Penile Frenulum Breve
Frenulum Breve or tight penile frenulum is a condition in which the piece of skin that connects the foreskin to the gland is shorter than normal. This causes pain during sexual intercourse and causes trauma to the frenulum. It is usually common amongst males aged 15 to 30 years old and there is a prediction that 5% of patients with this condition are uncircumcised males . There is not enough awareness on frenulum breve that some men suffer from this condition for years with the idea that this condition is untreatable. Most male patients are afraid to speak about this issue which then leads to anxiety for the patient and his partner. Most patients are afraid to be circumcised whereas the solution to this condition is not necessarily circumcision. There are other less invasive procedures that can be offered to the patient as treatment.
How do males develop frenulum breve?
The frenulum of prepuce of the penis is often known as the frenulum, an erogenous elastic band of tissue under the gland of the penis and contains frenular vessels. The function of the frenulum is that it acts as a ‘retractor’ of the foreskin over the glands which is the head of the penis. Usually a frenulum is long and stretchable, allowing the foreskin to slide down the penile shaft and expose the entire surface of the glands. This is why during erection, if the frenulum is tight or short, it will cause some pressure that leads to downward curvature of glands. This condition also prevents any free movement of the foreskin during sexual intercourse or masturbation. This condition can become severe during sexual intercourse which can cause pain and bleeding especially if the frenulum has rip or tear. Repeated tear will be hard to heal and will cause scarring which leads to more pressure if the condition precedes. If this condition is left untreated, his can lead to the patient having difficulties during penetrative sex or any sexual dysfunction. Early intervention is important to detect this condition earlier.
Signs and symptoms of frenulum breve.
A common symptom of frenulum breve is pain and bleeding during sexual intercourse. However, to identify frenulum breve is simply just pulling down the foreskin completely and record the reaction of the patient if the patient feels tightness around the frenulum. The head of the penis will therefore be bent downwards when the foreskin is pulled.
This condition is also frequently misdiagnosed as phimosis ( a condition where the foreskin is unable to retract fully). For this condition, the only treatment is to have a full circumcision where else for frenulum breve, the short or tight frenulum would be the cause of the condition, therefore a full circumcision is not required. Since the symptoms for these two conditions are similarly related to each other, a full physical examination is performed by the doctor to properly diagnose the condition as well as the severity of the condition.
Treatments to frenulum breve.
A surgical procedure called Frenulectomy or Frenuloplasty is done by removing the tight band of tissue to release it from the surrounding tissue. Trial of different techniques such as the use of steroid creams or skin stretching exercise can also be considered. However, this technique has little benefits.
Conservative (non-surgical) method
This method includes the use of steroid creams or skin stretching exercise. The use of steroid cream increases the effect of stretching by creating the thinning of the skin for easier stretch but upon stopping to the cream, the frenulum would get thicker. For young patients, they would have difficulties to prolong abstinence from sexual activity and therefore would prefer to get a surgical intervention compared to a conservative approach.
This surgical method is called a Frenulectomy where the frenulum is cut and removed from the head of the penis. This procedure would take about 20-30mins under local anaesthesia. The stitched wound will be removed within a week because it takes about 1 week for the wound to heal and it is advised to avoid any sexual activity for 1 month to maximise the healing process. The goal for this procedure is to release the tightness of the tight frenulum and give an improved sexual pleasure without pain or bleeding.
Commonly Asked Questions
Can Frenulum Breve and its Problems Associated Problems Get Better By Themselves?
No, unfortunately frenulum breve will not get better on its own. Some doctors may suggest stretching exercises but the frenulum is a rather tough tissue that is not easily stretched, therefore, the patient will end up with frenulectomy procedure to treat these conditions.
Is Frenulectomy Painful?
For men who have undergone this procedure, it is usually described as virtually painless since the patient will be under a local anesthesia prior to performing the frenulectomy.
If I Am Uncircumcised, How Will Frenulectomy Affect My Foreskin?
Frenulectomy does not affect your foreskin and you will remain uncircumcised. Frenulectomy only involves releasing the tight band of tissue underneath the penis and your foreskin will be preserved. However, circumcision can be done together with the frenulectomy procedure.
What Are The Risks Of Frenulectomy?
- Swelling and bruising at the site of the procedure
- Infection requiring antibiotics
- Bleeding (usually mild)
- Scarring at the site of the operation
- Lightheadedness after the procedure.
- Suboptimal cosmetic or functional effect requiring a second procedure
- Meatal stenosis (rare)
- Chronic pain at the site of the surgery (rare)
How Long Does The Recovery Take?
Recovery from penile frenulectomy is fairly fast and painless. Most men are able to return to office work the next day. If your work requires heavy or physical activity, you may need a few days off.
When Can I Have Sex Again After Frenulectomy?
We generally recommend no sex for at least 2-4 weeks to allow the surgical site to heal optimally and sutures, if required at the time of the procedure, to dissolve.
How Will Frenulectomy Affect My Sex Life?
After a frenulectomy, sex should becomes more pleasurable due to less pain and worry from tearing and bleeding as the tight band has been released.