Penile frenuloplasty consists of lengthening the frenulum of the penis (penile frenulum or preputial frenulum or even "fillet" of the penis). It is often performed in conjunction with circumcision.
The frenulum of the penis is the flap of skin that connects the foreskin to the glans (the head of the penis). It is a "V" located in the ventral part of the penis (the part facing the body). It is heavily supplied with blood and contains numerous nerve endings, making it susceptible. The function of the frenulum is to prevent the foreskin, the flap of skin that covers the glans penis, from sliding excessively when the penis is erect. If the frenulum is too short, it does not allow the foreskin to slide correctly over the glans; this anomaly, called the short frenulum, and its problems are described in greater detail in the content dedicated to the topic.
Frenuloplasty: how is it performed, and when is it needed?
Frenuloplasty is used when the short frenulum causes discomfort to the patient. In the presence of a short frenulum, the patient may feel discomfort or pain when the penis is erect. The traction exerted by this skin flap can cause the erect penis to curve downwards and be an obstacle to sexual intercourse. When the frenulum rubs against itself during sexual activity or masturbation, it can become inflamed or even break. This causes a lot of pain and bleeding, which can significantly affect the patient's emotions.
Some specialists believe that the short frenulum may play a role in premature ejaculation as the feeling of discomfort and traction could lead the patient to anticipate the end of the relationship. The short frenulum, hindering the movements of the foreskin, makes intimate hygiene more complex and can increase the risk of infections. Frenuloplasty is also helpful for people with a short frenulum that didn't start that way but was caused by scarring after a frenulum broke.
Frenuloplasty surgery is performed in a day hospital. Before the surgery, the patient will undergo some preoperative tests (blood tests, electrocardiogram, and visits with the anaesthetist). On the day of the surgery, the patient must have been fasting for at least 8 hours; this is because, as with all surgeries, even if local anaesthesia is planned, it is always possible that general anaesthesia becomes necessary, which becomes very risky if the patient has food in the stomach. Most of the time, the patient has to pay for hair removal in the genital area (groin and scrotum) before being admitted.
The operation does not require general anaesthesia but is performed with only local anaesthesia by applying an anaesthetic cream or injecting the drug into the part after disinfecting it. If the patient is particularly anxious, mild sedation can be used. The doctor cuts the frenulum (frenulotomy) with scissors, a scalpel, or a laser and then applies sutures in the longitudinal direction to reshape the frenulum, lengthening it.
Depending on the circumstances, the incision can be transverse, "Z" or "Y". Stitches made of resorbable material are used, which fall off on their own in about ten days. The dressing is then performed, and after a short observation period, the patient is discharged. It is a very short intervention, around 30 minutes. After the surgery, the penis is more elongated, but it is so only in appearance.
What are the risks associated with frenuloplasty?
Frenuloplasty is a safe procedure that rarely gives rise to complications such as infections or bleeding. After frenuloplasty, the patient may experience an annoying or painful sensation in the penis once the effect of the anaesthesia is exhausted, which resolves within 1-2 days. The part may be a little swollen for a few days. It is best to avoid physical exertion in the first weeks after surgery.
The patient needs to stop all sexual activity (making love and masturbating) for about a month to let the wound heal and keep from getting an ugly scar that could make it hard to get an erection.