Occult penis is a common congenital developmental abnormality and deformity, also known as buried penis. In this condition, the penis body is hidden inside the body, and the only thing that protrudes out is the small, pointed foreskin. If you squeeze the penile skin inward with your hand, the penis body will be revealed, and when you release your hand, the penis body will retract. Although concealed penis looks like circumcision, it is a completely different disease. Causes Concealed penis is a congenital malformation caused by abnormal development of the meatus, which is different from the case of obesity caused by the accumulation of fat at the base of the scrotum of the mons pubis and the deep hiding of the penis under the skin, where the penis can return to its normal state after maturation and reduction of fatty tissue. Patients with occult penis have abnormal development of the sarcolemma in the penis, where the loose and elastic sarcolemma becomes inelastic, thick fibrous fascia, and sometimes forms cords. These abnormalities pull the penis proximally and bind it below the pubic symphysis. Clinical manifestations Penile occlusion is due to the foreskin not being attached to the body of the penis. If the penis is held with the fingers and the skin around it is pushed back, the concealed penis under the skin can be revealed. When the child grows and the subcutaneous fat decreases, the penis can be revealed. If the foreskin cannot be turned up to reveal the head of the penis, then a phalloplasty will be done. Differential diagnosis It is necessary to differentiate from micropenis, penile dysplasia and prepuce. The first two are caused by endocrine defects or chromosomal abnormalities, and are seen clinically as small penile body, less erection and weak erection. In the latter case, the penile head cannot be exposed due to the narrow opening of the foreskin. Treatment There is a great debate on the treatment of occult penis and the age of surgery. If the foreskin can be turned up to expose the head of the penis, surgery is not necessary, and occult penis gradually improves with age. The purpose of surgery is to enlarge the foreskin opening and expose the head of the penis. Care should be taken not to do a simple circumcision.