Frenulum breve

Last updated
Frenulum breve
Frenulumbreve.jpg
Specialty Urology
Before (above) and after (below) frenuloplasty Before and after frenoloplasty.jpg
Before (above) and after (below) frenuloplasty

Frenulum breve, or short frenulum, is a condition in which the frenulum of the penis, which is an elastic band of tissue under the glans penis that connects to the foreskin and helps contract it over the glans, is too short and thus restricts the movement of the foreskin. The frenulum should normally be sufficiently long and supple to allow for the full retraction of the foreskin so that it lies smoothly back on the shaft of the erect penis.

Contents

The penile frenulum is comparable to the tongue's frenulum between the tongue's lower surface and the lower jaw, or the frenulum between the upper lip and the outside of the upper gum.

Symptoms and signs

A frenulum breve leads to ventral deviation of the glans and pain during erection. Sometimes, tearing of the frenulum causes heavy bleeding. The tearing of frenulum breve occurs particularly during sexual activity of young men. [1]

Frenulum breve may be complicated by tearing of the frenulum during sexual or other activity and is a cause of dyspareunia. The torn frenulum may result in healing with scar tissue that is less flexible after the incident causing further difficulties.[ citation needed ] However, this tearing can also solve the problem, healing such that the frenulum is longer and therefore no longer problematic.[ citation needed ]

A short frenulum can present in various grades of severity, and its diagnosis may depend on the subjective criteria of evaluation at physical examination in a medical office as there is no standard definition. Frenulum restricts the movement of the prepuce, even when not causing obvious phimosis. When the foreskin is completely retracted over the glans, a short frenulum tugs down the glans. One study arbitrarily defined a "short frenulum" as that which causes a ventral curvature of the glans major of 20° or more upon gentle retraction of the foreskin in the clinic. [2] Short frenulum in this study was a common cause of premature ejaculation, and frenuloplasty significantly improved the ejaculation latency. Short frenulum may be more sensitive in subjects with premature ejaculation. [3] Also, due to the limitation of the length of frenulum, and for the fear of pain, the strokes during Sexual intercourse may shorter, but faster, thus leading to early ejaculation.

Severe frenulum breve when associated with significant difficulty during sexual intercourse may lead to erroneous labelling of the sufferer as having psychosexual problems. [4]

Diagnosis

The diagnosis of severe frenulum breve is almost always confused with that of phimosis and a generally tight foreskin, since the symptom is difficulty retracting the foreskin. Most men with phimosis also have frenulum breve to a certain extent. [5] A milder frenulum breve may go unrecognized, since foreskin may retract over the glans variably.

Treatment

The condition may be treated with stretching exercises and steroid creams. It also may be treated with surgery. There are several different techniques to treat this condition. Threading a suture through the lower membrane, and then tying a tight knot around the frenulum itself is a procedure that minimises invasive action. After a few days the frenulum will weaken and eventually break apart to allow the prepuce to fully retract. Other procedures involve the cutting of the skin and require the use of sutures to help in the healing process. Alternatively, it may be treated by a reparative plastic surgery operation called a frenuloplasty, or by complete circumcision including resection of the frenulum (frenectomy).[ citation needed ] An alternative method that does not require stitches (sutures) is the "pull and burn" method, where high-frequency electrical current is used to destroy the sort and tight frenulum. [6] This method may circumvent common complications such as frenular artery ligation and subsequent stenosis of the urethral meatus or creation of skin tags and suture remnants that create a poor cosmetic result. [7]

Etymology

The word "frenulum" is a diminutive of the Latin word frenum, which means "bridle". Breve is Latin neutral for "short".[ citation needed ]

Related Research Articles

<span class="mw-page-title-main">Glans penis</span> End of the penis

In male human anatomy, the glans penis, commonly referred to as the glans, is the bulbous structure at the distal end of the human penis that is the human male's most sensitive erogenous zone and primary anatomical source of sexual pleasure. The glans penis is present in the male reproductive organs of humans and most mammals where it may appear smooth, spiny, elongated or divided. It is externally lined with mucosal tissue, which creates a smooth texture and glossy appearance. In humans, the glans is located over the distal ends of the corpora cavernosa and is a continuation of the corpus spongiosum of the penis. At the summit appears the urinary meatus and at the base forms the corona glandis. An elastic band of tissue, known as the frenulum, runs on its ventral surface. In men who are not circumcised, it is completely or partially covered by a fold of skin called the foreskin. In adults, the foreskin can generally be retracted over and past the glans manually or sometimes automatically during an erection.

<span class="mw-page-title-main">Foreskin restoration</span> Process to expand skin on the penis

Foreskin restoration is the process of expanding the skin on the penis to reconstruct an organ similar to the foreskin, which has been removed by circumcision or injury. Foreskin restoration is primarily accomplished by stretching the residual skin of the penis, but surgical methods also exist. Restoration creates a facsimile of the foreskin, but specialized tissues removed during circumcision cannot be reclaimed. Actual regeneration of the foreskin is experimental at this time. Some forms of restoration involve only partial regeneration in instances of a high-cut wherein the circumcisee feels that the circumciser removed too much skin and that there is not enough skin for erections to be comfortable.

Smegma is a combination of shed skin cells, skin oils, and moisture. It occurs in both male and female mammalian genitalia. In females, it collects around the clitoris and in the folds of the labia minora; in males, smegma collects under the foreskin.

<span class="mw-page-title-main">Clitoral hood</span> Part of the vulva that covers and protects the glans of the clitoris

In female humans and primates in general, the clitoral hood is a fold of skin that surrounds and protects the glans of the clitoris; it also covers the external clitoral shaft, develops as part of the labia minora and is homologous with the foreskin in the male reproductive system. The clitoral hood is composed of mucocutaneous tissues; these tissues are between the mucous membrane and the skin, and they may have immunological importance because they may be a point of entry of mucosal vaccines.

<span class="mw-page-title-main">Paraphimosis</span> Medical condition

Paraphimosis is an uncommon medical condition in which the foreskin of a penis becomes trapped behind the glans penis, and cannot be reduced. If this condition persists for several hours or there is any sign of a lack of blood flow, paraphimosis should be treated as a medical emergency, as it can result in gangrene.

<span class="mw-page-title-main">Phimosis</span> Medical condition

Phimosis is a condition in which the foreskin of the penis cannot stretch to allow it to be pulled back past the glans. A balloon-like swelling under the foreskin may occur with urination. In teenagers and adults, it may result in pain during an erection, but is otherwise not painful. Those affected are at greater risk of inflammation of the glans, known as balanitis, and other complications.

<span class="mw-page-title-main">Frenulum</span> Small fold of tissue that secures or restricts the motion of a mobile organ in the body

A frenulum or frenum is a small fold of tissue that secures the motion of a mobile organ in the body.

Premature ejaculation (PE) occurs when a man expels semen soon after beginning sexual activity, and with minimal penile stimulation. It has also been called early ejaculation, rapid ejaculation, rapid climax, premature climax and (historically) ejaculatio praecox. There is no uniform cut-off defining "premature", but a consensus of experts at the International Society for Sexual Medicine endorsed a definition of around one minute after penetration. The International Classification of Diseases (ICD-10) applies a cut-off of 15 seconds from the beginning of sexual intercourse.

Dyspareunia is painful sexual intercourse due to medical or psychological causes. The term dyspareunia covers both female dyspareunia and male dyspareunia, but many discussions that use the term without further specification concern the female type, which is more common than the male type. In females, the pain can primarily be on the external surface of the genitalia, or deeper in the pelvis upon deep pressure against the cervix. Medically, dyspareunia is a pelvic floor dysfunction and is frequently underdiagnosed. It can affect a small portion of the vulva or vagina or be felt all over the surface. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain.

The glans is a vascular structure located at the tip of the penis in male mammals or a homologous genital structure of the clitoris in female mammals.

<span class="mw-page-title-main">Balanitis</span> Inflammation of the glans penis

Balanitis is inflammation of the glans penis. When the foreskin is also affected, the proper term is balanoposthitis. Balanitis on boys still in diapers must be distinguished from redness caused by ammoniacal dermatitis. The word balanitis is from the Greek βάλανοςbalanos, literally meaning 'acorn', used because of the similarity in shape to the glans penis.

Preputioplasty or prepuce plasty, also known as limited dorsal slit with transverse closure, is a plastic surgical operation on the prepuce or foreskin of the penis, to widen a narrow non-retractile foreskin which cannot comfortably be drawn back off the head of the penis in erection because of a constriction (stenosis) which has not expanded after adolescence.

<span class="mw-page-title-main">Posthitis</span> Inflammation of the foreskin of the penis

Posthitis is the inflammation of the foreskin (prepuce) of the penis. It is characterised by swelling and redness on the skin and it may be accompanied by a malodorous discharge.

<span class="mw-page-title-main">Penile frenulum</span> Band of tissue under the glans penis connecting the foreskin to the ventral mucosa

The frenulum of the penis, often known simply as the frenulum or frenum, is a thin elastic strip of tissue on the underside of the glans and the neck of the human penis. In men who are not circumcised, it also connects the foreskin to the glans and the ventral mucosa. In adults, the frenulum is typically supple enough to allow manual movement of the foreskin over the glans and help retract the foreskin during erection. In flaccid state it tightens to narrow the foreskin opening.

<span class="mw-page-title-main">Human penis</span> Human male external reproductive organ

In human anatomy, the penis is an external male sex organ that additionally serves as the urinary duct. The main parts are the root (radix); the body (corpus); and the epithelium of the penis including the shaft skin and the foreskin (prepuce) covering the glans penis. The body of the penis is made up of three columns of tissue: two corpora cavernosa on the dorsal side and corpus spongiosum between them on the ventral side. The human male urethra passes through the prostate gland, where it is joined by the ejaculatory duct, and then through the penis. The urethra traverses the corpus spongiosum, and its opening, the meatus, lies on the tip of the glans penis. It is a passage both for urination and ejaculation of semen.

<span class="mw-page-title-main">Dorsal slit</span> Incision on penis foreskin expoing the glans

A dorsal slit is a single incision along the upper length of the foreskin from the tip to the corona, exposing the glans without removing any tissue. An ancient practice, it has been a traditional custom among a number of peoples, particularly Filipinos and Pacific Islanders, probably for thousands of years.

Frenulectomy of the penis is a surgical procedure for cutting and removal of the frenulum of prepuce of penis, to correct a condition known as frenulum breve. This condition prevents the full retraction of the foreskin with or without an erection.

<span class="mw-page-title-main">Foreskin</span> Retractable fold of skin which covers and protects the glans of the penis

In male human anatomy, the foreskin, also known as the prepuce, is the double-layered fold of skin, mucosal and muscular tissue at the distal end of the human penis that covers the glans and the urinary meatus. The foreskin is attached to the glans by an elastic band of tissue, known as the frenulum. The outer skin of the foreskin meets with the inner preputial mucosa at the area of the mucocutaneous junction. The foreskin is mobile, fairly stretchable and sustains the glans in a moist environment. Except for humans, a similar structure known as a penile sheath appears in the male sexual organs of all primates and the vast majority of mammals.

A frenuloplasty of prepuce of penis is a frenuloplasty of the frenulum of prepuce of penis.

<span class="mw-page-title-main">Buried penis</span> Male congenital condition

Buried penis, also called hidden penis or retractile penis, is a congenital or acquired condition in which the penis is partially or completely hidden below the surface of the skin. A buried penis can lead to urinary difficulties, poor hygiene, infection, and inhibition of normal sexual function.

References

  1. "Frenulum Breve".
  2. Gallo, Luigi; Perdonà, Sisto; Gallo, Antonio (March 2010). "The Role of Short Frenulum and the Effects of Frenulectomy on Premature Ejaculation". The Journal of Sexual Medicine. 7 (3): 1269–1276. doi:10.1111/j.1743-6109.2009.01661.x. PMID   20074312.
  3. Halata, Zdenek; Munger, Bryce L. (April 1986). "The neuroanatomical basis for the protopathic sensibility of the human glans penis". Brain Research. 371 (2): 205–230. doi:10.1016/0006-8993(86)90357-4. PMID   3697758. S2CID   23781274.
  4. Whelan, P (24 December 1977). "Male dyspareunia due to short frenulum: an indication for adult circumcision". British Medical Journal. 2 (6103): 1633–1634. doi:10.1136/bmj.2.6103.1633-a. PMC   1633287 . PMID   563279.
  5. "Tight Foreskin" . Retrieved 1 September 2012.[ unreliable medical source? ]
  6. Gyftopoulos, Kostis (September 2009). "Male dyspareunia due to short frenulum: the suture-free, "pull and burn" method". The Journal of Sexual Medicine. 6 (9): 2611–2614. doi:10.1111/j.1743-6109.2009.01357.x. ISSN   1743-6109. PMID   19523037.
  7. Gyftopoulos, Kostis I. (2018). "Meatal stenosis after surgical correction of short frenulum: Is the "pull-and-burn" method the way to go?". Urology Annals. 10 (4): 354–357. doi: 10.4103/UA.UA_25_18 . ISSN   0974-7796. PMC   6194789 . PMID   30386085.