Cicatrix

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A cicatrix is a scar resulting from "the healing of a wound, such as one caused by injury, illness, smallpox vaccination, or surgery." Scar tissue is formed by dense masses of granulation tissue.[1]

All circumcision amputations leave a scar. The circumcision scar is noted for the unique way in which dissimilar tissue is mated at the scar. There usually is a unnatural visible texture and color change because skin on the proximal side is fused with mucosa on the distal side of the cicatrix.

Problem cicatrices

A circumcision scar may contract and trap the glans penis inside a tight scar, thus creating iatrogenic phimosis. Alpert et al. (2018) presented their successful experience that combines cicatrix stretching with a hemostat using local anesthesia in the office followed by several weeks of topical steroids with a minority of patients needing any additional therapy.[2]

Fekete et al. (2011) reported 48 revisions to adult circumcisions. The revisions were deemed necessary due to such issues as hypertrophic scar (n = 21, 44%), scar wrinkling (n = 13, 27%), incomplete circumcision (redundant foreskin) (n = 11, 23%) and paraphimosis (n = 3, 6%). Two patients required a second revision.[3]

References

  1. REFweb (2012). Cicatrix, The Free Dictionary. Retrieved 16 January 2022.
  2. REFjournal Alpert, Seth A., Ching, Christina B., DaJusta, Daniel G., et al. Combination treatment for cicatrix after neonatal circumcision: An office-based solution to a challenging problem. Journal of Pediatric Urology. 27 June 2018; 14(5): P471-5. PMID. DOI. Retrieved 17 January 2022.
  3. REFjournal Fekete F, Török A, Nyirády P. Revisions after unsatisfactory adult circumcisions. Int Urol Nephrol. June 2011; 43(2): 431-5. PMID. DOI. Retrieved 17 January 2022.