Plastics of the frenulum of the penis

A healthy, correctly folded penis has always been the pride of a self-respecting man, because in many ways thanks to this body he has success with the female. But, alas, not everyone can boast of the ideal size and structure of the penis. Quite often the problem is a small strip of living tissue that connects the glans penis and foreskin. This part of the penis is called a bridle, and operations to correct its deficiencies are united by a common name - the plastic of the penis frenulum.

[1]

Indications for the procedure

To begin with, the longitudinal skin fold that connects the foreskin and the glans penis plays an important role in erectile function. During erection, she acts as a regulator of the movement of the foreskin relative to the head of the penis, therefore, when it increases, the foreskin is displaced to the base to a certain position, while the head of the organ is exposed.

But that is not all. The rigidity of the penile frenulum with a large number of receptors allows a man to experience strong sexual arousal. It is clear that the soreness of this part of the body leads to a decrease in sexual function.

Insufficient size of the frenulum is considered a fairly common congenital pathology (about 5% of newborn males). In most cases, there is also a contraction of the foreskin, which is called phimosis by medical language.

Nevertheless, in some young people, pathology can occur during puberty due to accelerated disproportionate growth of different parts of the body. Eliminate a young man or an adult man from discomfort and psychological trauma in this case will help the plastic short frenulum of the penis (it is in the scientific frenulotomy), which can be carried out in various ways.

Changes in the shape and size of the penile frenulum can be either an anatomical feature or result of exposure to adverse factors. These factors include mechanical injuries and injuries of the penis, some diseases that alter the structure of the tissue and cause its deformation, previously performed operations on the penis, including circumcision.

A short frenulum of the penis can be the result of a postoperative complication of the inflammatory plan if the patient has already undergone plastic surgery on the foreskin. A similar complication can be observed after the circumcision procedure practiced by some nationalities. The size of the bridle in this case decreases due to the formation of constrictive scar tissue.

Such pathology as phimosis, quite often occurs in childhood. To prevent the head of the penis from being squeezed by the deformed tissue of the prepuce and the development of the inflammatory process, a relatively simple plastic operation for excising or cutting the foreskin can be carried out even in early childhood. Sometimes such early operations lead to the fact that even during puberty, a defect such as a short frenum of the male organ is detected, which requires repeated surgical intervention.

As a result of mechanical injuries, the integrity of the skin fold (for example, its rupture) and its elastic properties can be disturbed, since the areas of scar tissue, rough, inelastic, and therefore prone to repeated cracking, often remain during healing.

Under the trauma of the penis most often understand the rupture of the bridle during a violent sexual intercourse (especially with elements of cruelty). However, even squeezing and rubbing the penis with close clothing can harm the organ, causing tissue regeneration (sometimes for this reason, the flesh of the foreskin and the male organ head are fused).

To pathologies that cause deformation of the tissues of the penile frenulum, it is possible to relate:

• Balanitis is an inflammation of the glans penis, which adversely affects the condition of the foreskin and frenulum, causing increased vulnerability.
• Balanoposthitis is a pathology in which the inflammation covers not only the head of the penis, but also the foreskin. Very often occurs against the background of phimosis and paraphimosis (narrowing of the tissues of the foreskin due to cicatricial changes in them and squeezing the skin of the penis altered by the skin).

These pathologies occur in 25% of boys up to 5 years of age and in 11% of adult men.

• Diabetes mellitus is a pathology of metabolism, which in itself becomes a frequent cause of the diseases described above. In addition, this disease significantly worsens the condition of blood vessels, which pierce almost all areas of the body, which means that the tension of the skin fold can lead to rupture of the capillaries, which will negatively affect the elasticity of the tissues.

It is clear that pathologies affecting the penis frenulum, including anatomical defects, are often accompanied by painful sensations that bring certain discomfort to the life of a man, depriving him of full sexual pleasure and not only.

For example, during intercourse, a rupture of the bridle tissue may occur due to excessive tension. In this case, a man in addition to acute pain can suffer from bleeding, which is not always easy to stop. And how much will the male pride suffer, if in the middle of the sexual intercourse the man will have to immediately stop and rush to the hospital for help to the organ damaged in such conditions. This is not only physical, but also psychological trauma.

However, if nothing is done, dangerous consequences are possible, for example, severe blood loss or complications in the healing of tissues at the site of the rupture. A moist environment in the penis, mobility of the organ tissues and traumatizing it when in contact with the laundry usually becomes an obstacle to a timely and uncomplicated tightening of the wound. In the area of rupture, inflammatory processes can begin, and long-term healing of lesions leads to the formation of a rough tissue (scar), which is especially prone to tearing under tension.

This moment is an occasion to call a specialist not only about the treatment of a wound, but also in connection with the prevention of such a thing in the future, which is quite feasible with the help of plasty of the penis frenulum.

In principle, you can do with the usual operation, i.e. Sew the fabric at the point of rupture, however, a positive result in this case is not guaranteed. The tissue at the point of splitting the gap will still be weaker, which means that the probability of a repeated rupture is still great. In addition, scar tissue, formed on the site of the wound, is abundantly supplied with nerve endings and is more sensitive to touching. This is the reason that the ejaculation of a man occurs at the beginning of the sexual act after a couple of active movements that cause the friction of the male organ about the genital tissues of the partner or even from a gentle touch to the penis.

And one more important point. A short frenum of the penis can become a factor provoking the development of erectile dysfunction, in particular impotence (male sex begins to be associated with pain, not with pleasure), psychological trauma (for example, a man begins to experience fear of sexual contact, afraid to disappoint a partner or disgraced before friends). Blame for everything will be premature ejaculation, which comes as a result of a strong pull on the bridle. After all, this small skin fold is a particularly sensitive part of the penis. Her irritation with tension causes an early orgasm in the man and all the consequences resulting from this (for example, male infertility).

So, let's sum up the subtotal. In connection with the above, indications for the plastic surgery of the penis frenum can be considered:

• too short a bridle in relation to other parts of a genital organ,
• the rupture of the skin fold that connects the head and the foreskin,
• such pathology as phimosis and its consequence of paraphimosis,
• The pathology of the frenulum, accompanied by early ejaculation,
• the presence on the bridle of cicatricial structures that violate its elasticity and functionality.

It is worth noting that such problems do not occur in men who have undergone a procedure of circumcision, in the process of which the bridle of the penis is cut. This ceremony can be considered a kind of plastic surgery on the penis, relieving men of many problems, if it is performed correctly and proper care was provided for the organ damaged as a result of the procedure.

[2]

Preparation

About what contraindications are surgical intervention, we were not talking in vain, because the account of these moments is considered the most important stage in the preparation for the plastic frenulum penis. Not always the patient is sufficiently informed about his pathologies, so the task of a urologist is to study anamnesis and a comprehensive examination of a man with a bridle pathology.

After examining the male organ and making a decision about the need for surgery, the doctor asks the patient about his state of health, clarifies suspicious symptoms. If there is an inflammatory pathology of the genitourinary system, the urologist prescribes effective treatment, and only after recovering or achieving a stable remission can the date of the operation be stipulated.

The operation is by no means carried out if the acute inflammation is observed directly on the penis, as is the case with balanitis or balanoposthitis. Treatment of such inflammation can also be considered a preparation for the operation.

To determine infectious pathologies, which often manifests itself in the form of chronic inflammation of the urogenital system, a blood test is carried out for infectious agents, especially those that are sexually transmitted, including an HIV test. Additionally, an overall urine test is administered.

Since surgical intervention is always associated with a risk of bleeding, it is mandatory to test blood for clotting. Such data the doctor has on the basis of the general analysis of blood and coagulogram.

During the preparation for the operation and the delivery of the tests, the doctor is recommended to clearly explain to the patient the need for the operation, the procedure and time, the moments associated with the postoperative period. The patient should know how long he will stay in the hospital in order to warn his relatives in advance, and also to specify with them the time of visit and the particular care.

The date and cost of the operation should be announced in advance so that there are no misunderstandings in the process. The date of the operation can be changed if the patient's condition on the appointed day is unsatisfactory. For example, there is an increase in temperature, with a high probability indicating the onset inflammatory process.

Shortly before the surgery, a skin test for the tolerability of anesthesia is carried out, because even local administration of anesthetics can cause violent allergic reactions or complications of kidney pathologies. Since the anesthesia is transferred by patients in different ways, it is advisable not to eat before the operation, but to limit yourself to light food on the eve.

A few days before the operation, it is better for the patient to limit physical activity, and to refuse from intimacy at all.

A doctor who will perform plastic surgery and anesthesia should be aware of the patient's cardiovascular and respiratory pathologies, as well as of liver and kidney diseases.

[3], [4], [5]

Technique of the plastics of the frenulum of the penis

Plastic surgery of the penis frenum has long been considered an ordinary urological operation, which is not particularly difficult. Nevertheless, not every man is ready to put his "tool" on the surgeon's table because of fears that the operation can affect sexual activity or cause difficulties with urination. Yes, there to say, the very word "hospital" causes on the face of most men a contemptuous grimace.

Although, in principle, the problem as such is not here. The operation is uncomplicated, the experience of surgeons is sufficient. Yes, and lasts a plastic procedure in just 15-20 minutes. It is carried out mainly with the use of local anesthesia (only the penile region is anesthetized), but at the request of the patient and some indications (for example, the age is under 18 years), a variant of general anesthesia is possible. Usually 2 hours after the operation a man can safely return home.

The operation to correct defects of the penis frenulum is called frenulotomy, and it gives almost an absolute guarantee that in the future the patient will not have problems in sexual life associated with impaired motor activity of the tissues of the male organ. In the case of phimosis, in parallel with the plastic of the bridle, circumcision of the foreskin is made, making it difficult to release the head of the penis. Since the operation is performed under sterile conditions, and the patient can monitor the course of the operation and his condition, without experiencing pain, complications are extremely rare.

The operation can be carried out in two ways:

• The classical method involves the use of the usual surgical instrument - the scalpel. Most surgeons and patients still prefer this method, despite the fact that when choosing it, there is always a risk of bleeding and getting into the wound infection (which happens, however, infrequently).
• The modern method is the plastic of a bridle with the use of a laser, which has proved itself well during many operations on the tissues of the body.

Each of the methods has its advantages and disadvantages, therefore before choosing the procedure for conducting the operation, it is necessary to really assess all the risks and possible result.

The classical method of plasty, of course, is associated with painful sensations and some blood loss, because after the dissection of the bridle tissue, it takes time to bandage the damaged vessels and apply seams. In addition, sterility at some stage may be impaired, which creates favorable conditions for infection of the wound. However, despite this, the method is considered quite reliable in the sense that the fabrics in the seam are reliably protected from divergence.

Laser correction of the penis frenulum is practically painless procedure, excluding infection in the open wound and blood loss. After the tissue cut by the laser beam, which heats them to a temperature of 400 ^to C and thus instantly cauterize vessels while preventing bleeding, and infection.

This method provides healing of damaged tissues without complications in a short time. Places of tissue connection after a time become almost invisible, in their place scar tissue is not formed.

Nevertheless, laser spike is rather unreliable and requires additional fixation in the postoperative period, because the penile tissue can not stay in the static position for a long time, especially for a man with a healthy sexual appetite. Even in the absence of sex, erectile dysfunction associated with an increase in the size of the penis and the tension of the bridle is often very difficult, and this threatens the divergence of the sutures. After complete healing of the wound, tissue rupture is no longer threatened.

Methods of carrying out frenum plasty

Since the defects of the penile frenulum can differ and, moreover, have accompanying pathologies that also require surgical intervention (most often phimosis), the organ's plastic in each particular case may differ somewhat in technique. Most often surgeons have to face a short bridle or its rupture.

In young patients, often simultaneously with the problem of a short frenulum, compression of the tissues of the foreskin, which complicates the release of the glans penis, is also observed. In this case, two operations are performed simultaneously: correction of the frenum and circumcision of the prepuce.

Let's consider some of the most popular varieties of surgical treatment of frenum defects and the stages of the operation.

Correction of rupture of the bridle

Inadequate length of the skin fold, connecting the glans penis and the foreskin, can cause tissue rupture during too active sex. It must be said that not all men are in a hurry with a similar problem to the hospital, experiencing a certain psychological discomfort. And very vain. The wound, of course, will sooner or later heal, but in its place can remain a rough scar, which later will cause a repeated rupture of the bridle. And it is good if the wound healing will pass without special complications, otherwise it can cause inflammatory processes in the field of "male dignity".

It is best to solve the problem of rupture of the penis frenulum in hospital conditions, especially since the operation is performed on an outpatient basis, and after it the patient returns home, staying in the hospital for only 1-2 hours. If there was a rupture of the bridle of the penis, do not hesitate. Applying a pressure bandage to the area of the wound to reduce blood loss, you must immediately go to the urologist or directly to the hospital.

After passing the necessary tests, examining the wound and treating its edges with an antiseptic, the doctor makes tissue suturing, after which an antiseptic dressing is applied to prevent getting into a fresh infection wound. In addition, the patient is prescribed medicines that will speed up the regeneration of tissue in the wound area and will prevent the infection from spreading and spreading.

Surgical treatment of short frenulum

The operation is performed both on the intact organ, and on the bridle, which was previously subjected to ruptures. In the first case, only the transverse dissection of the bridle tissues is carried out, in the second case, the parts of the embossed tissue and neoplasms (not malignant ones) are removed additionally at the site of the ruptures.

After the incision is made, measures are taken to stop the bleeding. To this end, the vessels tie up or coagulate (burn) the edges of the wound. If the operation is performed by a laser, additional moxibustion is usually not required.

After the bleeding is stopped and the wound is treated with an antiseptic, the wound is stitched in the longitudinal direction using a thin bobbin thread.

Elongation of the frenulum of the penis

This is also a surgical operation, in which the incision and seam have a certain shape, due to which the length of the bridle can be increased by approximately 10-12 mm. The cut in this operation has the form of the letter V, and the suturing is carried out in the form of the letter Y. The amount by which the penis of the penis will be enlarged depends on the depth of the incision and the length of the seam (the lower part of the letter Y).

Frenectomy

This is a conservative form of plasty of the penile frenulum, which is used in the case of the impossibility of other types of surgery due to the poor condition of the skin fold. In fact, this is the removal of the fold itself, which was previously repeatedly fractured, so that its tissues finally lost elasticity, covered with a multitude of scars. This bridle is no longer able to perform its functions normally and is the cause of soreness during intercourse and other male frustrations. In this case, the skin fold is removed, and the wound site is sewn with threads.

Contraindications to the procedure

Plastic surgery of the penis frenulum is not a cosmetic procedure, but a real surgical operation that is performed under anesthesia. And like any operation, it, of course, has its contraindications, which can not be ignored, because they usually lead to complications.

Since the male organ belongs to both the urinary tract and the reproductive system of the body, any inflammatory processes in these systems make plastic surgery on the organ impossible. First, you have to remove the inflammation, and then prepare for an operation to dissect or lengthen the frenulum of the penis.

The operation is not performed during exacerbation of chronic pathologies. First, a persistent remission of the disease is achieved, and then there is already talk of surgical intervention.

Contraindication to the procedure is also the presence in the body of an infectious factor, especially sexually transmitted infections (STIs), to combat which use antibiotics. And only a complete irradiation of the infectious pathogen will make it possible to perform a surgical operation without complications.

The frenulum is not made in the presence of severe viral infection (eg, HIV or hepatitis), with clotting disorders (great risk of hard-to-stop bleeding), malignant neoplasms, intolerance to anesthetics (as a result of individual characteristics of the organism or some pathologies, for example, allergies or acute renal failure ).

[6], [7]

Consequences after the procedure

Frenuloplasty is not just a surgical operation, but in some way a cosmetic procedure. Rough scars from the rupture of the bridle tissues do not look very aesthetic, let alone the danger of infection. The plasticity of the penis frenum helps not only to solve sexual problems, but also to keep the attractiveness of "male dignity", so it is so important that the operation is performed by an experienced surgeon with sufficient experience in this direction.

It is better, of course, to consult a surgeon before the onset of unpleasant consequences in the form of a short bridle rupture, the onset of the inflammation in the penis, multiple unsuccessful attempts to acquire offspring resulting in severe psychological trauma and other embarrassing situations. Plastic short frenum in this case is carried out in a short time and passes mostly without complications. The only consequence after the procedure is a short soreness at the site of the incision, redness and swelling, which, with due care, quickly disappear.

The unattractive appearance of the operated penis and the need to refrain from sexual intercourse in the first weeks after the operation is considered a temporary phenomenon, but what is the result! After the postoperative period, the male member already looks pretty decent, and the patient gets the opportunity to live a full sexual life.

If the operation was performed under general anesthesia, during the first minutes of the return of consciousness nausea and vomiting are possible. Further during the day, the patient may experience dizziness, absent-mindedness, disorientation.

The results of frenulotomy after removal of scar tissue may not look so attractive, however, the result will be the same - a happy sex life without a passion for rupture of the bridle, pain or premature ejaculation.

It happens that the patient does not like the appearance of the genitals after the operation, but this moment should be discussed with him even before the operation. Yes, the bridle will look different (but it's inevitable), but its functionality will increase.

It's another matter if the question is whether the surgeon is incompetent or inaccurate (sloppy incisions or stitches, infection during surgery, etc.), resulting in the appearance of the organ. In this case, all claims must be addressed to the surgeon and his immediate superiors. Although often patients themselves become the perpetrators of their problems, if they do not comply with the requirements for care of the body in the postoperative period.

[8]

Complications after the procedure

If the plastic of the penile frenulum has been carried out under sterile conditions in accordance with the requirements for surgery, complications after it have not been observed. Painful sensations, hyperemia and edema of the tissues pass fairly quickly, and the man simply forgets them.

Complications after the procedure can be associated with either infection of the wound during the operation, or with non-compliance with the requirements for caring for sexual members in the postoperative period. In this case, there may be: severe soreness of the wound for a long time (more than 2 weeks), severe swelling of the organ, suppuration of the wound at the site of the incision and suture.

In rare cases, the wound may begin to bleed again due to the weakness of the vessel walls or due to insufficient prevention of bleeding.

Infection of the wound during surgery or during the postoperative period can be prevented if you take antibiotics and use aseptic dressings as directed by your doctor. Otherwise, prolonged healing of the wound will result in the formation of a rough scar tissue at the cut site, which is considered weak due to its inelasticity, and does not look aesthetically pleasing.

In addition, infection from the wound can spread to other tissues of the genital organ or enter the body where it will be carried by the blood stream, and this is even more serious complications than soreness and unattractive appearance.

Another complication after laser plasty may be the divergence of the joints, which are connected only by high temperature without the use of threads that fix the edges of the wound. This complication can be avoided by providing additional fixation of the wound and ensuring the control of erectile function in the postoperative period.

[9], [10]

Care after the procedure

In spite of the fact that the patient can leave the hospital after plastics of the penis bridle after a couple of hours, for some time he will have to take care of his "dignity". As with any surgical intervention with a violation of the integrity of tissues, after frenulotomy, there is a rehabilitation period with special care for the injured organ. In this case, this period lasts about 1 month, although the patient can feel some discomfort and soreness even after this time has passed.

Both before surgery and after it, doctors strongly recommend to reduce motor activity. In the early days, preference is given to bed rest, because the location of the male organ is such that even walking can be a traumatic factor for him, not to mention rubbing sensitive fabrics with linen.

By the way, at desire the patient after operation can remain for some days in clinic where to him the corresponding leaving will be provided. If a man leaves the clinic immediately, it is desirable that someone met him, helped to reach the car and brought home.

After the operation on the wound, an antiseptic bandage is applied to the patient, which will protect it from infection. The bandage can be removed after 12 hours, treat the wound with antibacterial ointment prescribed by the doctor, and apply a sterile tissue. It is important to strictly follow the doctor's prescriptions, applying all the prescribed medications, this is the only way to speed up the recovery process.

Upon agreement with the physician, alternative agents with anti-inflammatory properties and improving tissue regeneration can be used. To such means can be attributed the infusion of calendula and chamomile, decoction of oak bark. They are used to treat wounds and lotions.

To wet a penis at bathing is not recommended. You should forget about the bath for at least a week, and you can take a shower, protecting the body from water using a condom.

After resorption and dropping of surgical threads in place of the seam, you can see crusts and blisters. In no event can you delete them yourself. Over time, they will disappear themselves, without any consequences.

Small physical exertion is allowed no earlier than two weeks after surgery, and resumption of sex life doctors are allowed, usually after 3 weeks of abstinence. Everything depends on the condition of the wound and the speed of its healing.

Obligatory during the entire rehabilitation period and after it are considered the observance of personal hygiene and frequent changes of linen. Dirty underwear is one of the sources of infection, and therefore its wearing is unacceptable. It is better to use free linen from natural fabrics, which will not squeeze the penis and provide air access to the body. Synthetics can create a greenhouse effect, which will only slow the process of scarring the wound.

As soon as the doctor allows you to wet the penis, you can take care of it with water and natural soap, not forgetting about the infusions of medicinal herbs.

When the wound is fully tightened, it is recommended to lubricate the seam with lubricants. They will reduce friction during intercourse, which means that tender scar tissue will not be injured.

Plastic surgery of the penis frenulum is not a whim of doctors wishing to earn more money, but a harsh necessity that preserves the physical and mental health of a man. Therefore, if there is such a problem as a short frenulum of the penis with the consequent circumstances, its pride and bias should be put aside, for in a short period of time an experienced surgeon can easily correct the situation and the man will no longer suffer from pain, sex is only pleasure.