Difference between revisions of "Circumcision scar"

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(→‎Appearance: Add information on concealing the scar.)
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[[File:Circumcised_flaccid.jpg|thumb|Penis with a visible circumcision scar]]
 
[[File:Circumcised_flaccid.jpg|thumb|Penis with a visible circumcision scar]]
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In males who have been circumcised, the '''circumcision scar''' refers to the [[scar]] after a [[circumcision]] has healed.  In some cases, the scar can be darker-colored, and, in all cases, it will encircle the shaft of the [[penis]].
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In males who have been circumcised, the '''circumcision scar''' refers to the scar remaining after a [[circumcision]] has healed.  In some cases, the scar can be darker-colored, and, in all cases, it will encircle the shaft of the [[penis]].
  
 
==Appearance==
 
==Appearance==
 
The scar, which completely encircles the shaft of the penis, is located at the boundary of the shaft skin and the inner [[foreskin]] remnant, which is the portion of the foreskin that was not removed during circumcision. This foreskin remnant is mucosa that lies between the glans and the circumcision scar, which results in dissimilar tissue healing together. In adult circumcision part of the [[frenulum]] may remain intact. The foreskin remnant is dried mucosa and can often have a different color and texture than the rest of the penile skin. It can be pinkish or light-colored, and it typically becomes covered with keratin to protect it from a dry environment. Some circumcision scars result in a marked color difference on the shaft.
 
The scar, which completely encircles the shaft of the penis, is located at the boundary of the shaft skin and the inner [[foreskin]] remnant, which is the portion of the foreskin that was not removed during circumcision. This foreskin remnant is mucosa that lies between the glans and the circumcision scar, which results in dissimilar tissue healing together. In adult circumcision part of the [[frenulum]] may remain intact. The foreskin remnant is dried mucosa and can often have a different color and texture than the rest of the penile skin. It can be pinkish or light-colored, and it typically becomes covered with keratin to protect it from a dry environment. Some circumcision scars result in a marked color difference on the shaft.
  
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The characteristics of the circumcision scar often depend on the technique that was used. Open surgical techniques using sutures may cause uneven scarring where the sutures were placed. Newborn circumcisions do not require sutures and therefore can result in a fine, even scar.<ref name="Infant">{{Cite conference| publisher = World Health Organization| title = Manual for early infant male circumcision under local anaesthesia|url=http://apps.who.int/iris/bitstream/10665/44478/1/9789241500753_eng.pdf| location = Geneva| date = 2010}}</ref> Circumcisions after the newborn period that are performed without sutures (techniques that use cyanoacrylate tissue adhesive instead of sutures and techniques like Plastibell that heal by secondary intention) often result in an even, circumferential scar.
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The characteristics of the circumcision scar often depend on the technique that was used. Open surgical techniques using sutures may cause uneven scarring where the sutures were placed. Newborn circumcisions do not require sutures and therefore can result in a fine, even scar.<ref name="Infant">{{REFdocument
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|title=Manual for early infant male circumcision under local anaesthesia
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|url=http://apps.who.int/iris/bitstream/10665/44478/1/9789241500753_eng.pdf
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|contribution=
 +
|last=
 +
|first=
 +
|publisher=World Health Organization
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|format=
 +
|date=2010
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|accessdate=2019-10-18
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}}</ref> Circumcisions after the newborn period that are performed without sutures (techniques that use cyanoacrylate tissue adhesive instead of sutures and techniques like Plastibell that heal by secondary intention) often result in an even, circumferential scar.
  
 
Non-surgical [[foreskin restoration]] will eventually result in the scar being concealed within the foreskin.
 
Non-surgical [[foreskin restoration]] will eventually result in the scar being concealed within the foreskin.
  
 
==Problems with the scar==
 
==Problems with the scar==
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There is some controversy as to what happens to the severed nerves of the foreskin at the scar. Xin ''et al''. (1997) suggest that nerves regenerate, forming new receptors.<ref>{{vcite journal|author=Xin ZC, Choi YD, Rha KH, Choi HK|title=Somatosensory evoked potentials in patients with primary premature ejaculation |journal|journal=J Urol|date=1997|volume=158|issue=2|pages=451–7|url=|doi=10.1016/S0022-5347(01)64499-9|pmid=9224321|pmc=}}</ref> However, pathologists Cold & Taylor (1999) report: "Histology of the male circumcision scar shows amputation neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. Amputation neuromas do not mediate normal sensation and are notorious for generating pain."<ref name="cold-taylor1999">{{REFjournal
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There is some controversy as to what happens to the severed nerves of the foreskin at the scar. Xin ''et al''. (1997) suggest that nerves regenerate, forming new receptors.<ref name="Xin1997">{{REFjournal
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|last=Xin
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|first=ZC
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|author-link=
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|last2=Choi
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|first2=YD
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|author2-link=
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|last3=Rha
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|first3=KH
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|author3-link=
 +
|last4=Choi
 +
|first4=HK
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|author4-link=
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|etal=no
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|title=Somatosensory evoked potentials in patients with primary premature ejaculation
 +
|trans-title=
 +
|language=
 +
|journal=J Urol
 +
|date=1997
 +
|volume=158
 +
|issue=2
 +
|pages=451-7
 +
|url=
 +
|quote=
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|pubmedID=9224321
 +
|pubmedCID=
 +
|DOI=10.1016/S0022-5347(01)64499-9|
 +
|accessdate=2019-10-18
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}}</ref> However, pathologists Cold & Taylor (1999) report: "Histology of the male circumcision scar shows amputation neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. Amputation neuromas do not mediate normal sensation and are notorious for generating pain."<ref name="cold-taylor1999">{{REFjournal
 
  |last=Cold
 
  |last=Cold
 
  |first=C.J.
 
  |first=C.J.
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  |DOI=10.1046/j.1464-410x.1999.0830s1034.x  
 
  |DOI=10.1046/j.1464-410x.1999.0830s1034.x  
 
  |accessdate=2019-10-10
 
  |accessdate=2019-10-10
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}}</ref> Three cases of penile cancer have occurred on the scar.<ref>{{cite journal |last1=Fetsch |first1=JF |last2=Davis CJ |first2=Jr |last3=Miettinen |first3=M |last4=Sesterhenn |first4=IA |title=Leiomyosarcoma of the penis: a clinicopathologic study of 14 cases with review of the literature and discussion of the differential diagnosis. |journal=The American Journal of Surgical Pathology |date=January 2004 |volume=28 |issue=1 |pages=115–25 |pmid=14707873|doi=10.1097/00000478-200401000-00014 |url=https://zenodo.org/record/1234754 }}</ref>
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}}</ref> Three cases of penile cancer have occurred on the scar.<ref>{{REFjournal
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|last=Fetsch
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|first=J
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|author-link=
 +
|last2=Davis
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|first2=CJ
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|author2-link=
 +
|last3=Miettinen
 +
|first3=M
 +
|author3-link=
 +
|last4=Sesterhenn
 +
|first4=IA
 +
|author4-link=
 +
|etal=no
 +
|title=Leiomyosarcoma of the penis: a clinicopathologic study of 14 cases with review of the literature and discussion of the differential diagnosis
 +
|trans-title=
 +
|language=
 +
|journal=
 +
|date=2004-01
 +
|volume=28
 +
|issue=1
 +
|pages=115-25
 +
|url=https://zenodo.org/record/1234754
 +
|quote=
 +
|pubmedID=14707873
 +
|pubmedCID=
 +
|DOI=10.1097/00000478-200401000-00014
 +
|accessdate=2019-10-19
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}}</ref>
  
 
==Additional images==
 
==Additional images==

Revision as of 13:24, 18 October 2019

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This article is work in progress and not yet part of the free encyclopedia IntactiWiki.

 

Penis with a visible circumcision scar

In males who have been circumcised, the circumcision scar refers to the scar remaining after a circumcision has healed. In some cases, the scar can be darker-colored, and, in all cases, it will encircle the shaft of the penis.

Appearance

The scar, which completely encircles the shaft of the penis, is located at the boundary of the shaft skin and the inner foreskin remnant, which is the portion of the foreskin that was not removed during circumcision. This foreskin remnant is mucosa that lies between the glans and the circumcision scar, which results in dissimilar tissue healing together. In adult circumcision part of the frenulum may remain intact. The foreskin remnant is dried mucosa and can often have a different color and texture than the rest of the penile skin. It can be pinkish or light-colored, and it typically becomes covered with keratin to protect it from a dry environment. Some circumcision scars result in a marked color difference on the shaft.

The characteristics of the circumcision scar often depend on the technique that was used. Open surgical techniques using sutures may cause uneven scarring where the sutures were placed. Newborn circumcisions do not require sutures and therefore can result in a fine, even scar.[1] Circumcisions after the newborn period that are performed without sutures (techniques that use cyanoacrylate tissue adhesive instead of sutures and techniques like Plastibell that heal by secondary intention) often result in an even, circumferential scar.

Non-surgical foreskin restoration will eventually result in the scar being concealed within the foreskin.

Problems with the scar

There is some controversy as to what happens to the severed nerves of the foreskin at the scar. Xin et al. (1997) suggest that nerves regenerate, forming new receptors.[2] However, pathologists Cold & Taylor (1999) report: "Histology of the male circumcision scar shows amputation neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. Amputation neuromas do not mediate normal sensation and are notorious for generating pain."[3] Three cases of penile cancer have occurred on the scar.[4]

Additional images

  • Two toned circumcision scar on an erect penis

  • Distinctive brown ring scar resulting from neonatal circumcision using the Gomco clamp method

  • Errors in circumcision may cause uneven scarring

  • Before and after

  • Excised frenulum on a circumcised penis

  • Frenulum remnant and scar from a Gomco clamp circumcision of a 34 year old male

    Frenulum remnant and scar from a Gomco clamp circumcision of a 34 year old male

References

<templatestyles src="Reflist/styles.css" />

  1. ↑ REFdocument Manual for early infant male circumcision under local anaesthesia, World Health Organization. (2010). Retrieved 18 October 2019.
  2. ↑ REFjournal Xin, ZC, Choi, YD, Rha, KH, Choi, HK. Somatosensory evoked potentials in patients with primary premature ejaculation. J Urol. 1997; 158(2): 451-7. PMID. DOI. Retrieved 18 October 2019.
  3. ↑ REFjournal Cold, C.J., Taylor, J.R.. The prepuce. BJU Int. 1 January 1999; 83 Suppl 1: 34-44. PMID. DOI. Retrieved 10 October 2019.
  4. ↑ REFjournal Fetsch, J, Davis, CJ, Miettinen, M, Sesterhenn, IA. Leiomyosarcoma of the penis: a clinicopathologic study of 14 cases with review of the literature and discussion of the differential diagnosis January 2004; 28(1): 115-25. PMID. DOI. Retrieved 19 October 2019.
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