Frenulum is a very sensitive part of the penis that allows the foreskin to be drawn back over the penis glans. In some people, however, the frenulum can be unusually short or tight, causing symptoms such as discomfort or pain in the penis, premature ejaculation, tearing and bleeding underneath the head of the penis, and trouble pulling back the foreskin.
If you are struggling with frenulum breve, a frenuloplasty surgery may be a suitable treatment method for you. Read on to learn more about penile frenuloplasty, how it is performed, its recovery period, and its potential benefits.
Who Needs Frenuloplasty?
A penile frenuloplasty is typically advised for individuals struggling with a tight or short frenulum. If you are struggling with any of the below-given symptoms, a frenuloplasty surgery may be an effective solution for you:
- Pain or discomfort, especially during intercourse
- Skin Tearing
- Difficulty in Retracting the Foreskin
- Difficulty Maintaining Hygiene
- Recurrent Penis Infections
Causes of Tight Frenulum
In most cases, frenulum breve is a congenital condition, meaning patients are born with it. But, in some cases, frenulum breve can also occur due to various penile conditions such as:
- Balanitis: Balanitis is a common urological condition that is characterized by pain and inflammation on the head of the penis. Most cases of balanitis can be treated with non-surgical methods such as antifungal creams and antibiotics. Severe or recurrent cases of the condition, however, may require circumcision.
- Sexually Transmitted Infection: Some Sexually Transmitted Infections (STIs) can lead to balanitis, which can further lead to a tight frenulum. Gonorrhea, herpes, and syphilis are some STIs that can potentially lead to a tight frenulum.
- Skin Diseases: Certain skin conditions like eczema, psoriasis, lichen sclerosis, and lichen planus may also act as risk factors for a tight frenulum. In such conditions, the skin of the penis develops red rashes, shiny itchy patches. Also, the accumulation of unusual fluid under the foreskin is a common symptom of the above-mentioned skin conditions.
- Balanoposthitis: Balanoposthitis is a condition of the penis that is characterized by pain and inflammation of both the penis glans and the foreskin. A fungal infection called candida is the major cause of balanoposthitis. Balanoposthitis is yet another major risk factor for a tight frenulum.
How to Prepare for Frenuloplasty Surgery?
To ensure a smooth and complication-free procedure, your urologist will likely advise you to follow some simple steps and guidelines before arriving at the hospital, such as:
- Shave off Pubic Hair: While it is not necessary to completely shave off your pubic hair, it is advisable to trim it fairly short. This can aid asepsis during the procedure and also minimize the chances of hair becoming trapped in the bandaging afterward. It is also advised to trim your pubic hair a few days in advance of the operation to ensure the softening of cut ends.
- No Alcohol: Refrain from consuming alcohol or smoking for at least a week prior to your frenuloplasty surgery. Alcohol can lead to dehydration and can affect the effectiveness of anesthesia during the procedure. Smoking can also slow down your recovery process.
- Maintain Hygiene: Before arriving at the hospital, make sure to take a good bath or shower. Thoroughly clean your penis and under the foreskin using mild soap and lukewarm water. It is also advised to completely empty your bladder before your frenuloplasty surgery.
- Wear Comfortable Underwear: It is advisable to bring a pair of tight-fitting briefs to wear after your procedure to help keep the surgical dressing in place. Continue to wear these at home until the swelling and soreness has eased.
- Do not eat or drink: A frenuloplasty surgery is generally performed under local anesthesia. Therefore, you can eat and drink as per normal. Drink sufficient water and stay well hydrated.
- Arrange time off work: Make sure to take at least a few days off from work. While most patients can return to their daily routine in just 2-3 days after frenuloplasty surgery, each patient has different healing capabilities, and your recovery time after the procedure may take slightly longer to complete.
How is Frenuloplasty Performed?
Preoperative Diagnostic Tests
Diagnosis of frenulum breve is a relatively simple procedure that your urologist will likely perform before your surgery. The aim behind these diagnostic tests is to assess your overall health, take precautions if required, and minimize the chances of any complications, either during or after surgery, as much as possible. In most cases, a simple physical evaluation is enough to diagnose frenulum breve. However, your urologist may also perform some additional tests to determine the cause of your condition. Some tests your urologist may perform include:
- Skin Test: A skin test is a simple and commonly performed test that will help your urologist identify bacteria, viruses, and fungi. In this test, the urologist will gently rub a cotton swab over the foreskin. The swab will then be sent to a laboratory for analysis.
- Urethral Discharge Swab: A urethral discharge swab will help your urologist identify bacteria and viruses. In this test, the urologist will carefully insert a cotton swab (about 3/4 of an inch in size) into your ureteral opening and gently rotate it. The cotton swab will then be sent to a laboratory for testing and analysis.
- Urinalysis: A urinalysis examines the visual, chemical, and microscopic aspects of your pee. They’ll look for different causes of your condition, including bacteria or high sugar (glucose) levels, which could be a sign of diabetes. You’ll be asked to urinate into a special cup by your healthcare provider. The urine sample will then be sent to a laboratory for testing.
- Blood Test: A blood test is one of the most common tests that your urologist may perform to monitor your overall health and check for signs of any infection that may have led to a tight frenulum. In a blood test, the urologist will use a thin needle to draw a small amount of blood from a vein in your arm. This blood sample will then be sent to a laboratory for testing and analysis.
There are primarily 2 methods of performing a frenuloplasty surgery: Laser Frenuloplasty and Open Frenuloplasty. While both methods are safe and effective, they vary in their overall procedure and equipment.
- Laser Frenuloplasty: Laser frenuloplasty is an advanced and minimally invasive surgical procedure. As the name suggests, a laser frenuloplasty procedure utilizes a Carbon Dioxide (CO2) laser to vaporize the tissue surrounding the frenulum and make necessary changes in order to correct it. Compared to traditional frenuloplasty, laser frenuloplasty allows for more precise incisions and maximum tissue conservation around the frenulum. This results in better cosmetic results, faster recovery, negligible chances of complications, and a significant reduction in chances of residual scarring. The entire procedure is typically performed under local anesthesia and does not take more than 10-20 minutes to complete.
- Open Frenuloplasty: Open frenuloplasty is a more traditional method of altering the frenulum. The goal of this procedure, similar to laser frenuloplasty, is to release the tension being exerted on the frenulum and allow for greater flexibility. In an open frenuloplasty procedure, the surgeon uses a scalpel to make small incisions on the frenulum tissue in order to change it. The exact location and size of the incisions depend on the tightness of the frenulum.
Once the frenulum has been released, the urologist will close the incision with the help of dissolvable sutures. These sutures will dissolve on their own over time. The entire procedure is typically performed under local anesthesia and does not take more than 20-30 minutes to complete.
Due to its more invasive nature, open frenuloplasty takes slightly longer to heal and carries an increased risk of complications. Actual cases of any postoperative problems, however, are rare.
Recovery After Frenuloplasty Surgery
In most cases, recovery after foreskin infection surgery takes anywhere from 7 to 14 days. However, depending on various factors such as your overall health, method of surgery, and quality of postoperative care, recovery time may differ. After the surgery, your penis may also appear swollen and bruised.
You may also have pain or a burning sensation when urinating. These side effects are to be expected and considered normal. They should subside on their own in a few days after surgery. If they continue to persist or worsen over time, contact your healthcare provider as soon as possible.
To ensure smooth recovery and minimize chances of any postoperative complications, your urologist may also instruct you to follow some simple guidelines such as:
- Wear briefs instead of boxer shorts on the day of your surgery. Briefs will give you support and hold your penis in one position. This will reduce friction and make you more comfortable after your surgery.
- While you are healing, erections may cause pain. To reduce nocturnal erections, empty your bladder before going to bed and lay on your side with your knees bent.
- For 24 hours after surgery, do not drive, use machinery, or drink alcohol.
- Stay hydrated and drink at least 2-3 liters of water every day. It is also recommended to increase your healthy fluid intake, such as coconut water and fresh fruit juice. This can help reduce acidity in your urine and ease any discomfort you may feel while urinating.
- Avoid performing any heavy or strenuous activities that exert excessive force on the groin area. This will prevent the chances of any kind of injury or complication while recovering after circumcision.
- Refrain from sexual intercourse or masturbation until your doctor thinks it’s safe to do so. Engaging in sexual intercourse before giving your penis sufficient time to heal can hinder recovery and lead to serious complications. In most cases, it is advised to refrain from any sex for at least 5-6 weeks after surgery.
- Do not apply any unprescribed antiseptic cream to the penis. While they can help kill germs, they can be corrosive to new skin and may slow down the healing process.
Benefits of Frenuloplasty Surgery
Some benefits that are commonly associated with penile frenuloplasty procedure are given below:
- Pain Relief: One of the primary benefits of penile frenuloplasty procedure is its ability to treat frenulum breve effectively. As a result, it helps alleviate its painful symptoms.
- Improved Sexual Function: A tight frenulum can interfere with sexual function and pleasure by causing pain or tearing during intercourse. Penile frenuloplasty can help enhance sexual function by allowing for smoother movement of the foreskin and glans, reducing discomfort.
- Reduced Risk of Tears and Bleeding: A short or tight frenulum can lead to tears or bleeding during sexual activity. By releasing some of the tension being exerted on the frenulum, a frenuloplasty procedure can significantly reduce the risk of such complications.
- Better Hygiene: Some individuals struggling with tight frenulum find it difficult to clean the area beneath their foreskin properly. This can facilitate the excess accumulation of smegma and the growth of harmful bacteria under the foreskin leading to penis infection. Frenuloplasty can improve access to proper hygiene and help prevent infections.
- Avoid the Need for Circumcision: One major benefit of the frenuloplasty procedure is that it does not require the foreskin to be removed. With the help of frenuloplasty, the urologist can treat a tight frenulum by making alterations to the frenulum itself.
Risks and Complications
A frenuloplasty surgery is considered to be a safe procedure with only a minimal risk of major complications. However, they can still happen and should not be taken lightly. If you start noticing any of the below-given symptoms, it is advised to contact your healthcare provider at the earliest:
- A wound infection may lead to symptoms such as fever, feeling ill, and pus discharge from surgical wounds.
- Excessive or persistent bleeding that does not stop on its own
- Prolonged swelling and bruising on the penis
- Reduced sensation in the head of the penis that may also affect functionality.
- Allergic reactions to anesthesia causing symptoms such as skin rash, hives, itching, nausea, dizziness, and difficulty breathing.
- Dissatisfaction with the cosmetic results
Frequently Asked Questions
Can tight frenulum be treated without surgery?
In most cases, urologists recommend undergoing surgery to treat tight frenulum effectively. However, for moderate cases, your urologist may consider non-surgical alternatives before moving on to surgery. One such non-surgical alternative may be stretching exercises to loosen up the tight frenulum or steroid creams and ointments.
What is the success rate of frenuloplasty surgery?
Frenuloplasty success rates range from 90-95%. A frenuloplasty surgery is generally considered to be a safe procedure with high success rates. While there may be some side effects, the chances of any major complications are minimal.
What is the average cost of frenuloplasty surgery in India?
On average, frenuloplasty surgery cost in India can range anywhere from Rs. 22,000 to Rs. 29,000. However, as is the case with any other surgical procedure, the actual cost may vary depending on various factors such as:
- Consultation and Operating fees
- Expertise of your surgeon
- Hospital charges
- City you are in
- Method of Surgery
- Cost of preoperative diagnostic tests
- Postoperative follow-ups and medications
What should I avoid after frenuloplasty surgery?
After your frenuloplasty surgery, it is imperative that you avoid erections for the first week. This is to prevent pain and stress from being placed on the surgical wound and potentially interfere with the healing. You can resume sexual activity after at least 5-6 weeks after surgery or until your doctor thinks it’s safe to do so. It is also advisable to avoid driving ot 24 hours following the surgery.
Does insurance cover frenuloplasty surgery?
Yes, a frenuloplasty surgery is covered by most health insurance plans in India if treatment is deemed to be medically necessary by your healthcare provider. Frenulum breve or tight frenulum is a penile condition that occurs when the skin fold that connects the penis glans to the underside of the foreskin is too short.
This can be an extremely painful condition that can affect your daily life. If left untreated, the frenulum can even tear and cause intense pain and bleeding. Due to this reason, frenuloplasty is typically considered to be a medical necessity. However, it is best to contact your insurance provider to get a better understanding of any inclusions and exclusions regarding coverage.
Is frenuloplasty surgery painful?
A Frenuloplasty is typically performed under either local or general anesthesia and, therefore, does not cause pain or discomfort. However, some patients might experience mild discomfort, which is generally manageable through medications.
Frenuloplasty is a urological procedure that is performed to effectively treat a condition known as frenulum breve or tight frenulum. Frenulum is a sensitive part of the penis.
However, in some cases, it can cause pain and discomfort during erection, especially when its length is too short. If left untreated for a long time, a tight frenulum also stands the risk of getting torn. If you are struggling with a tight frenulum, a frenuloplasty surgery may be a suitable treatment for you.
However, each patient’s case is unique, and the decision to undergo a frenuloplasty should be made only after consulting a qualified urologist.
If you are considering undergoing frenuloplasty surgery or have any further questions regarding the procedure, you can contact us and book an appointment with our highly qualified and experienced team of urologists. Call us today!