Frenulum Breve – A cause of penile tear, pain & bleeding during sex
The frenulum of the penis is a band of tissue located underneath the penis. When the frenulum is tight or short, this is called a frenulum breve. The degree of tightness and thickness of the frenulum varies from men to men. This can result in a lot of tension on the frenulum and makes the penis bent downward when pulling the foreskin back or during an erection.
This can cause the frenulum to rip and tear during more vigorous activities such as sexual contact, resulting in severe pain and bleeding which in turn causes many men to lose their erections. Repeated tears can cause scars to form and it causes the frenulum to become even tighter which leads to more tears. Some men go through their entire lives suffering from pain and bleeding unaware that there is a cure for this.
How To Identify A Short Or Tight Frenulum?
In most cases, it’s easy to identify whether the frenulum is shorter or tighter than normal. It can be done by pulling the foreskin completely, and you will feel tightness or pressure sensation on the frenulum.
However, other signs that may indicate this problem include:
- Pain or discomfort that makes sexual contact unpleasant.
- The head of the penis folds down when the foreskin is pulled back (penis bent downward)
- The skin of the glans cannot be completely pulled back.
This problem can often be confused with tight foreskin (phimosis). Thus, if there is a suspicion of either a frenulum breve and/or phimosis, it is recommended to seek a doctor to start the appropriate treatment where a combination of both circumcision and frenulectomy might be necessary.
How To Treat Frenulum Breve?
A surgical repair by frenulectomy is usually necessary to remove the tight band of tissue in order to release it from the rest of the surrounding tissue. Trial of different techniques, such as with steroid cream or skin stretching exercises, can be done, however it has little benefits.
How We Approach Frenulectomy
- Procedures are performed under local anaesthetic.
- Depending on the size and shape of your frenulum, we may employ a scalpel and radiofrequency assisted surgery to release the frenulum.
- With the radiofrequency assisted surgery, this will provide safer, rapid and effective results compared to traditional electrocautery.
- Once the frenulum is released, we will then assess whether glue stitch with or without dissolvable stitches will be necessary to approximate the incision.
- Patients can return home shortly after the procedure.
- Regardless of your anatomy, our goal is to provide the optimal aesthetic and functional result.
- Recovery using our technique takes only a few weeks.
Patient Instructions Before Frenulectomy
- Do not take any Non-Steroidal Anti-Inflammatory Drugs such as Aspirin, Ibuprofen, Naproxen, or Diclofenac for one week prior to your procedure.
- You may call our office to confirm your frenulectomy procedure one day prior to your appointment
- Avoid any alcohol the day before the procedure.
- You are allowed to eat before your procedure such as normal breakfast or lunch on the day of your surgery.
- You are welcome to come 15 minutes prior to your appointment.
- You are allowed to drive yourself to the office and back home unless you have a history of easy fainting.
- Our staff will usher you into one of our surgical rooms and the one of our doctors will administer the local anesthetic. It is then time for your procedure.
Patient Instructions After Frenulectomy
- We may prescribe you additional pain medication after the procedure as needed for pain control.
- There may be a small amount of bleeding at the surgical site. This is normal and will stop in a few days. If it does not, please contact us.
- Continue applying antibiotic ointment at the site for 1 week as prescribed.
- You may return to office work the next day but if your work requires a lot of activity you should take 2-3 days off.
- We recommend no sexual activity for about 4 weeks or until the sutures come out completely.
- Patients who are traveling more than 3-4 hours away may want to stay at a local hotel overnight.
Other Commonly Asked Questions:
Can Frenulum Breve and its Problems Associated Problems Get Better By Themselves?
No, unfortunately frenulum breve generally does not get better on its own. Some doctors may suggest stretching exercises but the frenulum is a rather tough tissue that is not easily stretched. Usually patient will end up with frenulectomy procedure to treat these condition.
Is A Frenulectomy Painful?
Those men who have undergone this procedure usually describe it as virtually painless since we perform the frenulectomy under adequate local anesthesia.
If I Am Uncircumcised, How Will Frenulectomy Affect My Foreskin?
Frenulectomy does not affect your foreskin and you will remain uncircumcised. Frenulectomy only involves releasing the tight band of tissue underneath the penis and your foreskin will be preserved. However, circumcision can be done together with the frenulectomy procedure.
What Are The Risks Of Frenulectomy?
- Swelling and bruising at the site of the procedure
- Infection requiring antibiotics
- Bleeding (usually mild)
- Scarring at the site of the operation
- Lightheadedness after the procedure.
- Suboptimal cosmetic or functional effect requiring a second procedure
- Meatal stenosis (rare)
- Chronic pain at the site of the surgery (rare)
How Long Does The Recovery Take?
Recovery from penile frenulectomy is fairly fast and painless. Most men are able to return to office work the next day. If your work requires heavy or physical activity, you may need a few days off.
When Can I Have Sex Again After Frenulectomy?
We generally recommend no sex for at least 4 weeks to allow the surgical site to heal optimally and sutures, if required at the time of the procedure, to dissolve.
How Will Frenulectomy Affect My Sex Life?
After a frenulectomy, sex should becomes more pleasurable due to less pain and worry from tearing and bleeding as the tight band has been released.
Next read: Phimosis & Paraphimosis (Tight And Retracted Foreskin)