Buried Penis
Understanding Buried Penis
What is buried penis?
A buried penis is when the penis is partially or completely hidden by surrounding skin and soft tissue (often the lower abdominal fat pad and/or scrotal skin). The penis itself is usually normal in size, but it is not well exposed externally.
Common symptoms
Difficulty aiming urine stream, spraying, dribbling, urine trapping
Recurrent skin irritation, fungal rash, odour, or infections
Painful erections, discomfort with sex, difficulty with penetration
Hygiene difficulty and embarrassment
In severe cases: skin breakdown, ulcers, or recurrent cellulitis
Why does it happen?
Often more than one factor contributes:
Suprapubic fat pad / weight-related concealment
Scarring or tight skin (after circumcision, inflammation, prior surgery, trauma)
Inflammatory skin disease (e.g., lichen sclerosus)
Penoscrotal webbing (scrotal skin tethering the shaft)
Lymphoedema / chronic swelling
Ageing, diabetes, smoking, reduced mobility can worsen skin health and healing
How is it diagnosed?
Diagnosis is clinical (history + examination). Your specialist may assess:
Degree of concealment and skin quality
Presence of scarring, infections, or inflammatory skin disease
Voiding issues and hygiene limitations
Risk factors affecting healing (BMI, diabetes control, smoking)
Key message
Buried penis is common and treatable. Treatment aims to restore function (hygiene, urination, comfort, sexual function) and reduce recurrent infections.
When to Treat Buried Penis
When is treatment recommended?
Treatment is considered when buried penis causes functional problems or recurrent medical issues, such as:
Recurrent fungal rash, infections, or cellulitis
Chronic irritation, skin breakdown, ulceration, or odour
Difficulty urinating: spraying, dribbling, urine trapping, UTIs
Painful erections or sexual difficulty
Difficulty cleaning the area or applying creams
Significant distress affecting confidence and relationships
Goals of treatment
Improve hygiene and reduce inflammation/infections
Improve urination (stream direction, less trapping/dribbling)
Improve comfort and sexual function
Improve appearance and confidence (where possible)
When is urgent review needed?
Seek urgent medical care if you have:
Fever, rapidly spreading redness, severe pain
Inability to pass urine
Black/purple skin changes or rapidly worsening swelling
Open wounds with increasing discharge or foul smell
Who may benefit most from surgery?
Surgery is more likely to help if symptoms are significant and:
The penis remains buried despite conservative measures
There is significant scarring/tight skin
There is overhanging pannus/pubic fat pad causing concealment
Skin disease requires excision/reconstruction
Shared decision-making
Not everyone needs surgery. Many people benefit from a stepwise plan: optimise health and skin first, then consider surgery if needed.
Non-Surgical Management
Can buried penis improve without surgery?
Yes—particularly in mild/moderate cases or when weight-related concealment is the main issue. Conservative management focuses on reducing inflammation, improving skin health, and preventing recurrence.
1) Weight management
Even modest weight loss can improve exposure and reduce infections.
Support may include dietitian input, exercise physiology, medical weight-loss therapy, or bariatric referral when appropriate.
2) Skin care and hygiene
Wash gently; avoid harsh soaps and excessive scrubbing.
Dry carefully after showering (moisture trapped in folds worsens rash).
Barrier creams can reduce irritation and friction.
Antifungal creams/powders may help if there is fungal rash.
Treat bacterial infections early—don’t “wait it out” if redness spreads.
3) Treat contributing skin conditions
Lichen sclerosus (if present) may require prescription topical steroid therapy and follow-up.
Managing chronic inflammation can reduce scarring and improve outcomes if surgery is needed later.
4) Optimise medical risk factors
Improve diabetes control, stop smoking/vaping, treat sleep apnoea.
These steps meaningfully reduce wound complications if surgery becomes necessary.
5) Urination strategies
Sitting to void can reduce spraying and urine trapping.
If urinary symptoms persist, your clinician may investigate bladder/prostate factors too.
When to escalate to surgery
If you still have persistent infections, urine trapping, pain, or significant concealment despite good conservative care, surgery may be the best option.
Surgical Treatment Options
When is surgery considered?
Surgery is usually considered if buried penis causes ongoing functional problems (hygiene/urination/sex), recurrent infections or skin breakdown, or significant scarring.
How is the surgery chosen?
Your surgeon tailors the approach based on:
Main driver: fat pad, overhanging pannus, scarring, skin disease, lymphoedema
Degree of concealment
Skin quality and availability of healthy shaft skin
Your general health and healing risk factors
Common surgical components
A) Suprapubic lipectomy / panniculectomy
Removes excess lower abdominal fat/skin (“pannus”) that pushes over the penis.
B) Pubic mound contouring
Reshapes the fat/skin above the penis to improve exposure.
C) Penile skin release and fixation
Releases tethering/scar bands and re-anchors tissues to help prevent re-burying.
D) Penoscrotal web correction (scrotoplasty)
Reduces scrotal skin tethering the shaft and improves the penoscrotal angle.
E) Skin reconstruction
Split-thickness skin graft (commonly used)
Full-thickness graft (selected cases)
Sometimes local flaps are used
F) Management of lymphoedema
Debulking of chronically swollen tissues with reconstruction.
Staged procedures
Severe inflammation, infection, lymphoedema, or complex scarring may require staged surgery for safest healing.
What results can surgery achieve?
Surgery typically aims to improve:
Hygiene and skin health
Urination (less trapping/spraying)
Comfort and sexual function
Visible exposure of the penis
Recovery and What to Expect
Immediately after surgery
Dressings are applied; if a graft is used, it may be secured with specific dressings.
Swelling and bruising are normal in the early weeks.
Pain is usually manageable with prescribed medications.
Hospital stay
This depends on the extent of surgery:
Smaller procedures may be day surgery
More extensive reconstruction may require an inpatient stay
Wound care
Keep wounds clean and dry as instructed
Avoid soaking (baths/pools) until cleared
You may be given creams/ointments and specific showering instructions
Monitor for redness, increasing pain, discharge, or fever
Activity restrictions
Avoid heavy lifting and strenuous exercise for several weeks
Walking is encouraged (helps reduce clot risk)
Driving depends on comfort and medications
Sexual activity is usually restricted for a period (often several weeks)—follow your surgeon’s advice
Timeline
Weeks 1–2: swelling, dressings, early healing
Weeks 3–6: gradual improvement; activity increases
Months 2–3+: swelling continues to settle; scar maturation begins
Final appearance can take several months to stabilise, especially after grafting.
When to seek urgent help after surgery
Fever, rapidly spreading redness, severe worsening pain
Increasing discharge or foul smell
Significant bleeding or rapidly increasing swelling
Difficulty passing urine
Dark/black skin changes
Risks, Complications and Long-Term Results
Expected short-term effects
Swelling, bruising, soreness
Temporary changes in sensation
Scarring (inevitable)
Wound and skin complications
Infection, cellulitis
Wound separation (dehiscence)
Fluid collection (seroma) or haematoma
Delayed healing (higher risk with diabetes, smoking, higher BMI)
Skin graft issues (partial graft loss, tightness/contracture, texture/colour changes)
Functional complications
Persistent spraying/dribbling (often improves, sometimes persists)
Ongoing discomfort or altered sensation
Recurrence (“re-burying”)—more likely if weight-related factors persist
Rarely: more serious skin loss or tissue necrosis
Anaesthetic and general surgical risks
Blood clots (DVT/PE), especially in higher-risk patients
Cardiopulmonary risks (individual assessment required)
Expected long-term results
Many patients experience meaningful improvement in:
Hygiene and infections
Urinary function
Sexual comfort and confidence
Recurrence risk is reduced by maintaining weight goals and managing skin conditions.
How to reduce complication risk
Stop smoking/vaping before surgery
Optimise diabetes and nutrition
Follow wound care instructions and attend follow-ups
Continue weight management and skin care long-term