Frenuloplasty of penis

 

Frenuloplasty of penis or release and division of Frenulum breve, or short frenulum

You have a tight foreskin that cannot be pulled back or tight at skin behind the head of the penis. This can cause problems with recurring infections or tear of the foreskin area. Frenuloplasty is not appropriate if your foreskin is scarred due to Balanitis xerotica obliterans (BXO) or Lichen Sclerosus. Please see further information for BXO.

There are 3 options with regard to treating a tight foreskin without BXO:

1. Observation – no specific treatment in mild cases

2. Circumcision, which means that the foreskin is removed completely. The advantage of this operation is that once the foreskin is removed then you will not have any problem related foreskin. Head of the penis is exposed permanently after the operation and irreversible.

2. Frenuloplasty, which is simply a foreskin releasing procedure. An incision is made on frenulum or excised the ridge underneath the surface, thus allowing frenulum was separated underneath of the glans. This will allow you to keep your foreskin free from the bridging and also be able to keep the area underneath clean.

What are the benefits of having a frenuloplasty? 

The benefit is that he retains foreskin. Frenuloplasty helps to get rid of bending of the penis.

Circumcision used to be a commonly practiced operation and on many occasions was performed with excellent results.

What does Frenuloplasty involve?

 Surgical treatment of a short penile frenulum by dividing the skin across and re‑stitching it in a lengthwise fashion.

Details of the procedure

1. Dr Khan usually puts a local anaesthetic injection to carry out the procedure.

2. This local anaesthetic injection also provides post-operative pain relief

3. He divides the frenulum across and re-stitch it in lengthwise fashion, which results in lengthening the frenulum

4. He uses dissolvable stitches throughout which usually fall off within two to three weeks

5. He seals the wound with special glue which sloughs off within 7-10 days 

6. We normally cover the wound in a loose bandage which you can remove it after 1-2 days.

What can I expect when I get home after frenuloplasty?

  • You will get some bruising and swelling of the penis which may last several days

  • All your stitches will dissolve, usually within two to three weeks, but may sometimes take a little longer

  • Pain relief such as paracetamol or Ibuprofen can be taken if you have any uneasiness or pain

  • Take off any dressing within 24 hours or if it becomes soaked with urine, it should be removed earlier

  • Keep the area dry for 48 hours; avoid taking a bath for 10 days

  • No swimming or any exercise for two weeks

  • Please try to keep your wound clean and dry after passing urine

  • Apply a little Vaseline to the tip of your penis and around the stitch line to stop it sticking to your clothing

  • Wear tight-fitting clothing for two to three days

  • You should retract your foreskin on a daily basis to maintain the benefits of the surgery after 3 days  

  • You will be given a copy of the GP letter which should be given to your doctor

  • Get prescribed cream from any pharmacy and keep the antibiotics tablets prescription safe.

  • You should refrain from sexual activity (intercourse and masturbation) for up to four to six weeks

  • Please stop smoking before and after any procedure. Smoking can delay the wound healing and makes complications more likely after the operation.

    What are the risks, consequences and alternatives associated with you having a frenuloplasty?

Most operations are straightforward; however as with any surgical procedure, there is a some chance of side-effects or complications such as:

Most operations are straightforward; however as with any surgical procedure, there is some chance of side-effects or complications such as:

Bleeding from the wound site (occurs in 2 - 3% of patients) but is usually minimal and settles quickly. Infection can arise and is usually minor but can be possibly serious with an incidence of less than 1% of patients. Tenderness of the scar at the site of your frenulum. Dissatisfied with the cosmetic result. Failure to improve your symptoms which may result in the need for a full circumcision. Redo operation or full circumcision: 10% foreskin becoming tight again due to scarring.

Best alternative for tight foreskin is circumcision (full)

Following 3 days after the operation, it is VERY IMPORTANT that you retracts your foreskin each day to avoid the foreskin becoming tight again due to scarring. If you are concerned about any of these risks, or have any further queries, please speak to us immediately.

This information contains evidence-based information about your proposed by the British Association of Urological Surgeons (BAUS 2017)

Ref: https://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Frenuloplasty.pdf

Note: This is the information for guidance only, it will not be a replacement of professional consultation by Dr Khan. Please Dr. Khan for free telephone advice +447527314081