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Background: A buried, or often called, hidden penis in children is either partially or completely covered by the surrounding pubic mound tissues. It is not due to a short or inadequately developed penis. While there are not usually significant medical problems from the lack of adequate or any penile show, the psychological effects are considerable in the young child or teen.

The cause of a buried penis are varied. Too much skin removal from a prior circumcision, ligamentous laxity at the base of the penis, or an excessive fat mound around the penis all are common etiologies.

Surgery is almost always needed to resolve a buried penis. Depending upon the cause, this could entail the removal of excessive skin, ligamentous tightening, anchoring the base of the penis or even skin grafting to effect improved penile show.  But in each of these surgical treatments there is frequently a role for fat removal as well.

Case Study: This male child had a near completely buried penis of which the suprapubic mound made. clear contribution.

Under general anesthesia and in conjunction with a pediatric urologist, suprapubic mound liposuction was performed though small groin incisions. A total of 200ccs of aspirate was removed. The urologist then performed a penile lengthening procedure.

 The combination of penile lengthening with suprapubuc mound liposuction can produce a significant increase in penile show. It is a synergistic surgical combination which produces a better result than either procedure does by itself. The presurgical identification of a visibly significant mound with a penis often ‘down in the hole’ is a common occurrence.

Case Highlights:

1) A buried penis in children is often associated with a suprapubic fat mound that magnifies the all of penile show.

2)  Suprapubic mound liposuction combined with penile lengthening produces the greatest amount of penile show.

3) Liposuction alone can only produce an incomplete correction of the retracted penis in children.

Dr. Barry Eppley

Indianapolis, Indiana

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