A concealed penis occurs when the head of the penis telescopes inside the foreskin under the healing circumcision line which then contracts into a tight ring. This happens soon after the circumcision mostly in chubby babies or obese children.
In children at risk of this complication, proper circumcision care can prevent it from happening.
Twice a day application of a steroid cream combined with gentle retraction for one month, can soften the contracted ring and release the penis. Subsequent proper care prevents recurrences.
Alternatively, the ring can be stretched using a hemostat after applying EMLA cream or a penile block.
Rarely, older kids present for the first time with this problem. After releasing the concealment in the operating room, this boy had a minimal amount of foreskin:
A scrotal skin graft was harvested and secured to the edges of the defect with interrupted 6-0 polydioxanone:
Before the surgery, he had no visible penis above the level of the scrotum. Surgery helped some, puberty should help significantly, and weight loss would be very beneficial too:
A concealed penis can occur after circumcision in chubby babies or obese children. Treatment with topical steroids or a quick office procedure is successful for almost all cases. Rarely, older children presenting for the first time can pose a challenge due to the deficient foreskin.