Concealed Penis Essay

The term concealed penis encompasses a spectrum of conditions in which the penis does not appear to adequately extend from the abdominal wall as an organ distinct from scrotum. (Kaefer 2009). Concealed penis is often of great concern to patient and family. Affected children are brought to surgeons’ attention for cosmetic reasons and difficulty to maintain proper hygiene, commonly patients are referred for circumcision revision. (Perger, Hanley et al. 2009) This anomaly can lead to phimosis, recurrent balanitis, difficulties with hygiene and inability to void while standing. This can be a significant source of anxiety.(Yang, Zhang et al. 2013). Classification and etiology of this condition have been made controversial. Buried penis was first classified by Crawford in 1977 into 3 broad categories; concealed penis, buried penis (partial or complete) and penoscrotal web. (Crawford 1977).
He defined micropenis as a normally formed penis that is less than 2 standard deviations below mean in stretched length (Maizels, Zaontz et al. 1986).

The buried penis is most commonly caused by inelastic dartos fascia with poor skin anchoring at base of penis (Li, Wei et al. 2012).It is also may be due to prominent prepubic fat pad. Many patients may have more than one underlying factor. (Abbas, Liard et al. 2007). However, the most accepted hypothesis is that the dartos fascia tethers the penile shaft. . (Liu, He et al. 2013). The webbed penis represents an abnormality of the attachment between penis and scrotum. In this condition the scrotal skin extends up the ventral aspect of penile skin. (Kaefer 2009)