Management of the buried penis in adults

Buried penis, most commonly seen in children, is particularly debilitating in adults, resulting in the inability to void standing and it affects vaginal penetration. The pathophysiology, including scar contracture of the distal soft tissue and skin envelope with concurrent descent of the abdominal fat pad, represents a surgical challenge. We developed a management algorithm to evaluate and treat adults with buried penis.

From January 1, 1994 to May 1, 1996, 7 patients 23 to 66 years old presented with buried penis. Diabetes mellitus, a common co-morbid condition, was present in 5 patients, and 5 of 7 were morbidly obese.

Surgical correction was performed in 5 patients with excellent results in 3. Resection of scar contracture was sufficient to provide adequate length and none required release of the suspensory ligament. Panniculectomy was performed in 1 patient. One man requiring a graft to achieve adequate penile coverage required reoperation. This patient had undergone a previous attempted repair with extensive contracture. All patients regained potency postoperatively.

With appropriate planning and adherence to basic reconstructive surgical principles, correction of the buried penis can yield a high success rate.