Circumcision scar

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 depend on the technique that was used. Open surgical techniques using sutures cause uneven scarring where the sutures were placed. Newborn circumcisions do not require sutures and result in a fine, even scar. 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) result in an even, circumferential scar.

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. 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."

Penile cancer can occur on the scar. In some cases, the scar can form a tight constricted ring causing preputial stenosis.