Frenulectomy of the penis is a surgical procedure for cutting and removal of the penile frenulum, to correct a condition known as frenulum breve. This condition prevents the full retraction of the foreskin with or without an erection. Most forms of circumcision also involve partial or complete removal of the frenulum. Alternative treatments for frenulum breve include stretching routines, steroid creams, frenulotomy(splitting the frenulum), and frenuplasty(restructuring the frenulum).
It is a simple and normally painless procedure that is performed in a urologist's office. First the physician applies a local anesthetic, such as lidocaine/prilocaine cream on the frenulum and surrounding area. If the patient retains any feeling there after the anesthetic has had time to take effect, the physician may recommend that the procedure be performed in a hospital, with stronger anesthesia. Anesthesia is required because of the extensive and complex nerve structure of the frenulum, more advanced anesthesia called a ring-block, a type of nerve block can be used.
Following the excision of the frenulum, the surgeon typically closes the wound using absorbable sutures, which dissolve on their own over two to four weeks. Post-operative discomfort is generally mild and can be managed with standard oral analgesics. To ensure optimal healing and prevent wound dehiscence, urological guidelines advise patients to abstain from sexual activity and masturbation for a minimum of four to six weeks.
The penile frenulum is a highly innervated structure containing a dense network of mechanoreceptive nerve fibers. For men who require the surgery to treat symptomatic frenulum breveâÂÂa condition that causes tearing, bleeding, and severe pain during intercourse (dyspareunia)âÂÂclinical studies report high rates of post-operative sexual satisfaction. In these cases, the relief of mechanical tension and the elimination of pain generally improve overall sexual function and comfort, outweighing the localized sensory alteration.