Concealed Epispadias Presenting with Buried Penis: A Case Report

Isolated epispadias is a rare congenital urological anomaly that can be easily missed, particularly when associated with a concealed penis and intact prepuce.We report the case of a 4-year-old boy who presented with continuous urinary dribbling and a hidden penile shaft.The condition was first noticed during a failed circumcision attempt, but no diagnosis was made until further evaluation at a tertiary care center.Examination revealed a dorsally located urethral meatus and unretractable foreskin, consistent with isolated epispadias.Investigations showed mild anemia and pyuria, with normal renal function and imaging.Surgical correction was performed using the Inverted Preputial Glanuloplasty and Meatoplasty (IPGAM) technique, along with corporoplasty and tuboplasty.The procedure was successful, with no complications.This case highlights the importance of early recognition of atypical penile anatomy, especially during circumcision, and the need for improved paediatric surgical services and awareness in resource-limited settings to prevent diagnostic delays and functional impairment.Key Clinical Message: Isolated epispadias can remain hidden behind an intact foreskin, making early diagnosis especially difficult-often only discovered during circumcision attempts.This case highlights the importance of careful genital examination in infants and the need for greater awareness among healthcare providers.With timely recognition and a tailored surgical approach like IPGAM, even children in resource-limited settings can achieve excellent functional and emotional outcomes.