Penile frenulum plasty

A healthy, properly shaped penis has always been a source of pride for a self-respecting man, because it is largely thanks to this organ that he is successful with the female sex. But, alas, not everyone can boast of an ideal size and structure of the penis. Quite often, the problem lies in a small strip of living tissue that connects the head of the penis and the foreskin. This part of the penis is called the frenulum, and operations to correct its defects are united by a common name - plastic surgery of the frenulum of the penis.

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Indications for the procedure

Let's start with the fact that the longitudinal skin fold that connects the foreskin and the head of the penis plays an important role in erectile function. During an erection, it acts as a regulator of the movement of the foreskin relative to the head of the penis, so when it increases, the foreskin shifts to the base to a certain position, and the head of the organ is exposed.

But that's not all. The frenulum of the penis is equipped with a large number of receptors, allowing 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 of the penis is considered a fairly common congenital pathology (about 5% of male newborns). In most cases, there is also a contraction of the foreskin, which in medical language is called phimosis.

However, some young people may develop pathology during puberty due to accelerated disproportionate growth of different parts of the organ. In this case, plastic surgery of the short frenulum of the penis (scientifically known as frenulotomy) can help relieve a young man or an adult man from discomfort and psychological trauma. It can be performed in various ways.

Changes in the shape and size of the frenulum of the penis can be both an anatomical feature and a result of exposure to unfavorable factors. Such factors include mechanical damage and trauma to the penis, some diseases that change the structure of the tissue and cause its deformation, previous operations on the penis, including circumcision.

A short frenulum of the penis may be the result of a postoperative inflammatory complication if the patient has already undergone plastic surgery on the foreskin. A similar complication may also be observed after the circumcision procedure, which is practiced by some peoples. In this case, the frenulum size decreases due to the formation of constricting scar tissue.

Such a pathology as phimosis is quite common in childhood. In order to prevent the compression of the head of the penis by deformed tissue of the foreskin and the development of an inflammatory process, a relatively simple plastic surgery to excise or circumcise the foreskin can be performed even in early childhood. Sometimes such early operations lead to the fact that already during puberty such a defect as a short frenulum of the male organ is discovered, 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 may be disrupted, since during healing, areas of scar tissue most often remain, which are rough, inelastic, and therefore prone to repeated cracking.

Penile trauma is most often understood as a rupture of the frenulum during violent sexual intercourse (especially with elements of cruelty). However, even squeezing and rubbing the penis with tight clothing can harm the organ, causing tissue regeneration (sometimes for this reason, the foreskin and the head of the male organ fuse).

Pathologies that cause deformation of the tissues of the frenulum of the penis include:

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

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

• Diabetes mellitus is a metabolic pathology, which in itself often becomes the cause of the above-described diseases. In addition, this disease significantly worsens the condition of the blood vessels, which penetrate almost all parts of the body, which means that tension in 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 frenulum of the penis, including anatomical defects, are most often accompanied by painful sensations that bring a certain discomfort to a man’s life, depriving him of full sexual pleasure and more.

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

However, if nothing is done, dangerous consequences are possible, such as severe blood loss or complications with tissue healing at the site of the rupture. The moist environment in the penis area, the mobility of the organ tissues and its injury when in contact with underwear usually become an obstacle to timely and uncomplicated wound healing. Inflammatory processes can begin in the area of the rupture, and prolonged healing of damage causes the formation of rough tissue (scar), which is especially susceptible to ruptures under tension.

This moment is a reason to contact a specialist not only regarding the treatment of the wound, but also in connection with the prevention of such in the future, which is quite possible with the help of plastic surgery of the frenulum of the penis.

In principle, it is possible to get by with a regular operation, i.e. stitch up the tissue at the site of the rupture, but a positive result in this case is not guaranteed. The tissue at the site of the rupture will still be weaker, which means that the probability of a repeated rupture is still high. In addition, the scar tissue formed at the site of the wound is abundantly supplied with nerve endings and is more sensitive to touch. This is the reason why ejaculation in a man occurs at the beginning of sexual intercourse after a couple of active movements that cause friction of the male organ against the genital tissues of the partner or even from just one gentle touch to the penis.

And one more important point. A short frenulum of the penis can become a factor that provokes the development of erectile dysfunction, in particular, impotence (a man begins to associate sex with pain, not pleasure), psychological trauma (for example, a man begins to experience fear of sexual contact, afraid of disappointing his partner or embarrassing himself in front of friends). The culprit will be premature ejaculation, which occurs due to strong tension of the frenulum. After all, this small skin fold is a particularly sensitive part of the penis. Its irritation during tension causes early orgasm in a man and all the ensuing consequences (for example, male infertility).

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

• too short frenulum in relation to the rest of the genital organ,
• rupture of the skin fold connecting the head and foreskin,
• such a pathology as phimosis and its consequence paraphimosis,
• pathologies of the frenulum, accompanied by premature ejaculation,
• the presence of scar formations on the frenulum, which impair its elasticity and functionality.

It is worth noting that such problems do not arise in men who have undergone the circumcision procedure, during which the frenulum of the penis is also cut. This ritual can be considered a kind of plastic surgery on the penis, which relieves men of many problems if it is performed correctly and appropriate care is provided for the organ damaged as a result of the procedure.

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Preparation

It was not for nothing that we talked about contraindications for surgical intervention, because taking these points into account is considered the most important stage of preparation for plastic surgery of the frenulum of the penis. The patient is not always sufficiently informed about the pathologies he has, so the task of the urologist is to study the anamnesis and comprehensively examine a man with a frenulum pathology.

Having examined the male organ and made a decision on the need for surgery, the doctor asks the patient about his health, clarifies suspicious symptoms. If there is an inflammatory pathology of the genitourinary system, the urologist prescribes effective treatment, and only after recovery or achievement of stable remission can the date of the operation be discussed.

The operation is never performed if acute inflammation is observed directly on the penis, as is the case with balanitis or balanoposthitis. Treatment of such inflammation can also be considered preparation for the operation.

To determine infectious pathologies, which often manifest themselves in the form of chronic inflammation of the genitourinary system, a blood test is performed for pathogens, especially those that are sexually transmitted, including an HIV test. Additionally, a general urine test is prescribed.

Since surgical intervention is always associated with the risk of bleeding, a blood coagulation test is mandatory. The doctor has such data on the basis of a general blood test and a coagulogram.

During preparation for surgery and taking tests, the doctor is recommended to clearly explain to the patient the need for surgery, the method and time of its implementation, and the issues related to the postoperative period. The patient should know how long he will be in the hospital in order to warn his relatives in advance, as well as discuss with them the time of the visit and the specifics of care.

The date and cost of the operation should be announced in advance to avoid misunderstandings during 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, which most likely indicates the onset of an inflammatory process.

Shortly before the operation, a skin test is performed to determine the tolerance of anesthesia, because even local administration of anesthetics can cause severe allergic reactions or complications of renal pathologies. Since anesthesia is tolerated differently by patients, it is advisable not to eat before the operation, and limit yourself to light food the day before.

A few days before the operation, it is better for the patient to limit physical activity and avoid intimate relations altogether.

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

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Technique penile frenulum plasty

Frenuloplasty of the penis has long been considered a routine urological operation that does not present any particular difficulty. However, not every man is ready to lay his “instrument” on the surgeon’s table due to fears that the operation may affect sexual activity or cause difficulties with urination. What can I say, the very word “hospital” causes a contemptuous grimace on the face of most men.

Although, in principle, there is no problem as such. The operation is not complicated, the surgeons have sufficient experience. And the plastic procedure lasts only 15-20 minutes. It is carried out mainly with the use of local anesthesia (only the penis area is anesthetized), but at the patient's request and for some indications (for example, age under 18), general anesthesia is also possible. Usually, 2 hours after the operation, the man can safely return home.

The operation to correct the defects of the frenulum of the penis is called frenulotomy, and it gives an almost 100% guarantee that in the future the patient will not have problems in sexual life associated with disorders of the motor activity of the tissues of the male organ. In the case of phimosis, in parallel with the plastic surgery of the frenulum, the foreskin is circumcised, which makes it difficult to release the head of the penis. Since the operation is performed in sterile conditions, and the patient can control the course of the operation and his condition, without experiencing pain, complications arise extremely rarely.

The operation can be performed in two ways:

• The classic method involves using a familiar surgical instrument - a scalpel. Most surgeons and patients still prefer this method, despite the fact that when choosing it there is always a risk of bleeding and infection in the wound (which happens, however, infrequently).
• A modern method is frenuloplasty using a laser, which has proven itself well during many operations on body tissues.

Each method has its own advantages and disadvantages, so before choosing a method for performing an operation, you need to realistically assess all the risks and possible results.

The classic method of plastic surgery, of course, is associated with painful sensations and some blood loss, because after cutting the frenulum tissues, time is needed to ligate the damaged vessels and apply stitches. In addition, sterility may be violated at some stage, which creates favorable conditions for infection of the wound. However, despite this, the method is considered quite reliable in the sense that the tissues at the suture site are reliably protected from divergence.

Laser correction of the frenulum of the penis is a virtually painless procedure, eliminating the possibility of infection in the open wound and blood loss. After all, the tissues are cut with a laser beam, which heats them to a temperature of 400 ^o C, and the vessels are immediately cauterized, simultaneously preventing both bleeding and infection.

This method ensures healing of damaged tissues without complications in a short time. The tissue junctions become virtually invisible after a while, and scar tissue does not form in their place.

However, laser adhesion is quite unreliable and requires additional fixation in the postoperative period, because the tissues of the penis cannot be in a static position for a long time, especially in a man with a healthy sexual appetite. Even in the absence of sex, it is often very difficult to eliminate an erection associated with an increase in the size of the penis and tension of the frenulum, and this threatens the divergence of the sutures. After complete healing of the wound, tissue rupture is no longer a threat.

Methods of performing frenuloplasty

Since the defects of the frenulum of the penis may differ and also have concomitant pathologies that also require surgical intervention (most often phimosis), organ plastic surgery in each specific case may differ slightly in the technique of implementation. Most often, surgeons have to deal with a short frenulum or its rupture.

In young patients, the problem of a short frenulum is often accompanied by a tightening of the foreskin tissue, which makes it difficult to release the head of the penis. In this case, two surgeries are performed simultaneously: frenulum correction and circumcision of the foreskin.

Let's look at several of the most popular types of surgical treatment for frenulum defects and the stages of the operation.

Correction of frenulum rupture

Insufficient length of the skin fold connecting the head of the penis and the foreskin can cause tissue rupture during too active sex. It must be said that not all men rush to the hospital with such a problem, experiencing a certain psychological discomfort. And very much in vain. The wound, of course, will heal sooner or later, but a rough scar may remain in its place, which will subsequently cause a repeated rupture of the frenulum. And it is good if the wound heals without any particular complications, otherwise it can cause inflammatory processes in the area of "male dignity".

It is best to solve the problem of a ruptured frenulum of the penis in a hospital setting, 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 a ruptured frenulum of the penis has occurred, there is no need to delay. After applying a pressure bandage to the wound area to reduce blood loss, you should immediately go to a urologist or directly to the hospital.

After passing the necessary tests, examining the wound and treating its edges with an antiseptic, the doctor sutures the tissues, after which an antiseptic bandage is applied to prevent infection from entering the fresh wound. Additionally, the patient is prescribed medications that will accelerate tissue regeneration in the wound area and prevent the entry and spread of infection.

Surgical treatment of short frenulum

The operation is performed both on an intact organ and on a frenulum that has previously been subject to ruptures. In the first case, only a transverse dissection of the frenulum tissue is performed, in the second, areas of hardened tissue and neoplasms (non-malignant!) at the site of the ruptures are additionally removed.

After the incision is made, measures are taken to stop the bleeding. For this purpose, the vessels are tied or coagulation (cauterization) of the wound edges is performed. If the operation is performed with a laser, additional cauterization is usually not required.

After the bleeding has stopped and the wound has been treated with an antiseptic, the wound is sutured longitudinally using a thin, self-absorbing thread.

Penile frenulum elongation

This is also a surgical procedure in which the incision and suture have a certain shape, thanks to which the length of the frenulum can be increased by approximately 10-12 mm. The incision in this procedure is in the shape of the letter V, and the suturing is done in the shape of the letter Y. The amount by which the frenulum of the penis will be increased depends on the depth of the incision and the length of the suture (the lower part of the letter Y).

Frenuectomy

This is a conservative type of plastic surgery of the frenulum of the penis, which is used when other types of surgery are impossible due to the poor condition of the skin fold. In fact, this is the removal of the fold itself, which has previously been repeatedly torn, as a result of which its tissues have finally lost elasticity, covered with many scars. Such a frenulum is no longer able to perform its functions normally and is the cause of pain during intercourse and other male disappointments. In this case, the skin fold is removed, and the wound site is sutured with threads.

Contraindications to the procedure

Frenuloplasty of the penis 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 cannot be ignored, because they usually lead to complications.

Since the male organ is related to both the urinary and reproductive systems of the body, any inflammatory processes in these systems make plastic surgery on the organ impossible. First, the inflammation will have to be removed, and then prepare for surgery to cut or lengthen the frenulum of the penis.

Surgery is not performed during exacerbation of chronic pathologies. First, stable remission of the disease is achieved, and then the conversation about surgical intervention begins.

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

Frenuloplasty is not performed in the presence of a severe viral infection (for example, HIV or hepatitis), blood clotting disorders (high risk of difficult-to-stop bleeding), malignant neoplasms, intolerance to anesthetics (as a result of individual characteristics of the body or certain pathologies, for example, allergies or acute renal failure).

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Consequences after the procedure

Frenuloplasty is not just a surgical operation, but also a cosmetic procedure in some way. Rough scars from a rupture of the frenulum tissue look completely unaesthetic, not to mention the danger of infection. Frenuloplasty of the penis helps not only to solve sexual problems, but also to preserve the attractiveness of "male dignity", so it is so important that the operation is performed by an experienced surgeon with sufficient experience in this area.

It is better, of course, to consult a surgeon before the onset of unpleasant consequences in the form of a rupture of the short frenulum, the onset of an inflammatory process in the penis, multiple unsuccessful attempts to have offspring, as a result of which the patient receives severe psychological trauma, and other awkward situations. In this case, plastic surgery of the short frenulum is carried out in a short time and is generally without complications. The only consequence after the procedure is short-term pain at the incision site, redness and swelling, which disappear fairly quickly with proper care.

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

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

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

It happens that the patient is not satisfied with the appearance of the genital organ after the operation, but this point should have been discussed with him before the operation. Yes, the frenulum will look different (but this is inevitable), but its functionality will increase.

It is another matter if the issue is in the surgeon's incompetence or carelessness (careless incisions or sutures, infection during surgery, etc.), as a result of which the appearance of the organ has suffered. In this case, all claims should be addressed to the surgeon and his immediate superiors. Although often patients themselves become the culprits of their problems if they do not comply with the requirements for organ care in the postoperative period.

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Complications after the procedure

If the frenulum plastic surgery of the penis was performed in sterile conditions in accordance with the requirements for the operation, there are no complications after it. Pain, hyperemia and tissue swelling pass quite quickly, and the man simply forgets about them.

Complications after the procedure may be associated either with infection of the wound during the operation or with failure to comply with the requirements for care of the penis in the postoperative period. In this case, the following may be observed: severe pain in 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 weakness in the vessel walls or due to insufficient bleeding prevention.

Infection of the wound during surgery or in the postoperative period can be prevented by taking antibiotics and using aseptic dressings as prescribed by the doctor. Otherwise, prolonged wound healing will lead to the formation of coarse scar tissue at the incision site, which is considered weak due to its inelasticity, and also looks unaesthetic.

In addition, the infection from the wound can spread to other tissues of the genital organ or penetrate into the body, where it will be carried by the bloodstream, and these are even more serious complications than pain and an unattractive appearance.

Another complication after laser plastic surgery may be the divergence of sutures connected only by means of high temperature without the use of threads fixing the edges of the wound. This complication can be avoided by providing additional fixation of the wound and ensuring control of erectile function in the postoperative period.

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Care after the procedure

Despite the fact that the patient can leave the hospital after a couple of hours of frenuloplasty, he will have to take good care of his "dignity" for some time. As after any surgical intervention with tissue integrity violation, a rehabilitation period with special care for the damaged organ is provided after frenulotomy. In this case, this period lasts about 1 month, although the patient may feel some discomfort and pain even after this time.

Both before and after the operation, doctors strongly recommend reducing physical activity. In the first 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 it, not to mention the rubbing of sensitive tissues by underwear.

By the way, if desired, the patient can stay in the clinic for a few days after the operation, where he will be provided with appropriate care. If a man leaves the clinic immediately, it is desirable that someone meet him, help him to the car and take him home.

After the operation, the patient applies an antiseptic dressing to the wound, which will protect it from infection. The dressing can be removed after 12 hours, the wound can be treated with an antibacterial ointment prescribed by the doctor, and a sterile cloth can be applied. It is important to strictly follow the doctor's instructions, using all prescribed medications, this is the only way to speed up the recovery process.

With the consent of a doctor, you can use folk remedies that have anti-inflammatory properties and improve tissue regeneration. Such remedies include calendula and chamomile infusion, oak bark decoction. They are used to treat wounds and lotions.

It is not recommended to wet the penis when bathing. You will have to forget about the bath for at least a week, and you can take a shower, protecting the organ from water with a condom.

After the surgical threads dissolve and fall off, crusts and blisters may be seen at the suture site. Under no circumstances should you remove them yourself. Over time, they will fall off on their own, without any consequences.

Light physical activity is allowed no earlier than two weeks after the operation, and doctors usually allow sexual activity to resume after 3 weeks of abstinence. Everything depends on the condition of the wound and the speed of its healing.

Personal hygiene and frequent changes of underwear are considered mandatory during the entire rehabilitation period and after it. Dirty underwear is one of the sources of infection, which means that wearing it is unacceptable. It is better to use loose underwear made of natural fabrics that will not squeeze the penis and will provide air access to the organ. Synthetics can create a greenhouse effect, which will only slow down the process of wound scarring.

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

When the wound is completely healed, it is recommended to lubricate the suture site with lubricants. They will reduce friction during sexual intercourse, which means that the delicate tissues of the scar will not be injured.

Frenulum plastic surgery of the penis is not a whim of doctors who want to earn more money, but a harsh necessity that preserves the physical and mental health of a man. Therefore, if such a problem as a short frenulum of the penis with the ensuing circumstances has arisen, it is better to put your pride and prejudice aside, because in a short period of time an experienced surgeon can easily correct the situation, and the man will no longer suffer from pain, receiving only pleasure from sex.