Thank you for consulting with Doctor spring. We understand that your 9 year old child has a buried penis and you were informed by your doctor that circumcision cannot be done.

First of all, you have a very good doctor and if his diagnosis of a buried penis is indeed right, the decision taken by him to avoid doing a circumcision is right and this will help the Urologist to perform a corrective surgery for buried penis at a later date if necessary.

Buried penis in children is a congenital disorder where the penis is of a normal length but it is buried in the abdominal skin due to a defective dartos muscle development (a muscle covering the penis and the scrotum). Some doctors also use the term buried penis to refer to other conditions like:

1. Trapped penis: Here, the penis is trapped in scar tissue because of a surgical procedure on the abdomen usually a radical circumcision.

2. Micropenis: Here, the length of the penis itself is abnormal. The measure is less than 2 SD’s for the age of the child. It may be associated with several intersex conditions, extrophy of the bladder (where the wall of the bladder is exposed to the exterior due a defect in development of the abdominal wall), hypspadias, epispadias.

3. Webbed penis: Here, the penis is concealed in webs of the scrotal skin at the junction of the penis and the scrotum.

The causes for a congenital buried penis are:

• an improperly developed dartos muscle and fascia
• excess fat in the pubis
• loose penile skin
• insufficient skin covering the penis
• abnormal attachments of the layers of tissue covering the penis and scrotum

In many children the problem is said to be self limiting and not requiring surgery. But, it is advisable that you meet with a Urologist and let him examine your child and see whether surgery is necessary. If the buried penis is due to the fact that your child is obese, weight reduction may help too.

Parents often visit the urologist because they are facing problems with hygiene like having a poor urinary stream, ballooning if the urine in the foreskin, constant dribbling of urine and collection of urine in the skin of the abdomen leading to infection and swelling and exacerbating the condition.

The indications for surgery for Buried penis are a debated issue among Urologists. If discovered within the first month of life, most surgeons would prefer observation. Other surgeons believe that the condition is self limiting in children less than 3 years in more than half the children. However, beyond this age, there is need for correction mainly due to issues with self hygiene and cosmesis.

There is no medical therapy for a buried penis and surgery is the only option. The surgeon will mobilize the penis from the underlying skin by releasing the tissue in the way. Hope this information was of help to you