Embedded (Invisible) Penis
It was first described by Dr Keyes in 1919 and was defined as “the testicle that is not covered by a suitable skin sheath, but is embedded in the abdominal adipose tissue or in the tissues of the scrotum (scrotum). In another definition, it is the condition that the penis is visually small, despite the average length and diameter accepted when the penis is stretched according to age grouping. Although it is also called micropenis because the penis is not visible, this is a completely wrong definition. It can happen for different reasons. Looking at the reasons;
- Excess suprapubic adipose tissue
- Shortness of the bands holding the penis – shortening the penis
- Skin curtain towards scrotum
- Weak penile skin
- Too much distance between the pubis bone and the penis
- Weak abdominal skin
- Forward displacement of the penis
- Excess skin tissue taken during the circumcision procedure has been described.
Therefore, evaluation by experienced surgeons and planning the surgical approach accordingly is very important for good results to be obtained. Depending on these reasons, the most common types are;
- Buried Penis: It is caused by either the lack of skin support or the excess of pubic adipose tissue in children. In adults, it appears due to being overweight. Penis size is normal. By pressing on the adipose tissue, normal penis size is seen. It can be congenital as well as after circumcision. For this reason, we recommend postponing the circumcision in those children if the pubic adipose tissue is excessive in the pre-circumcision examination. If they are circumcised, the foreskin will also go away, and it will cause more morale upset for the child, as it will give the impression that the penis is buried even more. However, in appropriate cases, we can make the pipi visible with different surgical methods than circumcision.
- Curtain (Webbed) Penis: Penis size is normal. The penile skin tissue forms a curtain towards the scrotum, which we call the scrotum. It may occur due to excess skin tissue removal at birth or during circumcision. It usually does not cause problems, but with an appropriate technique, this problem can be corrected and the penis can be brought to its normal appearance.
- Megaprepisium: It was described in 1994. It is a condition in which the buried penis is accompanied by pathological phimosis. During urination, serious ballooning of the foreskin and difficulty in urination are observed.
- Trapped Penis: This occurs as a result of the skin tissue healing with bad tissue on the head of the penis after circumcision. This tissue does not allow the head of the penis to protrude. Especially in infants or children with excess pubic adipose tissue, it occurs after circumcision. While steroid creams work in the early period, surgical intervention is required in the late period.
Research shows that early diagnosis is important. While no intervention is required, especially in those who are buried due to adipose tissue, it is important to detect and treat other causes. Regardless of the buried penis, some serious problems in the future; It can lead to urinary tract infections, loss of confidence, shyness and, rarely, sexual dysfunctions.