Case Report

Received: April 19, 2000

Urol Int 2001;66:117–118
Accepted: September 27, 2000

Concealed Penis:
Rare Complication of Circumcision
A. Adil Esen Güven Aslan Hatem Kazımoğlu Deniz Arslan İlhan Çelebi
Department of Urology, Dokuz Eylül University School of Medicine, Izmir, Turkey

Key Words
Circumcision, complication W Concealed penis

Abstract
A man presented with a concealed penis which devel-
oped after circumcision. In addition to anatomic varia-
tions in penile skin attachment and obesity, circumcision
is an iatrogenic cause in the etiology of a concealed
penis. Although it is a frequent and simple operation, it
may lead to uncommon complications due to a lack of
experience and poor technique.
Copyright © 2001 S. Karger AG, Basel

Introduction Fig. 1. Preoperative appearance of the patient with concealed penis.

Concealed penis is a rare condition which may result

from anatomical variations in the attachment of penile
skin, obesity and circumcision as an iatrogenic cause [1].
Besides the cosmetic deterioration of the genital area, the
most prominent complaint is penile functionality. We
present a case of concealed penis as an uncommon com-
plication of circumcision.
Case Report
A 33-year-old man was admitted with recurrent urinary tract
infection symptoms and the complaint of a small penis that was not
adequate for intercourse. He had been circumcized by a layman 21
years earlier. He also mentioned that he was able to void only in the
sitting position. Physical examination revealed an invisible penis
with a wide prepubic fat pad. The shaft of the penis was palpated in
the subcutaneous tissue. A thick ring of scar tissue surrounded a
small sinus, making it impossible to find the urethral meatus (fig. 1).
The scrotal contents and both testes were normal.
To correct the cosmetic appearance and functionality, scar tissue
was excised and the penis was repositioned as described in the litera-
ture (fig. 2) [2]. The patient was discharged 3 days after operation. In
the follow-up, he mentioned that he was able to void in the standing
position and his sexual performance had become satisfactory.

© 2001 S. Karger AG, Basel A. Adil Esen

ABC 0042–1138/01/0662–0117$17.50/0 Department of Urology, Dokuz Eylül University School of Medicine
Fax + 41 61 306 12 34 TR–35340 Inciralti-Izmir (Turkey)
E-Mail karger@karger.ch Accessible online at: Tel. +90 232 277 7777 3454, Fax +90 232 259 9723
www.karger.com www.karger.com/journals/uin E-Mail aslang@kordon.deu.edu.tr/adil.esen@deu.edu.tr
 reported in a few cases [2, 3]. Removal of too much prepu-
tial skin during circumcision causes the penis to retract
into the fatty mons pubis and contraction of the wound
leads to a submerged penis [2]. Thus, the penis is trapped
beneath a phimotic band. In addition to iatrogenic causes,
congenital variations, such as variations in the attach-
ment of penile skin to the underlying fascia of the corpore-
al bodies, are attributed in the etiology of concealed penis
[1]. Boys with this anomaly are also more prone to cir-
cumcision complications when this condition has not
been determined in advance.
In conclusion, concealed penis is an uncommon com-
plication which is caused mainly due to lack of experience
and poor technique. This problem can be corrected with
appropriate surgical procedures.
Fig. 2. Postoperative appearance at 3 months.

References 1 Cromie WJ, Ritchey ML, Smith RC, Zagaja

Discussion
Circumcision is a frequent operation performed in
many countries for religious and medical reasons. Though
hemorrhage and infection are the most common compli-
cations, rare conditions such as concealed penis have been
GP: Anatomical alignment for the correction of
buried penis. U Urol 1998;160:1482–1484.
2 Kon M: A rare complication following circum-
cision: The concealed penis. J Urol 1983;130:
573–574.
3 Talarico RD, Jasaitis JE: Concealed penis: A
complication of neonatal circumcision. J Urol
1973;110:732–733.

118 Urol Int 2001;66:117–118 Esen/Aslan/Kazımoğlu/Arslan/Çelebi

Copyright: S. Karger AG, Basel 2001. Reproduced with the permission of S. Karger AG, Basel. Further
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