Masuda Atsushi, Aosaki Tomohiko, Shudo Kana, Yoshikawa Katsuhiro
From the Department of Plastic and Reconstructive Surgery, Shiga General Hospital, Moriyama, Shiga, Japan.
Department of Plastic and Reconstructive Surgery, Kyoto University Hospital, Kyoto, Japan.
Plast Reconstr Surg Glob Open. 2025 May 8;13(5):e6786. doi: 10.1097/GOX.0000000000006786. eCollection 2025 May.
Buried penis is a condition in which the penis lacks a proper skin sheath and is buried beneath the skin of the abdomen, thighs, or scrotum. The penis is partially or completely hidden, and subsequent phimosis may result in splitting or spraying of the urine stream or dribbling. It can significantly impact an individual's physical and psychological well-being. In this report, we describe a case of a man with a history of phimosis surgery of unknown details in the distant past. He developed phimosis with dysuria following a total prostatectomy, which was aggravated by circumcision and eventually resulted in a buried penis. He could not urinate standing up because of urine stream spraying and had to sit down, catching the scattered urine with the palm of his hand and letting it fall. A surgical procedure involving excision of the scar, release of the contracture, and skin grafting was successful, and the symptoms resolved. If a patient develops a buried penis because of balanitis xerotica obliterans or scar contracture, they may complain of phimosis. In cases where there is sufficient skin, circumcision proves an effective treatment for the symptoms. However, in instances where the patient has undergone a previous circumcision and there is insufficient skin, the symptoms actually worsen as a result of the procedure. In the case of secondary phimosis, the decision whether to perform circumcision or to release the penis and reconstruct the skin defect should be based on the degree of skin sufficiency.
埋藏阴茎是一种阴茎缺乏正常皮肤鞘且埋藏于腹部、大腿或阴囊皮肤之下的病症。阴茎部分或完全隐藏，随后的包茎可能导致尿流分叉、喷洒或滴沥。它会对个人的身心健康产生重大影响。在本报告中，我们描述了一例有既往包茎手术史但具体细节不详的男性病例。他在前列腺全切术后出现包茎并伴有排尿困难，包皮环切术后病情加重，最终导致埋藏阴茎。由于尿流喷洒，他无法站立排尿，只能坐下，用手掌接住散落的尿液让其落下。一项包括切除瘢痕、松解挛缩和植皮的手术取得成功，症状得以缓解。如果患者因闭塞性干燥性龟头炎或瘢痕挛缩而出现埋藏阴茎，他们可能会主诉包茎。在皮肤足够的情况下，包皮环切术被证明是治疗这些症状的有效方法。然而，在患者既往已行包皮环切术且皮肤不足的情况下，手术实际上会使症状恶化。对于继发性包茎，决定是进行包皮环切术还是松解阴茎并修复皮肤缺损应基于皮肤充足程度。
