Buried penis: surgical management in adults

The penis can be defined as small when its length is less than two standard deviations with regard to average length, e.g. less than around 9.5cm. In some cases, the corpus cavernosum is hypoplastic, whereas in others the condition is associated with a hypospadias and the penis is defined as a microphallus, whereas a small or micro-penis is not associated with such anomalies. The small penis is a cause of psychological unease and, with a length of less than 7cm, it can even be difficult to introduce into the vagina. Today, there are surgical techniques available to make the penis appear larger or to increase its girth (incision of suspensory ligament of the penis, liposuction of suprapubic fat, adipose tissue insertion, skin grafting, etc.), in addition to stretching techniques. Results are not always satisfactory. Some individuals feel uncomfortable due to their “small penis” and are in search of solutions, even though the length of their penis falls within average.

In these cases, there are often psychological issues, altered self-perception and inadequate sexual education.

The hidden penis belongs to these “false” short penises and is found in overweight individuals. The penis is normal in form and size, but not very visible, or “hidden”: the excess suprapubic adipose tissue surround the base of the penis at the level of the pubis causing its abnormal appearance.

This condition is also known as pseudo-micropenis insofar as it is a normal penis buried in suprapubic fat (particularly in obese young men). The hidden penis, in addition to significant psychological unease, can also case recurrent urinary tract infections. In most cases, a suprapubic lipectomy is carried out, removing suprapubic fat such that the hidden penis may re-emerge.