What is Concealed Penis?
This order is congenital or occurs at later times and causes the penis to seem concealed due to the excessive fat tissue on the genital region or the insufficient development of the skin or the tissues underneath. 2/3 of the penis is normally outside. In this patients however, 2/3 or more is concealed. Normally, the penis is attached to the bone behind it with a ligament. As this ligament isn’t developed in cases of concealed penis, it causes this disorder.
Are Penis Dimensions Normal in Concealed Penis?
They are generally normal. The penis is concealed within the tissue. This shouldn’t be confused with patients that congenitally have small penises.
Should Children with Concealed Penis be Circumcised?
Newborn suspected of having concealed penis shouldn’t be circumcised. One should wait for 6-12 months. That is because during this period, the penis can correct itself. Operation is needed if it the disorder doesn’t disappear over time.
Does a Correction of Concealed Penis Occur if Obese Children Lose Weight?
Although partial healing is seen, the majority of cases nevertheless require surgery.
Causes of Concealed Penis
- Excessive or insufficient removal of skin during circumcision;
- The congenital absence or the insufficient development of penis suspensory ligament;
- Disappearance of penis inside the fat tissue in obese patients when excessive amounts of fat accumulate in the genital region;
- Occurrence of edema in the testis sac and the penis when lymph canals become obstructed in some cancer types;
- Excessiveness or deficiencies in the interior layers of penis.
Which Problems are Caused by Concealed Penis?
The testis sac and the legs are wetted by the urine in concealed penis patients. The acid content in urine causes wounds and irritations in the skin. There may be rubescence and inflammation in the penis skin and the penis glans. Akin to the skins of “bulldog” family dogs, wrinkles in the penises of the concealed penis patients may lead to wounds and inflammations. In addition to grave hygiene problems, this disorder also causes erection problems during pubescence. Sexual intercourse become difficult, low self-confidence may occur in patients, depression and anxiety can be seen.
Diagnosis of Concealed Penis
An urologist or a pediatric surgeon can examine and easily diagnose this disorder, which shouldn’t be confused with cases of small or micro penis.
When should Concealed Penis Surgery be Performed?
It is ideal to perform concealed penis surgery at early ages. Correcting this order at early ages before the patient attains full conscience will ensure bypassing psychological and hygienic problems he may encounter during maturity. Also, surgeries performed by expert surgeons at early ages are easier and have higher rates of success.
Concealed Penis Surgery
An all-around incision made on the skin that is below the penis glans. The old circumcision scar is used for patients that have been circumcised previously. The penis skin is completely peeled between the “Bucks” and “Dartos” fascia. One should pay attention to preserving the blood vessels and nerves of the penis. Erroneously formed bad and weak tissues are incised and removed. The penis layers are corrected and reshaped. At 3-9-12 o’clock alignments, they are fixated on the “Periosteum” (the membrane over the bone), which is located on the “Pubis Bone”, with special sutures. Later, a special sling is created that will replace the penis’ suspensory ligament, which is underdeveloped congenitally. If needed, excessive fats in the pubis region are also removed.
In cases of concealed penis, which owe to the excessive removal of the penis foreskin, the surgery should be performed by experienced pediatric surgeons as the tissue needed for wrapping the penis is deficient. One may need to take skin “Graft” (patch) from hairless regions. Fat tissues that result in concealment are removed. In cases where the penis’ suspensory ligament is weak or has never developed, the penis is fixated to its normal position with special sutures.
Is any scar left after concealed penis surgery?
No scar is left other than the circumcision scar. This operation also corrects malformation, removes hygiene problem and ensures that the penis attains its normal size.