With the improvement of living standard and the increase of obese children, the incidence of occult penis has been increasing in recent years, and it has become a problem that draws more and more people’s attention. The surgery itself has become a medical factor for the occult penis, which makes the future treatment more difficult. Therefore, it is necessary to clarify some issues related to this disease. (1) Anatomical outline of the anaphylactic penis The normal penile meatus is loosely attached to the skin and its deep Buck’s fascia, and extends proximally to the superficial and deep layers of the superficial fascia of the abdominal wall. The meatus is very elastic, so the penile body can slide freely under the skin. In contrast, in patients with anaphylactic penis, due to the abnormal development of the sarcolemma layer, the thickened fibrous cords or fibrous fascia with no or poor elasticity are attached to the base of the penis, thus pulling the penis body proximally, restricting the penis from straightening and fixing it below the pubic symphysis, and also pulling the subcutaneous fascia of the abdominal wall and its surrounding fatty tissue distally, so that the penis is buried in the swollen subcutaneous fatty tissue. (2) Diagnosis and differentiation of anaphyseal penis Anaphyseal penis is a congenital malformation that is not uncommon, but is often not recognized by parents, resulting in late diagnosis. It means that there is too much fat at the pubic bone and not enough skin attached to the penis body, so that the penis is hidden in the skin of the pubic bone. At present, there are many controversies about the pathogenesis, name and diagnosis of occult penis, and no unification has been reached. Foreign scholars believe that there are many different pathogenetic mechanisms that can elucidate the occult expression of the penis, among which the retracted penis is due to the underdeveloped fibrous cords that connect the penis to the tissue in front of the pubic bone. The concept of buried penis was also proposed and its mechanism was elaborated. It is believed that buried penis is a congenital malformation in which the penis is buried in the subcutaneous tissue, and the penile body and glans are well developed, while the defect of penile skin is attributed to the abnormal attachment of the sarcoid muscle layer during embryonic development. Some domestic scholars believe that retracted penis and buried penis are both occult penis, which can be confirmed by the following method, that is, pulling the head of penis and releasing it, if the penis can stick out of the foreskin, but quickly retracted into the diagnosis. In addition, clinically, it is necessary to distinguish occult penis from prepuce, webbed penis and micropenis, which are easily overlooked and confused. The circumcision is a small opening, the foreskin can not be turned upward to reveal the head of the penis, while the body of the penis is completely exposed, and the skin of the penis sliding well. The appearance of webbed penis can be seen from the scrotum to the ventral side of the penis with a thin strip of skin, usually without any symptoms. Micropenis refers to the normal appearance of the penis, but the spongy body is small. Patients often combine bilateral cryptorchidism, testicular hypoplasia, hypopituitarism and obesity and other endocrine abnormalities, and systematic endocrine examination is required for diagnosis. (3) Treatment of anaphylactic penis Because there are different etiological theories of anaphylactic penis, flexible surgical methods should be adopted according to its pathophysiological research in order to obtain satisfactory results. At present, the most commonly used corrective surgeries include standard penile decortication, penile body fiber scar cutting, lower abdominal prepubic fat excision, local flap reconstruction of penile skin and penile scrotal angle molding. In clinical practice, the treatment of anaphylactic penis is also based on the above principles. On the basis of Devine’s surgery, the surgical steps and focus areas are chosen according to different etiologies, and finally, the penile body is completely released, the anterior extension is good, the appearance of the penile scrotal angle is restored, and the penile skin is adequate. The disadvantage is that the lymphatic vessels are damaged by the circumferential incision of the penile skin and meatus, and some patients have transient lymphedema after surgery.