Short frenulum of the penis: causes, symptoms, diagnosis and treatment

Features of the anatomical structure of the foreskin

The foreskin is represented by folds of skin, which are one of the elements of the protective cover covering the male penis.
One of the folds is located along the body of the latter and connects the foreskin and the head of the penis to each other. It's called a bridle. The features of this anatomical formation are such that it can stretch when the flesh moves, or during sexual intercourse, when friction is performed. In the latter case, if the frenulum is of sufficient length, the head receives additional stimulation due to slight bending. If it is too short or the skin folds do not have the desired elasticity, complete exposure of the head of the penis during erection becomes impossible, so this defect can only be identified during the boy’s puberty. Treatment of a short frenulum of the foreskin is simply necessary, since this defect is characterized by a number of extremely unpleasant manifestations for any man. The penis becomes cosmetically defective, appearing curved during erection. During sexual intercourse, a man feels pain, and the frenulum, due to excessive tension, can tear and even rupture. Due to scarring of wounds, the defect intensifies, causing disruption of erectile function, emotional distress, and even fear of sexual relations.

In what cases should you contact a urologist for consultation?

So, in what cases should you contact a urologist for consultation on plastic surgery of the frenulum of the penis?

with a short frenulum
with previous tears and microcracks of the frenulum
when the head of the penis is deviated downwards
with premature ejaculation

Why is it important not to delay surgery for a short frenulum of the penis?

A timely operation prevents complications such as rupture or tearing of the frenulum, accompanied by quite severe bleeding
Frenumplasty relieves pain and discomfort during erection and sexual intercourse
Eliminating this problem in some cases restores the normal duration of sexual intercourse

You can familiarize yourself with contraindications for frenuloplasty, as well as the list of necessary examinations, on the “Preparation for planned operations” page.

I will be glad to help you solve this delicate problem and offer any of the frenuloplasty options, performed by experts at a competitive price.

Pay attention to the promotion - frenuloplasty as a gift (Learn more...) when denervation of the head is performed in combination with circumcision. An ideal option to actually increase the duration of sexual intercourse!

Author: candidate of medical sciences, doctor of the highest category, Rotov Anton Evgenievich

Why does a short frenulum of the foreskin develop?

In the vast majority of cases, this defect is congenital, often combined with a pathological condition such as phimosis. The latter is characterized by the narrowness of the foreskin, which does not allow the head of the penis to be exposed.

It is found in 96% of newborn boys, but as their body develops, the foreskin gains the necessary mobility, and the problem goes away on its own. At the age of three, it is found in only 10% of young patients.

The causes of a short frenulum are as follows:

different rates of development of skin structures and cavernous bodies of the penis;
inflammatory processes of the structures of the penis, occurring in a chronic form;
constant injury to the foreskin when playing sports, wearing incorrectly selected underwear and too tight trousers;
diabetes mellitus, which provokes failures in tissue regeneration.

Rehabilitation after frenulotomy

After frenulotomy, the patient rests for several hours in the ward, then he is sent home. After 2-3 days you can go to work, if it does not involve lifting heavy loads (the seam may come apart).

There is usually some slight swelling or bruising in the first 24 hours, which goes away within a few hours. Within two days, a few drops of blood may come out of the suture. This is fine. They need to be blotted with a sterile napkin and observed over the wound.

Antibacterial therapy is usually not required. The course of antibiotics is replaced by antiseptic ointment "Levomekol". A thin layer of it is applied to the suture area once a day for 5 days. You must appear for a dressing change the next day, and for a final examination after 10 days. The pain goes away completely after 2 weeks. During an erection, slight discomfort may remain for 3-4 weeks.

During the rehabilitation period, the patient should adhere to the following recommendations of the attending physician:

carry out hygiene measures after each visit to the toilet and use an antiseptic solution prescribed by a doctor for this;
take a course of antibiotics to prevent the development of purulent infections;
during rapid healing, do not use fat-based ointments, as they can prolong the rehabilitation period;
visit a urologist a week after the operation so that he can determine the need to remove the remaining threads, which should be completely resolved by this time.

In addition, during the recovery period you should avoid:

physical activity and sports;
visits to baths, saunas, swimming pools;
taking baths; sexual intercourse and masturbation.
The latter is necessary in order to eliminate the risk of seams coming apart.

How does a short frenulum of the foreskin manifest itself?

The clinical manifestations of this defect can be more or less pronounced, depending on its degree. They are as follows:

strong tension of the frenulum in the erect state of the penis and the development of pain (including during sexual intercourse);
insufficient filling of the cavities of the cavernous bodies with blood and, as a result, insufficient increase in the volume of the penis and its hardening;
strong curvature of the penis towards the scrotum, making sexual intercourse very difficult (or even completely inaccessible);
development of sexual dysfunction, in which ejaculation occurs too quickly;
damage to the frenulum during sexual intercourse in the form of cracks and tears with bleeding.

We should not forget that the inability to move skin folds significantly complicates hygiene measures and favors the stagnation of smegma. As a result, serious inflammatory processes develop, which aggravate the situation. Frequent traumatic injuries are accompanied by scarring and even greater shortening of the frenulum, and as a result, they can provoke the development of secondary infectious processes (including those that are sexually transmitted).

An important indicator is the psychological state of the patient. He suffers from neurotic disorders and is afraid of sexual intercourse. Such manifestations further aggravate the situation, provoking erectile dysfunction at the psychogenic level.

Circumcision and removal (excision) of the frenulum

Surgical intervention to circumcise the frenulum of the foreskin is not considered mandatory if there are no alarming symptoms. But most experts advise carrying out this procedure as a preventive measure.

Carrying out the procedure

in circumcision of the foreskin followed by frenuloplasty, mainly for phimosis;
in excision of the frenulum followed by plastic surgery to restore the anatomical length;
in excision of the frenulum of the foreskin.

Circumcision of the foreskin and frenulum together is carried out for medical reasons or for religious reasons. If circumcision is performed for medical reasons, the most common reason for the procedure is phimosis - this is a pathological narrowing of the foreskin, which makes it difficult to expose the head of the penis. Phimosis can also be either congenital or acquired as a result of diseases or injuries.

In its presence, the patient may experience difficulties during sexual intercourse, urination, and also very often suffers from swelling and inflammatory processes.

The main danger of this disease is the formation of cracks in the frenulum and foreskin, which can turn into scars and welts after healing. In some cases, the tissues of the glans penis adhere to the foreskin, which can cause pain when trying to open the glans. During the operation, the foreskin and frenulum are excised, which can lead to the return of anatomical functions. Also, phimosis can be operated on with subsequent preservation of part of the foreskin. Circumcision can also be performed simultaneously with frenuloplasty.

Indications for frenulum circumcision

The operation of circumcision of the foreskin and frenulum, in contrast to frenulotomy, is performed not only in adults, but also in children and infancy, if indicated.

Operation techniques

At the moment, circumcision of the frenulum of the foreskin can be carried out using a standard method using a scalpel, as well as using laser technologies.

The operation is carried out over thirty to forty minutes. The likelihood of complications is minimal, and in most cases there are none at all.

During the recovery period, it is very important not to violate hygiene, and also to follow all established instructions and doctor’s advice. The scar after surgery can heal very quickly and becomes almost invisible. Stitches are usually applied using special self-absorbable threads; they can disappear after ten days. After healing and rehabilitation, it will take fourteen to twenty-one days, after which you can continue to be sexually active.

How is a short frenulum of the foreskin diagnosed?

As already mentioned, this defect can only be identified during puberty. That is why adolescents going through this stage need to visit a consultation with a professional urologist.

Diagnosis of the disease involves analyzing the patient’s complaints and conducting an examination of the penis, during which a specialist identifies the existing problem. Timely diagnosis and adequate treatment play a vital role in this case. They eliminate the risk of complications and also prevent psychological trauma to the patient, which can be very difficult to treat.

Price for plastic frenulum of the tongue

The cost of this procedure usually consists of the cost of consultation and examination, local anesthesia and the service itself. This is a fairly simple surgical procedure, so no additional tests are required. The price of a classic operation (with a scalpel) for adults and children is the same, but may be slightly higher if the patient has too dense frenulum tissue. Then they do not give local anesthesia, but general anesthesia; it costs more, and, accordingly, costs increase due to this. The average cost of classic lingual frenuloplasty in Moscow is 3,800 rubles. The price for laser plastic surgery of the frenulum of the tongue is about 5,000 rubles.

Preparation for plastic surgery

A medical examination is carried out, during which the degree of shortening of the frenulum of the penis and existing scar changes are revealed. The genitals are examined for the presence of rashes and skin changes, which are a contraindication to plastic surgery.

During the preoperative consultation, you should inform the urologist about the medications you are taking. Some medications have a negative effect on blood clotting and may be incompatible with anesthesia drugs. In this case, the medications are canceled or replaced with others.

The patient undergoes tests:

General – blood and urine.
Analysis for sexually transmitted infections, which are a contraindication to plastic surgery.
Blood test for coagulogram - clotting time and bleeding duration. If there is increased bleeding, surgery is contraindicated. Sometimes it can be done after preliminary normalization of blood counts.
Blood for the group and Rh factor is donated in case of unexpected blood loss, which is eliminated by the introduction of donor blood. If a man has documentary evidence of his group and rhesus, the study is not carried out.

Patients who are planning to undergo surgery under general anesthesia are prescribed an ECG and a consultation with an anesthesiologist - a doctor who will deal with pain management.

If necessary, other research methods and additional consultations with doctors may be prescribed.

One day before surgery, you should refrain from sexual activity, physical activity, and drinking drinks containing caffeine. You should not drink alcohol, as they are incompatible with pain medications and can cause bleeding. During the period of preparation for surgery, you should not take medications not recommended by your doctor.

Before plastic surgery of the frenulum of the foreskin of the penis, performed under general anesthesia, you should not eat for 8 hours. You can drink still water and unsweetened tea.

Pubic and groin hair is removed. Carrying out basic hygiene procedures is mandatory. Before the operation, you need to remove removable dentures, contact lenses, hearing aids, and empty your bladder.

Non-surgical methods

Traditional medicine categorically denies the effectiveness of such techniques. However, if there are contraindications to surgical treatment, it is worth trying home methods for stretching the skin fold. There are several of them:

The thumbs are carefully inserted into the prepuncial sac and begin to slightly stretch the skin. In this case, the feeling of discomfort should not develop into pain.
Before the procedure, take a warm 15-minute shower or hot bath to soften the skin. Then the foreskin is retracted as much as possible and fixed for several minutes - this slightly stretches the frenulum and makes it more elastic.

Like any unconventional methods, such treatment will only work if used for a long time - more than 3 months minimum. The effectiveness will also depend on the individual characteristics of the organism. Such as age, physiology, regularity and correctness of execution.

How to recognize pathology in a child

A neonatologist, pediatrician, or the mother herself can recognize a pathological frenulum of the tongue in a newborn. If during the first and subsequent breastfeedings the baby experiences difficulties and cannot grasp the nipple correctly, then there is a reason to consult a doctor.

The second common sign of a pathological frenulum of the tongue in children is the occurrence of a speech defect when they begin to speak in phrases, namely at 3-4 years. Most often, with this anomaly, children do not pronounce several letters: “zh”, “sh”, “sch”, “ch”, “z”, “l” and “r”. Moreover, the sound “l” is easily pronounced if it is followed by a soft vowel, for example, “i”, “yu”, “e”, “e”, “ya”, in other cases it is simply “swallowed”. If there is incorrect pronunciation of sounds, then an examination by a speech therapist is necessary.

The most common symptoms of a tongue tie in a child are the following:

the child is not able to reach the front teeth of the upper jaw or palate with the tip of his tongue;
the child may have difficulty moving the tip of the tongue from one side to the other;
the front teeth of the lower jaw may have a gap between each other;
when the tongue is pulled forward, its tip remains flat, square or heart-shaped (that is, the front edge of the tongue seems to bifurcate);
feeding problems in newborns.

It is important to understand that if the problem of the tongue frenulum exists, then sooner or later it will have to be solved. The sooner measures are taken, the easier and more painlessly the baby will endure them.