Frenuloplasty of the frenulum

Pathology can be congenital or acquired:

1. After the birth of most healthy boys, the head of the penis is completely covered by the foreskin. Some children may have functional constriction of the foreskin (phimosis), which prevents complete exposure of the glans. This is considered a congenital pathology. As the child grows and develops, phimosis passes in most cases. According to statistics, 8% of boys have phimosis[1] at the age of 6-7 years old, 6% of teenagers aged 10-11 years, and only 1% of teenagers aged 16-17 years. For those who have a problem that has not gone away, frenulotomy is recommended. Frenula surgery without suturing the edges of the incision, or frenuloplasty with cosmetic sutures.
Acquired cases include cases of non-opening of the glans penis caused by pathologies. In particular, the problem is caused by inflammation of the foreskin and glans penis. The chronic inflammatory process leads to scarring and loss of elasticity of the foreskin. Unlike physiological phimosis, cicatricial phimosis does not go away spontaneously, surgery is mandatory.

Frenuloplasty at the EMC clinic is performed in the following cases:

• recurrent or chronic inflammatory process in the foreskin area;

• vesicoureteral reflux caused by infravesical obstruction;

• phimosis over the age of 8 years;

• feeling of discomfort in the groin;

• painful urination;

• pinching of the glans penis;

• curvature of the penis;

• adults have dyspareunia (painful sensations during sexual contact), early ejaculation.

Preparation for frenuloplasty

Frenuloplasty does not require long-term preparation, but doctors need to make sure there is no risk of complications, so before surgery, the patient is prescribed basic examinations:

1. Consultation with a urologist to confirm the indications for surgery.
2. Basic laboratory blood and urine tests, blood tests for infections (HIV, syphilis, hepatitis).
3. Fluorography.
4. ECG.
5. Consultation with a therapist.
6. Consultation with an anesthesiologist to choose the method of anesthesia.

Frenulum surgery is not performed in the period of acute inflammatory diseases, but also in patients with severe somatic pathologies.

How is the operation going

The operation is performed on an outpatient basis.&The same day he returns home. Surgical intervention does not take more than 30 minutes. In most cases, local anesthesia is used with anesthesia only for the surgical area. However, depending on the age of some patients, general anesthesia is used.

The classical method refers to reliable and effective operational methods. During this procedure, it is possible not only to increase the length of the frenulum, but also to eliminate scars and tissue tears caused by microtrauma. However, with the classical method, the pain syndrome after surgery is more pronounced, the risk of postoperative bleeding is higher, and the patient will have to undergo bandages and take anti-inflammatory drugs for several days.

The course of the procedure according to the traditional method:

1. Anesthesia is performed. Under local anesthesia, the doctor gives an injection of anesthetic into the area under the frenulum.
The surgeon dissects the surface tissues in a transverse direction.
2. The skin stretches longitudinally in a diamond shape, which allows you to adjust the tension.
3. Longitudinal seams are applied with special thin self-absorbing threads.

Sometimes the plastic surgery of the frenulum does not give the desired result and does not completely eliminate all the symptoms. In this case, a larger operation has to be performed, complete circumcision of the foreskin.

Rehabilitation after the procedure

The operation is considered quite simple and does not require general anesthesia, so the patient is under medical supervision for only 1-2 hours. The main stage of rehabilitation takes place at home. The patient is prescribed nonsteroidal anti-inflammatory drugs, a local antibiotic. Adult patients can return to sexual activity 2-3 weeks after surgery. To avoid complications, it is necessary to follow the doctor's recommendations on protective measures.

The most common complications include:

• swelling of the penis for 7-14 days;

• temporary decrease in sensitivity of the glans penis;

• bleeding from the operated area (it is necessary to consult a doctor);

• signs of infection or inflammation (it is necessary to consult a doctor).

Frequently asked questions

Is it possible to have a plastic frenulum without circumcision?

Frenuloplasty can be performed both in conjunction with circumcision and as a separate operation.

At what age is it better to trim the bridle?

Quite often, phimosis spontaneously regresses to the age of 6-7 years, therefore, until this time, many doctors recommend the tactics of expectant observation. Some surgeons recommend surgery only after the age of 14. However, in the presence of severe symptoms and complications, frenulum plastic surgery is also performed in newborns. Recommendations regarding the best age for surgery can only be given by a urologist after a face-to-face examination.

What can not be done after the plastic frenulum?

After surgery, you should temporarily refrain from physical exercise, swimming pools and bathing in open water, thermal procedures, including hot baths, baths and saunas. In the first days after surgery, you should not wear too tight underwear or touch the surgical site. Special precautions are necessary during hygiene procedures: water and household detergents should be avoided on the seams.

How long does the frenulum heal after frenuloplasty?

Healing depends on individual parameters. In most patients, postoperative symptoms resolve within two weeks after the procedure, but full healing can take up to a month.