Buried Penis in a 9-Month-Old Baby Boy
The condition of a 9-month-old baby boy with a penis that appears smaller than normal due to concealment within the pubic tissue is called "buried penis." 1, 2
Definition and Characteristics
- Buried penis is defined as a penis of normal size that appears smaller than expected because it is concealed within the pubic tissue, with only the glans (often covered by prepuce) protruding above the skin level 1
- This condition is distinct from micropenis, as the penile shaft is actually normal in size when exposed by holding the base of the penis 1
- Buried penis is part of a group of conditions collectively referred to as "inconspicuous penis," which also includes webbed penis and trapped penis 2
Causes of Buried Penis
- Excessive development of the penile fascia which retracts the penis 3
- Insufficient attachment of the penile skin at the base of the penis 3
- Often excessive prepubic fat worsens the appearance, but is not the sole cause 3
- A tight phimosis is frequently present 3
Clinical Presentation
- The penis may be partially visible or completely invisible, with only the glans covered by prepuce protruding 1
- The condition can be completely asymptomatic or cause micturition difficulties 1
- In some cases, patients present with ballooning of the prepuce during urination 1
- Recurrent urinary tract infections or balanitis may occur 1
Diagnosis and Management
- Diagnosis is primarily clinical, based on physical examination 1
- It's important to distinguish buried penis from other conditions like cryptorchidism (undescended testis), which requires different management 4, 5
- Referral to a pediatric urologist is appropriate for evaluation and management 4
- Circumcision should be avoided in these patients until they have been evaluated by a urologist, as it may worsen the condition by removing skin necessary for reconstruction 3, 2
Treatment Approach
- Surgical treatment is necessary as this condition tends to persist even after puberty 3
- The surgical procedure typically involves:
- In more complex cases, additional techniques may be required, including penile degloving, basal anchoring, and potentially skin grafts 6
Important Considerations
- Early intervention is preferred rather than waiting for puberty or weight reduction 6
- Surgical outcomes are generally favorable with high patient satisfaction 6
- Complications may include minor skin breakdown or superficial wound problems 6
- Follow-up is important to ensure proper healing and functional outcomes 6