Men also have a frenulum that connects the foreskin, or prepuce, to the head of the penis the glans and the shaft. Normally, the frenulum is long enough to enable the foreskin to retract normally when the penis becomes erect; but sometimes, the frenulum is short, resulting in a condition called frenulum breve. A short frenulum can result in pain and even bleeding during erection and intercourse, and in some cases, the frenulum may rupture and tear during sex.
Many men with frenulum breve develop curvature when the frenulum exerts continual pressure on the glans. Correcting frenulum breve can be achieved with one of two procedures: frenectomy sometimes called frenulotomy or frenulec tomy and frenuloplasty , and both procedures can be combined with a circumcision if desired. A frenectomy or frenulectomy involves cutting the frenulum to release the tension on the glans and shaft. The focus of a frenectomy is on function rather than aesthetics. A frenuloplasty also involves cutting the frenulum as well as remodeling the skin in the local area to provide a more aesthetically pleasing result.
In most cases, both procedures are performed using local anesthetics to numb the area prior to incision. Sedation may also be used to calm anxiety and promote a more relaxed state. Most procedures take from 15 minutes to 45 minutes, and there is very little discomfort following the procedure.
It is important to roll down the foreskin twice a day to prevent any sticking. It is unusual to have any significant issues. It will be slightly tender and it is best not to have sex for a month. Some men may get a bit of swelling in the area. In some cases, frenuloplasty may not be curative and may require circumcision. Dr Robert Tan is a practicing consultant urologist with over 35 years of experience. He graduated from the medical school at the University of New South Wales, Australia, and has cared for thousands of patients over the decades.
Dr Lincoln Tan is a consultant urologist and accredited robotic surgeon. Dr Tan is trained in all aspects of open and endoscopic urology and specialises in the minimally invasive treatment of urologic cancers. Select Language: : EN. Home About Us. Testis Hernias Testicular Cancer Varicocele.
Contact Us. The frenulum preputii is composed of mesenchymal tissue covered by an epithelium that unites the prepuce to the ventral region of the glans [ 5 ]. Penile innervation consists of the dorsal, cavernosal and perineal nerves.
The prepuce has somatosensory innervation from the dorsal nerve of the penis and branches of the perineal nerve. This unique innervation of the prepuce establishes its function as an erogenous tissue [ 4 ].
Arterial blood supply to penile skin derives from two separate origins. External pudendal artery branches supply the dorsal and lateral aspects of the penis, branches of the internal pudendal artery the ventral aspect of the penis and the scrotum via the posterior scrotal artery.
The penile skin drains via the superficial dorsal vein, which drains into the saphenous vein via the superficial external pudendal veins [ 3 ]. Lymphatic drainage from the glans and foreskin drains into the inguinal lymph nodes.
Some lymphatic drainage is to the presymphyseal lymph nodes and to the lateral lymph nodes of the external iliac lymphatics [ 6 ].
This is the third reported case of dorsal penile frenulum incidentally found in a traditionally circumcised male and completely asymptomatic. An assumption can be made that circumcision without release of the dorsal frenulum is another symptomatic treatment option. Urol Int 59 1 — Arora B Dorsal penile frenulum: a rare developmental abnormality.
Int J Case Rep Imag 7 5 — Article Google Scholar. Br J Urol 83 Suppl. Google Scholar. Histol Histopathol — Article PubMed Google Scholar. Download references. AMM involved in substantial contributions to conception of the case report; acquisition of data; drafting of the manuscript; critical revision for important intellectual content; and approval of final version. SWD involved in substantial contributions to critical revision and approval of final version.
Both authors read and approved the final manuscript. Written informed consent was obtained from the patient for publication of this manuscript and accompanying pictures. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
You can also search for this author in PubMed Google Scholar. Correspondence to A. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Reprints and Permissions. Mukendi, A. Dorsal penile frenulum a rare congenital abnormality.
Afr J Urol 25, 1 Download citation. Received : 17 October Accepted : 29 October
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