Concealed penis refers to a condition where the structure of the penis develops normally but anatomical abnormalities cause it to become buried beneath the pubic fat pad, leading to the appearance of a shortened penis. Prolonged concealment of the penis can result in physical and psychological harm to affected individuals, such as difficulty in urination, urinary tract infections, balanitis, and feelings of inferiority or social isolation. The causes of concealed penis are classified as either congenital or acquired. In infants, congenital concealed penis occurs due to poor attachment of the penile skin to the penile root and the pubic area, as well as abnormal development of the dartos fascia, restricting penile extension. In obese children and adults, excessive abdominal subcutaneous fat can bury the penis, leading to acquired concealed penis. Additionally, scarring following penile surgery—such as circumcision—may tether the glans penis, preventing its externalization.
Physical examination reveals normal corpora cavernosa on palpation. Pressing the pubic fat in front of the symphysis pubis toward the pubic area can expose the penis, which retracts once the pressure is relieved. Concealed penis is frequently accompanied by phimosis or a narrowed preputial opening.
Treatment for concealed penis depends on its underlying cause. In cases of congenital concealed penis, observation and conservative management may be followed by surgical intervention if spontaneous resolution does not occur. For obese patients, weight loss may be explored as an initial approach. Acquired concealed penis caused by medical procedures can be treated with topical corticosteroid ointments, scar excision, or surgical correction.