Frenuloplasty of the penis is a procedure to treat a tight frenulum (frenulum breve). The frenulum (banjo string) is a small band of skin under the head of the penis below the urethral opening (wee hole).
A tight frenulum may cause pain during sexual activities, difficulty retracting the foreskin, or small tears and infections in the frenulum area.
Frenuloplasty is not suitable if the foreskin is scarred due to balanitis xerotica obliterans (BXO) or lichen sclerosus, causing phimosis (tight foreskin).
What is Frenulum Breve?
Frenulum breve is a short or tight frenulum that limits the movement of the foreskin. It may cause pain, tearing, or bending during erection. It often becomes more noticeable during sexual activities.
Causes of a Tight Frenulum
A tight frenulum may be caused by:
- Congenital tightness
- Repeated minor trauma
- Sexual activities leading to small tears
- Local inflammation or infection
- Scar tissue
- Skin conditions
Symptoms of a Tight Frenulum
A tight frenulum may cause:
- Pain during erection
- Pulling or bending of the penis
- Tearing or bleeding of the frenulum
- Difficulty retracting the foreskin
- Recurrent inflammation or infections
- Problems with sexual activities
These issues usually continue unless the frenulum is released or removed.
Who Is Suitable for Frenuloplasty?
Frenuloplasty may be suitable if:
- The foreskin retracts but feels tight due to the frenulum
- You experience pain at the underside of the glans
- The frenulum tears repeatedly
- There is no scarring caused by BXO or lichen sclerosus
- You wish to keep your foreskin
- Circumcision is not required for any other reason
If there is significant foreskin tightening (phimosis), circumcision may be more suitable.
Treatment Options for a Tight Frenulum (Without BXO)
1. Observation
No treatment may be needed in mild cases.
2. Frenuloplasty (Penile Frenulectomy)
An incision is made across the frenulum, or the tight ridge is removed. The skin is re-stitched lengthwise to increase length and improve foreskin movement. Sometimes the frenulum is removed completely. This is called frenulectomy or frenulum removal.
3. Circumcision
Circumcision removes both the foreskin and the frenulum in the case of phimosis. The head of the penis remains permanently exposed. This is irreversible but removes all foreskin- and frenulum-related problems.
Benefits of Frenuloplasty
- The foreskin is retained
- Reduction in pain and tearing
- Less bending or pulling during erection
- Improved foreskin movement
Frenuloplasty has been performed for many years at our clinic by the specialist urologist with excellent results.
Details of the Procedure
Frenuloplasty of the penis is carried out under local anaesthesia.
- A local anaesthetic injection is given to numb the area.
- The injection also provides pain relief after the procedure.
- The frenulum is divided across and re-stitched lengthwise. In some cases, the frenulum is removed completely (frenulectomy).
- Dissolvable stitches are used. They usually fall off within 2–3 weeks.
- A medical glue seals the wound. It sloughs off within 7–10 days.
- A loose bandage is applied. Remove it after 1–2 days.
Aftercare and Recovery
You may have bruising and swelling. This may last several days. Mild discomfort is expected.
Pain Relief
Paracetamol or ibuprofen may be taken.
Wound Care
- Remove any dressing within 24 hours
- Remove sooner if soaked with urine
- Keep the area dry for 48 hours
- Avoid baths for ten days
- No swimming or exercise for two weeks
- Keep the wound clean and dry after passing urine
- Apply a small amount of Vaseline to the stitch line
- Wear tight-fitting clothing for 2–3 days
Foreskin Retraction
After three days, the foreskin should be retracted daily to prevent tightening due to scarring.
Medication and Letters
- You will receive a GP letter.
- A cream will be prescribed and can be purchased from any pharmacy.
- Keep the antibiotic prescription safe.
Sexual Activity
Avoid intercourse and masturbation for four to six weeks.
Smoking
Stop smoking before and after the procedure. Smoking delays healing and increases complications.
Risks and Complications
Possible risks include:
- Bruising or swelling (settles in 2–3 weeks)
- Minor bleeding
- Infection (usually mild)
- Tenderness of the scar
- Cosmetic concerns
- Persistent symptoms requiring circumcision
- Tightening of the foreskin again if daily retraction is not performed
- Disruption of the wound and requiring stitches again
Alternative: Circumcision
Circumcision may be recommended if:
- The foreskin is tight due to scarring
- A hidden tight foreskin is present
- Frenuloplasty may not give enough improvement
Circumcision is usually the best treatment for a tight foreskin.
Contact us if you have concerns after the procedure.