Buried Penis After Total Prostatectomy and Circumcision

Buried penis is a condition in which the penis lacks a proper skin sheath and is buried beneath the skin of the abdomen, thighs, or scrotum. The penis is partially or completely hidden, and subsequent phimosis may result in splitting or spraying of the urine stream or dribbling. It can significantly impact an individual's physical and psychological well-being. In this report, we describe a case of a man with a history of phimosis surgery of unknown details in the distant past. He developed phimosis with dysuria following a total prostatectomy, which was aggravated by circumcision and eventually resulted in a buried penis. He could not urinate standing up because of urine stream spraying and had to sit down, catching the scattered urine with the palm of his hand and letting it fall. A surgical procedure involving excision of the scar, release of the contracture, and skin grafting was successful, and the symptoms resolved. If a patient develops a buried penis because of balanitis xerotica obliterans or scar contracture, they may complain of phimosis. In cases where there is sufficient skin, circumcision proves an effective treatment for the symptoms. However, in instances where the patient has undergone a previous circumcision and there is insufficient skin, the symptoms actually worsen as a result of the procedure. In the case of secondary phimosis, the decision whether to perform circumcision or to release the penis and reconstruct the skin defect should be based on the degree of skin sufficiency.