Frenulectomy, or Frenectomy, is quite a non-invasive, brief, outpatient procedure that takes only about 20 minutes, and is virtually pain free with local anesthetic. Essentially, it is the removal the tight or short bit of elastic skin called the frenulum, between the shaft of the penis, under where the foreskin would be in both circumcised and uncircumcised adult males. A frenulectomy can be combined with an adult circumcision as well if desired. It can also be done to fix abnormalities such as Frenulum Breve, which causes pain and often bleeding during sexual activity. For other men, if the frenulum is wide and firm, it doesn’t break, but causes a sensation od painful grip when erect, resulting at times to premature ejaculations, which is more rare but also treated with a frenulectomy.
If the frenulum is too tight or short, it tugs on the glans (head of the penis) and can restrict the foreskin from stretching fully. This can cause pain, bleeding, or both during intercourse. Such a bleed calls for immediate tentativeness to control and prohibit the bleeding with usually dissolvable stitches, although not all frenulectomies require stitches. If the frenulum is abnormally wide, it constitutes absorbable stiches.
Frenulectomy Vs Circumcision
It is important to note that the correction is a short frenulum or Frenulum Breve, is even more of a minor surgery than an adult circumcision, and not to be nervous about, especially considering its health benefits. An uncorrected short frenulum, causes pain and uncontrollable bleeding during coitus, and even sometimes morning erections. The bleeding would be deemed as a need to stop what you are in the middle of, and get to an Urgent Care immediately, which would be often and unpleasant.
The Surgical Procedure
There are several terms to describe this procedure, including frenulum lengthening, plasty of the frenulum, and frenulumectomy. The technique is quite straight forward and brief. Simply the frenulum is cut out and dissolvable stitches may be applied. A dressing is applied for the first few days and special care instructions will be provided. The surgery occurs under local anesthesia via syringe. As a results, it is virtually pain free. The following days after the procedure, if at all pain is experienced, you will be given a brief as-needed only non-addictive medication regimen such as Tylenol extra strength. The surgery fixes the problem conclusively.
At our clinic, we offer a complimentary no-obligation consultation with Dr. Tahmoures Bahrami to consult about frenulectomy procedures for those who are medically cleared and in good health for small surgery. If you have any questions or wish to get a second opinion with us, please don’t hesitate to call. In fact, feel free to call us at 905-475-2506 Monday to Friday 9am -5 pm or leave us an after hour message to return your call shortly. Dr. Bahrami, CCFP is a board certified Family Physician of Ontario with years of experience in vasectomies, pediatric and adult circumcision, as well as adult frenulectomies. He successfully manages Toronto Safe Circumcision with 20 years of continued expertise in this field (www.torontosafecircumcision.com).
What is the Frenulum of the Penis?
Frenulum of the penis connects the foreskin to the glans penis and the long shaft region. Generally speaking, the frenulum is located on the ventral or underneath portion of the penis. Some men are born with a hereditary or naturally occurring congenitally short and tight frenulum, causing pain and often bleeding when their penis is erect or during intercourse.
What Could Happen If Left Untreated?
When the frenulum is tight and short, an erection can cause tension of the frenulum leading to pain and bleeding, as blood pools into the penis with high pressure at this time. Not only is it a destructive situation when the bleeding and pain doesn’t stop on its own, but over time, pressure on a tight frenulum leads to an overcompensated, bent penis. Thus, a Frenulum Breve could turn into a penis with a permanent curvature to the right, left or downward.
What Are The Risks of A Frenulectomy?
Bleeding (usually mild, treatable): 1 / 100
Scarring at the site of the operation (minimal, lessens): 1 / 100
Swelling and bruising at the site of the procedure (time heals this): 1 / 100
Suboptimal cosmetic or functional effect requiring a second procedure: 1 / 100
Vasovagal reaction causing light-headedness after the procedure (treatable): 1 / 200
Meatal Stenosis due to injury to the Frenular Artery requiring a Meatotomy (treatable, rare): 1- /500
Chronic pain at the site of the surgery (treatable) 1 / 500
Infection requiring antibiotics (treatable): 1 / 500
Treatment Options for Short Frenulum
A number of treatment options are available for short frenulum. These include:
- Circumcision plus a Frenulectomy (all done at one time)
- Just Frenulectomy (other names: Frenuloplasty or Frenectomy)
How Long Does The Frenulectomy Take?
It can be performed in an outpatient clinic setting under local anesthesia. The procedure takes about 20 minutes to perform. Anesthesia is injected about 20 minutes prior to beginning. Please expect to reserve an hour for the entire process of filling out medical paperwork and so on.
When Can I Resume Sex?
After a frenulectomy, you are advised to refrain from sexual activity for a minimum of 3 weeks until the tissue heals completely.
Can It Go Away On Its Own?
Unfortunately, a short frenulum does not get better on its own. It either stays about the same or worsens, as described in details above. Usually fernulectomy is necessary to remove it.
Can we detect this problem in children?
This abnormality can sometime be detected in children during spontaneous erections. It is possible to treat it preventively before puberty. Otherwise, it is up to the teenager or young adult to refer to a specialist. Although it may be embarrassing to do so at that age, we prefer to talk about its advantages than its disadvantages. Do not hesitate to refer to a specialist. It is common urological problem and the treatment is rather simple.
The procedure requires simply braking the frenulum with the aid of a surgical knife. Sometimes, excision of the edges of the frenulum is necessary for a more aesthetically pleasing result. Otherwise, there may be a slight undesirable growth on the glans and the foreskin.
Post – Operative Care
Apply polysporine ointment (green label) four times a day for 3 weeks in order to reduce the risk of sticking. Postoperative bleeding may occasionally occur within one week after surgery, especially after a strong erection. In which case, obtain and use a compressive bandage in those instances.
Are The Risks of Frenulectomies the Same as Other Surgical Procedures? Yes
- Bleeding (rare)
- Infection (rare)
- Scarring (minimal, if any)