Penile Frenuloplasty or Frenulectomy
What does Frenuloplasty involve?
The surgical procedure of a short penile frenulum by dividing the skin across and re-stitching it in a lengthwise fashion.
You have a tight frenulum that can have a tear or pain during sexual activity. This can cause problems with recurring scarring of the frenulum area.
What is Frenulum Breve?
The frenulum is skin ridge which connects the foreskin to the head (glans) of the penis. Frenulum breve means short or tight frenulum of the penis. This may cause pain with erection, tears, bleeding, laceration and penile bending. The tight frenulum can have repeated trauma during sexual activity. This can cause problems with scarring of the frenulum area. Frenuloplasty is not suitable if your foreskin is scarred due to BXO. Please see further information for BXO.
There are 3 options with regard to treating a tight frenulum without balanitis:
1. Observation – no specific treatment in mild cases
2. Circumcision, which means that the foreskin is removed completely. The advantage of this operation is that once the foreskin is removed then you will not have any problem related to the foreskin. Head of the penis is exposed permanently after the operation and the procedure is irreversible.
3. Frenuloplasty, which is simply a foreskin releasing procedure. An incision is made on frenulum or excised the ridge underneath the surface, thus allowing full retraction. This will allow you to retain your foreskin, but at the same time be able to keep the area underneath clean.
What are the benefits of having a frenuloplasty?
The benefit is that he retains foreskin. Frenuloplasty helps to get rid of bending of the penis. Circumcision used to be a commonly practised operation and on many occasions was performed with excellent results.
Details of the procedure
1. I usually carry out the procedure under a local anaesthetic injection.
2. Local anaesthetic nerve blocks also provide post-operative pain relief
3. I divide the frenulum across and re-stitch it in lengthwise fashion, which results in lengthening the frenulum.
4. I use dissolvable stitches throughout which usually disappear within two to three weeks.
5. I apply and seal the wound with modern glue which sloughs off within 10 days.
6. We normally wrap the penis in a loose bandage which you can remove it after 1-2 days.
What are the risks, consequences and alternatives associated with you, having a frenuloplasty?
Bruising and swelling of the penis which may last a few days. Most operations are straightforward; however as with any surgical procedure, there is some chance of side-effects or complications such as: Bleeding from the wound site but is usually minimal and settles quickly. Infection can occur and is usually mild but can be potentially serious (less than 1% of patients). Sensation may alter with this procedure. The infection requires antibiotics and medicated honey dressing/gel.
Tenderness of the scar at the site of your frenulum. The dissatisfaction with the cosmetic result. Failure to improve your symptoms which may result in the need for full circumcision, Redo operation or full circumcision: 10% foreskin becoming tight again due to scarring. The best alternative for the tight foreskin is circumcision.
What can I expect when I get home?
• You will get some swelling and bruising of the penis which may last several days
• All your stitches will disappear, usually within two to three weeks, but may sometimes take a little longer
• Simple painkillers such as paracetamol or Ibuprofen are helpful if you have any discomfort
• Any dressing should fall off within 24 hours; if it does not, or if it becomes soaked with urine, it should be removed
• Keep the area dry for 48 hours; avoid soaking in a bath
• You should not swim or any exercise for two weeks
• Try to keep your wound clean and dry after passing urine
• Apply a little Vaseline to the tip of your penis and around the stitch line to stop it sticking to your clothing
• Wear tight-fitting clothing for two to three days
• You should retract your foreskin on a daily basis to maintain the benefits of the surgery after 3 days
• You will be given a copy of a letter which should be given to your GP
• Any antibiotics or another cream, you need to get from any pharmacy
• You should refrain from sexual activity (intercourse and masturbation) for up to four to six weeks
Smoking and Surgery: Ideally, we would prefer you to stop smoking before any procedure. Smoking can worsen some urological conditions and makes complications more likely after surgery
Instructions after frenuloplasty: Following 3 days after the operation, it is VERY IMPORTANT that you retract his foreskin each day to avoid the foreskin becoming tight again due to scarring. If you are concerned about any of these risks, or have any further queries, please speak to us immediately.
Note: This is the information for guidance only, it will not be a replacement of professional opinion by medical doctors. Please call Mr Khan for any issues