Frenuloplasty

Some boys are born with a short penile frenulum which is a tissue band that connects the back of the urethral meatus at the tip of the penis. It also connects the head of the penis  (called the glans penis) to the far end of the penile shaft and the foreskin.  Sometimes, strenuous activities like vigorous masturbation or partner sex, or riding a bike can pull on the foreskin and the frenulum which results in micro-tears in this skin band and scarring which further shortens this tissue band.  Over time, the frenulum can get so short and fragile that any pull can result in severe pain or an even bigger tear which will cause excessive bleeding.

What Happens When the frenulum tears?

When the frenulum tears, typically there is pain and excessive bleeding.  But there is no cause for panic- simply wash the area with water and apply tight pressure with a clean cloth or small gauze.  You need to hold pressure for at least 10 minutes to assure the bleeding has stopped.  At that point, it is best to apply some first aid antibiotic ointment such as Bacitracin ointment and apply a bandage.   If the bleeding should continue and soaks the bandages or the gauze, you need to seek medical attention.

What are the best treatments for short Frenulum?

There are two treatment options for a short frenulum.  The first is a simple frenotomy and the second option is a frenuloplasty.

What is the Frenulotomy procedure?

The Frenulotomy procedure is an office procedure that is performed under local anesthesia.  During this procedure, the frenulum is cut and both ends are tied off with absorbable sutures.  Over time, the tied ends fall off and the frenulum will disappear.

What is the Frenuloplasty procedure?

The frenuloplasty procedure is also an office procedure which is usually done under local anesthesia or a penile block.  During this procedure, the frenulum is transected in the middle, the excess tissue is trimmed off and the suture is placed in the opposite direction to prolong the length of the frenulum.  The cosmetic difference between a frenotomy and frenuloplasty is that with a frenotomy, the patient will lose the frenulum altogether while with a frenuloplasty, the frenulum, which has been lengthened, remains.