Occult penis means that the penis is hidden under the skin, the appearance of the penis is short, and the distance between the foreskin opening and the penis heel is short. The foreskin looks like a bird’s beak holding the penis and is not attached to the penis body. It is short on the dorsal side and long on the ventral side, with more inner plates and less outer plates. Holding the penis with the hand while pushing back the surrounding skin can show a normal penile body. The presence of supraurethral cleft should be noted. If the urethral fissure is complicated by the head of the penis, a shallow groove can be palpated on the dorsal side of the head of the penis. In obese children with fat accumulation in the lower abdomen, especially in front of the pubic bone, the penis may be occluded. In our clinic, we often have parents who bring their children for examination and say that they have a short penis and that their penis has not grown with age since birth, and that they can see a little penis when they urinate or in the morning before they wake up. Upon close examination, the child’s penis can only be seen as a small pagoda. Holding the penis and pushing the foreskin backward, the penis body can be revealed, and after releasing the hand, it is still a pagoda-shaped penis. It is generally believed that the occult penis is due to the separation of the foreskin from the penis body and the abnormal development of the white membrane layer, and this condition is usually treated surgically at around 2-6 years old by fixing the skin to the prepubic fascia and the root of the penis. The surgery is performed under general anesthesia. Cryptogenic penis is a congenital abnormality of penile development. There is a report of a survey of more than 5,000 cases of adolescent external genitalia in China, and the prevalence rate is 0.67%. This abnormality has certain specificity in diagnosis and treatment. If there is a lack of awareness of it and it is treated rashly, it can make subsequent corrective surgery complicated and difficult. The occult penis occurs because the subcutaneous meatus of the penis connected with the fascia of the lower abdominal wall develops abnormally, loses elasticity and turns into thicker fibrous fascia, which pulls the penis backward and binds it below the pubic symphysis, without the stimulation of the penis body, the skin of the penis cannot attach to the penis body and is also stunted, and as a result, the penis is hidden. The child’s penis looks short, conical, or even completely invisible, only a bunch of folded skin mounds, and the foreskin mouth is very narrow (prepuce). Some children have a normal-looking penis in infancy, and as they become obese, a large amount of fat builds up around the lower abdomen and pubic bone, which also buries the penis. These children are obese, often weighing more than 20% of the normal standard, and careful examination reveals normal penile corpus cavernosum and penile skin attachment, normal development, and no prepuce present. In fact, this is a kind of pseudo-incognito penis. It is very important to distinguish between the above two cases. Children with pseudohypospadias can naturally return to a normal state after they mature and lose weight, so they do not need surgical treatment. The treatment of occult penis is completely different. It should be treated by penile release surgery at the right time, otherwise it will definitely affect the penis development of the child and cause physiological and psychological obstacles. However, some doctors wrongly blame the cause of occult penis on the circumcision, thinking that circumcision will make the penis visible. On the contrary, circumcision is contraindicated for this kind of children. If the skin of the penis is poorly developed in occult penis, the inner and outer plates of the foreskin are valuable materials to supplement the lack of penile skin after the thickened flesh membrane and fibrous cords wrapped around the penis are removed and the penis is completely loosened and fully straightened during the penile correction surgery. . About the timing of surgery varies according to the clinical experience of different doctors. However, surgery in infancy is riskier, and it is safer and more reasonable to choose surgery before school age. I. Is a short penis a hidden penis? Some people think they are suffering from micropenis, but in fact, their penis is not small and the development is normal, only that most of the penis is hidden in the skin or fatty tissue, so that from the appearance of the penis is short, even only some foreskin folds can be seen, and urine is only shot out from these folds. This condition is medically known as occult penis. In a group of people with the same length of penile corpus cavernosum, fat people appear short on the outside, while thin people appear long. Therefore, doctors always emphasize that when measuring the length of the penis, the end of the ruler must be placed against the pubic bone to minimize the error caused by the thickness of the fat layer. This condition is mostly seen in children, because the penis is not yet developed before puberty, and it is smaller in itself, and when combined with obesity, it appears even smaller. In fact, if this condition is manifested in children, it can not be seen as a true occult penis, and the penis will often increase in size after puberty. Therefore, no special treatment is usually needed. Therefore, if parents find that a child’s penis is relatively short, they should go to a urological specialist at a children’s hospital to check whether it is an occult penis or dysplasia, in order to prevent delays in diagnosis and treatment. How to treat and take care of occult penis surgery? The surgery method generally adopted for occult penis is penile revision or occult penis lengthening, which is to loosen the deformed penile fibrous cords in the white membrane layer and fix one stitch in the subcutaneous tissue in front of the pubic bone at 2 and 10 points of the white membrane layer at the root of the penis. Since the original outer foreskin plate is not enough, the inner plate must usually be used instead of the outer plate. After the operation, the penis may be edematous and there may be difficulty in urination. A catheter should be left in place for 3 days, and the blood flow to the head of the penis should be observed and care should be taken not to touch the penis. Older children may have pain due to penile erection, especially at night. Therefore, it is better to use analgesic pump if possible, which can reduce the pain and prevent bleeding caused by painful erection. If there are adhesions between the glans and foreskin before surgery, there is often white or yellowish discharge from the glans after surgery. Parents need not be nervous and generally do not deal with it, as this discharge will crust over and fall off naturally after a few days.