shaft. This may cause it to become buried in the scrotal skin (El-Koutby, 2010).
Complications of buried penis
A buried penis may cause physical or psychological complications, including:
- Erectile dysfunction: A buried penis can make it difficult to have an erection hard enough or long enough for satisfying sex (Anandan, 2018).
- Urinary tract issues: A buried penis may cause difficulty urinating, urine leakage, a weak urine stream, and urinary tract infections (Ho, 2018). This may result in chronic inflammation that can damage the penile skin.
- Balanitis: Chronic inflammation may lead to balanitis, inflammation of the glans.
- Phimosis: Inflammation may also cause phimosis, a condition in which the foreskin becomes so tight that it’s difficult or impossible to retract (Anandan, 2018).
- Cancer: People with a buried penis have an increased risk of penile cancer (Pekala, 2019)
- Mental health concerns: A person with a buried penis may experience low self-esteem, anxiety, or depression (Ho, 2018)
How to treat a buried penis
People with symptoms of a buried penis should talk with a healthcare provider to help decide on the best treatment plan for their needs. For example, people with obesity and a buried penis may improve with weight loss.
Surgical treatment is an option if necessary. Usually, surgery is done to remove fat tissue and rebuild the structures that support the penis. The specific treatment depends on the cause and symptoms of each individual.
Best sex positions for a small penis
Common surgical treatments include a “tummy tuck” (abdominoplasty), which removes fat tissue and tightens the muscles near the base of the penis. Liposuction may be used to remove fat from the public area or lower abdomen. A skin grafting procedure (Z-plasty) may be necessary if the skin is severely damaged (Zhao, 2009).
If you suspect you may have a buried penis, don’t hesitate to reach out to your healthcare provider to help you identify the best next steps to take.
- Anandan, L. & Mohammed, A. (2018). Surgical management of buried penis in adults. Central European Journal of Urology, 71(3), 346–352. doi:10.5173/ceju.2018.1676. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6202613/
- Cohen, P. R. (2021). Adult Acquired Buried Penis: A Hidden Problem in Obese Men. Cureus, 13(2), e13067. doi:10.7759/cureus.13067. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7932830/
- El-Koutby, M. & El Gohary, M. E. (2010). Webbed penis: A new classification. Journal of Indian Association of Pediatric Surgeons, 15(2), 50–52. doi:10.4103/0971-9261.70637. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952775/
- Hartley, A., Ramanathan, C., & Siddiqui, H. (2011). The surgical treatment of Balanitis Xerotica Obliterans. Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India, 44(1), 91–97. doi:10.4103/0970-0358.81455. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111133/
- Ho, T. S. & Gelman, J. (2018). Evaluation and management of adult acquired buried penis. Translational Andrology and Urology, 7(4), 618–627. doi:10.21037/tau.2018.05.06. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127540/
- Pekala, K. R., Pelzman, D., Theisen, K. M., et al. (2019). The prevalence of penile cancer in patients with adult acquired buried penis. Urology, 133, 229–233. doi:10.1016/j.urology.2019.07.019. Retrieved from https://linkinghub.elsevier.com/retrieve/pii/S009042951930682X
- Pestana, I. A., Greenfield, J. M., Walsh, M., et al. (2009). Management of “buried” penis in adulthood: an overview. Plastic and Reconstructive Surgery, 124(4), 1186–1195. doi:10.1097/PRS.0b013e3181b5a37f. Retrieved from https://pubmed.ncbi.nlm.nih.gov/19935302/
- Sachs, D., Campos, M. S., & Murray, J. (2020). Panniculectomy. StatPearls. Retrieved Sept. 11, 2020 from https://www.ncbi.nlm.nih.gov/books/NBK499822/
- Stephen, J. R. & Burks, F. N. (2020). Buried penis repair: Tips and tricks. International Brazilian Journal of Urology, 46(4), 519-522. doi:10.1590/S1677-5538.IBJU.2020.99.06. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32167731/
- Zhang, P., Wang, B., Zhang, X., et al. (2020). Suprapubic Liposuction With a Modified Devine’s Technique for Buried Penis Release in Adults. Plastic Surgery (Oakville, Ont.), 28(3), 172–178. doi:10.1177/2292550320903440. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436850/
- Zhao, Y. Q., Zhang, J., Yu, M. S., & Long, D. C. (2009). Functional restoration of penis with partial defect by scrotal skin flap. The Journal of Urology, 182(5), 2358–2361. doi:10.1016/j.juro.2009.07.048. Retrieved from https://www.auajournals.org/doi/10.1016/j.juro.2009.07.048
- Zimmerman, W. & Santucci, R. (2011). Treatment of adult-acquired buried penis. Skin Grafts – Indications, Applications and Current Research. Retrieved Sept. 11, 2020 from https://www.intechopen.com/chapters/18935
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.