What is Buried Penis Syndrome?

Buried penis syndrome refers to the phenomenon whereby the penis becomes obscured by fat and excess skin in men that put on weight. It occurs because as the fat accumulates below the skin it pushes the skin surrounding the penis outwards but the penis cannot move outwards with the skin because it is attached to the underlying pelvic bones. It can occur even in men who have lost weight because the process of gaining weight stretches the ligaments between the skin and the underlying deep tissues such that even after the fat goes, the skin does not return to its normal position. This causes several problems. Firstly, the skin becomes exposed to urine as it dribbles from the foreskin and this causes inflammation and eventually thickening of the tissues including the foreskin, head of penis (glans) and water pipe (urethra) – a condition called ‘balanitis’. This can cause narrowing of the water pipe such that the urine pressure increases and damages the kidneys. Balanitis also predisposes to cancer of the penis.

The other problem for men suffering from buried penis syndrome is that it makes sexual intercourse difficult as the penis is effectively shortened. This causes difficulties in relationships and psychological insecurities in the affected men. It can, of course, be prevented by not putting on weight. Once weight has been gained, losing the weight and maintaining the weight reduction may be enough to reverse it. If the patient is unable to lose the weight or still has a problem despite weight loss, then the only possible solution is surgery. My preferred treatment involves making an incision in the abdomen just above the pubic hairline, lifting up the skin in this area, removing all of the fat and then stitching the skin back down to the deep tissues to restore penile length. In addition, if the penis is affected by balanitis, a circumcision can be helpful, and sometimes dilatation of the water pipe if that has become narrowed.

This condition is likely to be very common as an increasing proportion of the adult male population is overweight or obese. However, in a similar way to erectile dysfunction 10 or 20 years ago, it is not much talked about and patients are often too embarrassed to seek medical help. The procedure would occur in hospital and a general anaesthetic would be required. The procedure lasts around two hours. Drains put into the wound would need to be placed and the patient would have to stay overnight for one or two nights and have the drains removed before going home. There is a permanent scar and there may be some numbness in the skin just above the penis. Other risks include infection, problems with wound healing and accumulation of fluid, temporary dimpling of the skin, and often the skin of the shaft of the penis is hairier than it otherwise would have been because some of the skin of the pubis is advanced onto the shaft.