Presentation
PH obesity and diabetes. Now has "buried" penis. Unable to achieve penetration. Seeking surgical intervention
Patient Data
The penis is morphologically normal but surrounded by excessive fat such that it is not visible externally (in this non-tumescent state). The suspensory ligament of the penis is identified (arrow) in all projections. This will be incised as part of the plastic surgical intervention as well as liposuction or surgical lipectomy of the excessive surrounding fat.
Case Discussion
This is a condition of increasing incidence due to the increasing rates of diabetes and morbid obesity. It is not just a cosmetic issue. It is a cause of infertility (due to an inability to penetrate) and can mask underlying pathology such as penile malignancy. Adult onset must be contrasted with congenital buried penis that is due to a very short penile shaft (from birth).
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