Restoring the frenulum of the foreskin after a rupture

The foreskin is the part of the skin that covers the head of the penis. With some diseases or developmental abnormalities, the foreskin is so narrow that the head of the penis does not open or does not open completely. The disease is called phimosis. This has a number of serious health consequences.

An experienced urologist provides assistance in our medical center. To avoid the need for circumcision of the foreskin, one of the methods used is stretching. The doctor will give detailed advice on how to do this.

Make an appointment with a urologist by phone or by filling out the online form

Answers to frequently asked questions regarding foreskin:

• Which doctor deals with foreskin problems?
• What tests and examinations need to be done for foreskin problems?
• How does the foreskin affect sensitivity?
• How to stretch the foreskin?
• What is the foreskin for?
• Diagnosis of diseases of the foreskin?
• Why doesn't the foreskin open completely?
• What to do if the foreskin is swollen?
• Have plaque appeared under the foreskin?
• Do you perform foreskin plastic surgery at your clinic?
• Do you have cracks in your foreskin?
• What to do with a short frenulum of the foreskin?
• How to remove papillomas on the foreskin?
• Do you have a rash on your foreskin?
• Why do condylomas appear on the foreskin?
• Causes of itching on the foreskin?

Short frenulum of the penis - symptoms

Congenital short frenulum of the penis is accompanied by pain during sexual intercourse, and sometimes ends in rupture.

A rupture (tear) of the frenulum is manifested by severe pain and bleeding.

First aid for a ruptured frenulum is to treat the penis with antiseptics, apply a bandage and apply ice. You should contact a urologist (surgeon) as soon as possible to treat and suturing the wound and stop the bleeding.

A short frenulum of the foreskin is one of the causes of premature ejaculation (link to the page “premature ejaculation”).

The fact is that tension on the frenulum leads to hypersensitivity during friction, and as a consequence, to uncontrolled early ejaculation.

Sometimes a short frenulum of the penis is combined with a narrowing of the foreskin (phimosis), which makes sexual life even more difficult and causes even more inconvenience.

Congenital shortening or insufficient length of the frenulum is a common pathology, detected in 15-20% of men. The cause of this disease has not been established. The problem is sometimes detected in childhood (sometimes in combination with phimosis), but more often it becomes obvious only with the onset of puberty and the first experience of sexual activity.

Diagnosing a short frenulum is not difficult for a urologist. And the patient himself can often suspect this condition based on the characteristic signs mentioned above (pain on the lower side of the glans during sexual intercourse, downward deviation of the head of the penis during erection). If you wish, you can measure the length of the frenulum yourself from the lower surface of the glans to the shaft of the penis. A length of 1.5-2 cm or more is considered normal.

Ways to solve the problem

At the moment, there are several correction methods:

• Trimming the frenulum in children with a scalpel.
• Laser cutting of the frenulum under the tongue.
• Stretching through exercise.
• Removing the defect using massage.

Surgical interventions can be performed in different ways, the main methods are:

• Frenuloplasty is the removal of a flap from the tissue of a defective bridge, which is sutured to the resulting wound to increase the mobility of the tongue. Local anesthesia is required, but the damaged mucous membrane heals very quickly. Used for preschool children.
• Frenulotomy: the length of the frenulum is conventionally divided into three parts, an incision is made between the lower and middle lobes, and the edges of the mucous membrane are sutured. This method is suitable for infants.
• Frenulectomy is the same manipulation, but the frenulum is clamped with instruments. The method is suitable for five-year-old children.

In more modern clinics, trimming is performed using a laser. The dissection is carried out after treatment with an anesthetic: gel, spray. For patients, such cutting is less traumatic, damage to blood vessels is minimal - the laser simultaneously cuts the mucous membrane and causes adhesions of the affected capillaries

.

Tissue regeneration after laser trimming takes place within a few days, and you can return to your normal lifestyle an hour after the procedure. But how long you need to stay in the clinic is decided by the doctor. Complications are less common than after eliminating the defect with a scalpel.

Treatment of short frenulum of the penis

The only treatment for short frenulum is surgery. Surgery for a short frenulum (frenuloplasty or frenuloplasty) involves lengthening or excision of this skin fold. There are several options for frenuloplasty.

Classic frenuloplasty

It involves transverse intersection of the frenulum followed by suturing in the longitudinal direction. The advantage of this technique is its simplicity (the operation takes a few minutes).

Among the disadvantages of such plastic surgery, we can note the unevenness along the edges of the incision, formed from the remains of the dissected frenulum. Although the latter can be easily excised and leveled.

Z-plasty

Professor N.D. Akhvlediani proposed Z-shaped plastic surgery with the appropriate incision shape for the correction of premature ejaculation. This method is advantageous in the formation of a more mobile, elastic scar.

Complete excision of the frenulum

In some cases, especially when combined with circumcision, it is better to perform a complete excision of the frenulum, which permanently eliminates this hypersensitive area.

Laser and radio surgery

In recent years, new technologies such as laser or radiosurgery have begun to be used in frenuloplasty. More and more patients are seeking laser frenuloplasty. Indeed, a laser or radiosurgical knife allows frenuloplasty to be performed almost bloodlessly and very aesthetically.

Regardless of the option chosen, frenuloplasty is performed on an outpatient basis under local anesthesia. At the request of the patient, it is possible to perform this operation under anesthesia (during sleep).

For suturing, I use thin self-absorbable threads, which provides excellent cosmetic results and eliminates the need to remove sutures.

After surgery, a circular pressure bandage is usually applied, which protects the wound and reduces the risk of postoperative bleeding.

Wound healing after frenuloplasty takes about 10 days. Dressings are usually performed by the patient independently.

Restrictions after surgery relate only to sexual abstinence during the period of wound healing. There is no need to take sick leave or give up sports.

Rehabilitation

1. If the doctor's recommendations are fully followed, full recovery occurs within a month. At this time, it is important to give up intimacy.
2. After frenulotomy, avoid getting water on the penis, rinse it with antibacterial drugs prescribed by the doctor and chilled chamomile decoction.
3. Avoid lifting weights and playing sports.

Almost all specialists in narrow fields work at the Heratsi Medical Center. You will be able to undergo diagnosis and treatment. Our clinic employs only experienced doctors with high professional training. Own diagnostic equipment (ultrasound) of expert class and laboratory. The cost of all services of the medical center can be viewed in the “Price” section or by calling the 24-hour hotline.

Complications after frenuloplasty

Like any other operation, frenuloplasty can be complicated by wound inflammation, bleeding and the formation of a rough scar.

Infectious and inflammatory complications can develop both as a result of violation of the rules of asepsis during surgery, and due to improper treatment of the wound in the postoperative period and during dressings. Prevention of this type of complications is strict adherence to hygienic requirements during and after surgery.

Bleeding may occur in the first day or two after surgery and is sometimes quite profuse. The cause may be insufficiently reliable suturing of the vessels during surgery or a violation of the blood coagulation system. To prevent bleeding, it is necessary to perform thorough hemostasis with control of all vessels, as well as a mandatory preoperative study of the coagulation system (coagulogram).

The formation of a rough scar after frenuloplasty is an unpleasant problem from both a cosmetic and functional point of view. A rough scar in the frenulum area can be a source of hypersensitivity and premature uncontrolled ejaculation.

The use of modern technologies, such as laser and radiosurgical knife, as well as careful treatment of tissues and the use of modern suture material, allow us to avoid this problem.

From my own experience, I can say that over the past ten years I have not had a single complication after frenuloplasty.

Optimal age for surgery

Is it worthwhile to manipulate the frenulum under the tongue and at what age is it better to trim it? Such decisions depend on when the anomaly was discovered and what the individual characteristics are. If in the maternity hospital the neonatologist determines that the baby has a defective hyoid frenulum, it is better to trim it immediately.

The baby is not yet so mobile as to interfere with the procedure, and the membrane itself is small, thin and does not contain blood vessels. Thanks to these factors, local anesthesia will be sufficient for the manipulations, and you can calm the baby by applying it to the chest after the operation.

Trimming the frenulum of the tongue in children over 6 months of age is associated with some difficulties. The baby becomes mobile, and parents cannot discipline him with persuasion. Due to careless movements, surgery may not occur correctly, which is why surgery is postponed until the age of five

.

During this period, children talk, the doctor can determine whether there are speech defects, whether the frenulum under the tongue is bothering the child, whether it needs to be trimmed or whether it can be stretched with gymnastics.

If the infant’s tongue frenulum was not cut, and many years later he developed speech defects, breathing and digestive problems, then it needs to be circumcised in adulthood. But the older a person is, the denser his membrane becomes, it becomes overgrown with capillaries and nerve endings - which is why cutting it is much more painful than in the case of a baby. Anesthesia is required to make the incision.

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

Functions of the foreskin

The foreskin performs important functions. Among them:

• protection from external influences (this includes dirt, infections, mechanical irritation);
• moisturizing the sensitive head of the penis, keeping it moist, warm, soft;
• immunological protection due to the glands of the foreskin, which secretes antibacterial and antiviral proteins;
• gives an additional pleasant sensation from sexual contact when stretched, since the prepuce is rich in many nerve endings.

The presence of foreskin in a man is a protection given by nature and an increase in erotic sensations. It is highly undesirable to remove it by cutting. Therefore, the flesh should be kept healthy. At the first adverse symptoms, consult a doctor.

Symptoms and diseases of the foreskin:

• Swelling of the foreskin
• Foreskin rupture
• Inflammation of the foreskin
• Redness of the foreskin
• Foreskin removal
• Narrowing of the foreskin
• Ulcers on the foreskin
• Herpes on the foreskin
• Red spots on the foreskin
• Sores on the foreskin
• Dryness of the foreskin

Questions about the article

Peter 20 years old

July 28, 2022 at 00:00

Doctor, hello. We performed a frenuloplasty operation, the operation was bloodless, the doctor did not use a scalpel. On the third day, sex occurred at night. In the morning I noticed very small specks of dried blood on the wound. Please tell me, is this dangerous? Could it be fraught with the formation of a rough scar or any other complications?

drrotov

July 29, 2022 at 15:30

No, I don't think it's dangerous. This area is healing well.

Ivan 21 years old

April 15, 2022 at 00:00

Hello. I had a quadruple operation at once: straightening the inverter (there was a downward tilt), lengthening the frenulum, complete circumcision and ligamentotomy.

drrotov

April 16, 2022 at 12:00

Great! You forgot to ask a question...