Article Data

  • Views 890
  • Dowloads 176

Original Research

Open Access

Patients with adult-acquired buried penis and their surgical management: a single-center study

  • Melissa Wong1
  • Bryan Torres2
  • Aadit Patel2
  • Abigail Chaffin2
  • David Jansen2
  • Wayne JG Hellstrom1,*,

1Department of Urology, Tulane University School of Medicine, New Orleans, LA 70112, USA

2Division of Plastic Surgery, Tulane University School of Medicine, New Orleans, LA 70112, USA

DOI: 10.22514/jomh.2023.112 Vol.19,Issue 11,November 2023 pp.11-15

Submitted: 30 June 2023 Accepted: 22 August 2023

Published: 30 November 2023

*Corresponding Author(s): Wayne JG Hellstrom E-mail:


Adult-acquired buried penis (AABP) is a condition in which the suprapubic fat (the escutcheon) conceals the penis. The etiologies of AABP include obesity, pelvic lymphedema, lichen sclerosis, and scar contraction following a circumcision. If untreated, AABP can lead to hygiene-related infections, urinary and sexual disorders, and psychological issues, such as depression, diminished self-esteem, and poor quality of life. When weight reduction fails to resolve this condition, surgical correction can successfully manage the patient’s AABP. The goal of surgical repair is to extract the telescoped penis from the escutcheon. In our experience, this has been successful with a urologist/plastic surgeon team. Cases of surgical repair for AABP performed at a single medical center from 2012 to 2022 were retrospectively reviewed. Fourteen patients, whose age ranged from 40 to 74 years old, were identified, and their characteristics as well as the surgical techniques performed on them were reviewed. All patients were obese, their body mass index ranging from 32.1 to 62.4; eight patients were severely obese. Five patients had a history of adult circumcision, 5 had a prior diagnosis of lichen sclerosis, and 3 had genital lymphedema. The initial procedures were routine but with some variation. The surgical techniques included performing a panniculectomy and/or an escutcheonectomy, degloving the penis, removing nonfunctional fibrotic tissue, incising the suspensory ligament, and using a meshed split-thickness skin graft (STSG) for penile coverage. The most common complication was wound dehiscence. Two patients with complications required a return to the operating room; one patient returned for closure of an infected wound and the other for penile reconstruction and the placement of a new STSG for lymphedema. All patients eventually recovered, with no further complications reported.


Adult-acquired buried penis; Escutcheon; Surgical repair; Meshed split-thickness skin graft

Cite and Share

Melissa Wong,Bryan Torres,Aadit Patel,Abigail Chaffin,David Jansen,Wayne JG Hellstrom. Patients with adult-acquired buried penis and their surgical management: a single-center study. Journal of Men's Health. 2023. 19(11);11-15.


[1] Keyes EL. Diseases of the penis-anatomy-anomalies-injuries-inflammations. In Urology (pp. 637–641). 1st edn. Appleton & Co.: New York, NY. 1917.

[2] Pekala KR, Pelzman D, Theisen KM, Rogers D, Maganty A, Fuller TW, et al. The prevalence of penile cancer in patients with adult acquired buried penis. Urology. 2019; 133: 229–233.

[3] Rybak J, Larsen S, Yu M, Levine LA. Single center outcomes after reconstructive surgical correction of adult acquired buried penis: measurements of erectile function, depression, and quality of life. The Journal of Sexual Medicine. 2014; 11: 1086–1091.

[4] Centers for Disease Control and Prevention. Adult obesity facts. 2022. Available at: (Accessed: 01 May 2023).

[5] Kara Ö, Teke K, Çiftçi S, Üstüner M, Uslubaş AK, Bosnalı E, et al. Buried penis in adults as a complication of circumcision: surgical management and long‐term outcomes. Andrologia. 2021; 53: e13921.

[6] Alsaif A, Karam M, Hayre A, Abul A, Aldubaikhi A, Kahlar N. Full thickness skin graft versus split thickness skin graft in paediatric patients with hand burns: systematic review and meta-analysis. Burns. 2023; 49: 1017–1027.

[7] Fuller TW, Theisen K, Rusilko P. Surgical management of adult acquired buried penis: escutcheonectomy, scrotectomy, and penile split-thickness skin graft. Urology. 2017; 108: 237–238.

[8] Monn MF, Socas J, Mellon MJ. The use of full thickness skin graft phalloplasty during adult acquired buried penis repair. Urology. 2019; 129: 223–227.

[9] Black PC, Friedrich JB, Engrav LH, Wessells H. Meshed unexpanded split-thickness skin grafting for reconstruction of penile skin loss. Journal of Urology. 2004; 172: 976–979.

[10] Falcone M, Sokolakis I, Capogrosso P, Yuhong Y, Salonia A, Minhas S, et al. What are the benefits and harms of surgical management options for adult-acquired buried penis? A systematic review. BJU International. 2023; 131: 8–19.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Directory of Open Access Journals (DOAJ) DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.

SCImago The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus® database (Elsevier B.V.)

Publication Forum - JUFO (Federation of Finnish Learned Societies) Publication Forum is a classification of publication channels created by the Finnish scientific community to support the quality assessment of academic research.

Scopus: CiteScore 0.9 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Norwegian Register for Scientific Journals, Series and Publishers Search for publication channels (journals, series and publishers) in the Norwegian Register for Scientific Journals, Series and Publishers to see if they are considered as scientific. (

Submission Turnaround Time