Cohen Philip R
Dermatology, San Diego Family Dermatology, National City, USA.
Cureus. 2021 Feb 1;13(2):e13067. doi: 10.7759/cureus.13067.
Buried penis is a condition where the penis is hidden by abdominal or suprapubic skin or fat. In adult men, buried penis occurs as an acquired condition most commonly caused by morbid obesity. The clinical characteristics of three obese men with adult acquired buried penis are described and the associated features of the buried penis are reviewed. In addition to morbid obesity, a buried penis can result from other etiologies, such as hidradenitis suppurativa, iatrogenic causes such as elective surgeries, infections, lichen sclerosus, penoscrotal lymphedema, and traumatic events. Lower urinary tract symptoms, such as voiding, and post-voiding problems are the most common presenting complaints; however, bacterial and fungal infections, phimosis, psychological issues, and sexual dysfunction, are also buried penis-related symptoms. The evaluation of a man with adult acquired buried penis begins with a detailed history for condition-related symptoms. Examination of the patient, both standing and supine with an attempt to demonstrate the penis using digital compression of the surrounding skin and fat, should be performed to determine the extent of the problem and whether comorbid conditions-such as infection and lichen sclerosus-are present. Both buried penis and lichen sclerosus can predispose to the development of penile squamous cell carcinoma; the diagnosis of this tumor can be delayed in men with adult acquired buried penis since an adequate penile examination is difficult or impossible. A multidisciplinary approach-including surgeons, primary care physician, registered dietitian nutritionist, and psychiatrist-should be considered for a patient with a buried penis. The surgical management is individualized and based on not only the extent of the problem but also whether an associated condition, such as urethral stricture, is present. Most patients are pleased with the functional and aesthetic outcome following surgery.
隐匿阴茎是指阴茎被腹部或耻骨上皮肤或脂肪所遮盖的一种情况。在成年男性中，隐匿阴茎是一种后天获得性疾病，最常见的原因是病态肥胖。本文描述了三名患有成年后天性隐匿阴茎的肥胖男性的临床特征，并对隐匿阴茎的相关特征进行了综述。除了病态肥胖外，隐匿阴茎还可由其他病因引起，如化脓性汗腺炎、医源性原因（如择期手术）、感染、硬化性苔藓、阴茎阴囊淋巴水肿和创伤性事件。下尿路症状，如排尿和排尿后问题是最常见的就诊主诉；然而，细菌和真菌感染、包茎、心理问题和性功能障碍也是与隐匿阴茎相关的症状。对患有成年后天性隐匿阴茎的男性进行评估时，首先要详细询问与病情相关的症状。应检查患者站立和仰卧时的情况，通过对周围皮肤和脂肪进行指压来试图显露阴茎，以确定问题的严重程度以及是否存在合并症，如感染和硬化性苔藓。隐匿阴茎和硬化性苔藓都可能易患阴茎鳞状细胞癌；由于对成年后天性隐匿阴茎患者进行充分的阴茎检查困难或无法进行，这种肿瘤的诊断可能会延迟。对于隐匿阴茎患者，应考虑采用多学科方法，包括外科医生、初级保健医生、注册营养师和精神科医生。手术治疗是个体化的，不仅要根据问题的严重程度，还要考虑是否存在相关疾病，如尿道狭窄。大多数患者对手术后的功能和美学效果感到满意。
