Acquired buried penis in adult males can significantly impair erectile and sexual function [1]. Suspensory ligament release or monsplasty have been used for length enhancement, a comprehensive approach may yield superior functional and aesthetic outcomes [2]. This video demonstrates a triple-component reconstructive technique addressing penile concealment through suspensory ligament release, monsplasty, and ventral scrotoplasty.

This video presents the surgical management of a 39-year-old male with acquired buried penis and concern over reduced penile length affecting sexual function. A combination of preoperative markings, targeted suprapubic liposuction, monsplasty, suspensory ligament release, and ventral scrotoplasty was performed. Key technical considerations included identification of the fundiform and true suspensory ligaments, careful dissection to preserve the dorsal neurovascular bundle, and redefinition of the penopubic and penoscrotal junctions. A Prevena™ VAC dressing was applied postoperatively.

Postoperatively, the patient achieved a stretched penile length (SPL) increase from 5.5 inches to 8 inches, representing a 45% gain in length. The phallus was fully exteriorized with clearly re-established penopubic and penoscrotal angles. The Foley catheter was removed on postoperative day 1, and the patient was discharged on day 2. Partial staple removal occurred on day 14, with complete removal by day 21. No wound complications were observed, and the patient was satisfied with the cosmetic and functional outcomes.

The combination of the suspensory ligament release, monsplasty, and ventral scrotoplasty provides an effective surgical solution for patients with acquired buried penis. The approach offers improved penile exposure, restoration of anatomical definition, and high patient satisfaction in both cosmetic and functional domains.

Rybak, J., Larsen, S., Yu, M., & Levine, L. A. (2014). Single center outcomes after reconstructive surgical correction of adult acquired buried penis: measurements of erectile function, depression, and quality of life. The journal of sexual medicine, 11(4), 1086–1091. https://doi.org/10.1111/jsm.12417
Anandan, L., & Mohammed, A. (2018). Surgical management of buried penis in adults. Central European journal of urology, 71(3), 346–352. https://doi.org/10.5173/ceju.2018.1676