FRENULOPLASTY


A penile frenulum that is too short may restrict the normal retraction of the foreskin, specially during erections. Or it may simply cause irritation due to the fact that it is way too tight, even if it doesn't limit the retraction of the foreskin.
If you are in a hurry to resolve this mechanical condition, then a frenuloplasty may be advisable. And, considering the that the success-rate of stretching of the frenulum is much lower than that of the phimotic ring, it may very well be the only way to fully solve your problem.

FRENULOPLASTY: A MINIMALLY INVASIVE PROCEDURE

Frenuloplasty has obtained satisfactory results when it comes to the resolution of frenulum breve.  It’s a relatively simple procedure which can be executed with local anesthesia. One of the two following methods is usually employed:
  • incision (cut) which frees the frenulum and allows it to be elongated. One of the most common incisions is the V-cut, which is then elongated and sutured into an Y-shape that often increases the length of the frenulum by a good half-inch or so. In some cases, however, a Z-cut may be more appropriate. The simple slit of the frenulum by a single horizontal cut produces less satisfactory results, and is not recommended. For the stitching, absorbable materials that dissolve on the course of 1 to 2 weeks are usually utilized.
  • the other method consists in the application of tight horizontal stitches (tie-ups) which, during the course of about a week, cut and free the frenulum. Post-surgery may be a bit more painful than the previous method (specially the first week), but on the other hand the total recovery time is a bit shorter.
It may sound complicated, but it's actually pretty simple. Have you ever heard about someone who's had his tight frenulum tore during sexual intercourse? Yep, it's kind of rare, but it does happen. And, in the end, it's essentially an accidental liberation of the frenulum, much more painful and with a worse final aesthetic result than the one performed by a doctor. But if the poor guy takes good care of the injury, it will eventually end up healing with a "freer" frenulum.

FRENULOTOMY (FRENULECTOMY)

The amputation of the frenulum (frenulotomy or frenulectomy) is a procedure even simpler and cheaper (for the surgeon, but not necessarily for the patient) than frenuloplasty[2]. For this reason some doctors, sometimes due to sheer laziness, choose to completely remove the frenulum on the basis that this will prevent the left over of "superfluous tissue". What they probably won't tell you is that most of the nerve endings of the penis are concentrated on the frenulum and its surroundings[3], and that its amputation will deprive you of a series of sensory stimuli. Besides, the complete removal of the frenulum can possibly (even if rarely) cause damage to the nerves that feed such widely sensitized region. Summing it up: you will probably lose most of your sensitivity in the region, but also run a small risk of getting a nerve ending unduly exposed and go to the other extreme, namely, of having an undesired hypersensitivity.
In extreme cases, such as when the frenulum tissue presents some chronic inflammation, for example, the complete removal may be inevitable. But if your problem is simply a frenulum that is too short and you are about to undergo a surgical intervention, be sure to ask your doc whether what will be performed will be a frenuloplasty and not a frenulectomy. If he looks like he has no idea what you're talking about, then do yourself a favor and seriously consider looking for another professional.

REFERences

  1. Rajan P, Mcneill S, Turner K (2006). Is Frenuloplasty Worthwhile? A 12-Year Experience. The Annals of The Royal College of Surgeons of England, 88(6):583-4.
  2. Camara F, Dias A. Frenuloplastia bálano-prepucial e frenulotomia: estudo comparativo. UNESP.
  3. McGrath K (2001). The frenular delta: a new preputial structure. In: Denniston GC. Understanding Circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem. New York: Kluwer/Plenum, 199-206.