Frenuloplasty

You have a tight foreskin that cannot be pulled back or tight at the skin behind the head of the penis. This can cause problems with recurring infections or tears in the foreskin area. Frenuloplasty is inappropriate if your foreskin is scarred due to balanitis xerotica obliterans (BXO) or lichen sclerosus. Please see further information for BXO.

There are three options concerning treating a tight foreskin without BXO:

• Observation – no specific treatment in mild cases
• Circumcision, which means that the foreskin is eradicated. The advantage of this operation is that once the foreskin is removed, you will not have any problem-related foreskin. The head of the penis is exposed permanently after the operation and is irreversible.
• Frenuloplasty, which is simply a foreskin-releasing procedure. An incision is made on the frenulum or excised the ridge underneath the surface, thus separating the frenulum underneath the glans. This will enable you to keep your foreskin free from the bridging and also be able to keep the area underneath clean.

What are the benefits of having a frenuloplasty? 

The benefit is that he retains his foreskin. Frenuloplasty helps to get rid of the bending of the penis.

Circumcision used to be a commonly practised operation and, on many occasions, was performed with excellent results.

What does frenuloplasty involve?

 Surgical treatment of a short penile frenulum by dividing the skin and re-stitching it lengthwise.

Details of the procedure

1. The urologist usually takes a local anaesthetic injection to carry out the procedure.
2. This local anaesthetic injection also provides post-operative pain relief
3. He divides the frenulum across and re-stitch it in a lengthwise fashion, which results in lengthening the frenulum
4. He uses dissolvable stitches throughout, which usually fall off within two to three weeks
5. He seals the wound with a special glue, which sloughs off within 7-10 days 
6. We usually cover the wound in a loose bandage, which you can remove after 1-2 days.

What can I expect when I get home after frenuloplasty?

• You will get some bruising and swelling of the penis, which may last several days.
• All your stitches will dissolve, usually within two to three weeks, but it may sometimes take a little longer.
• Pain relief, such as paracetamol or ibuprofen, can be taken for uneasiness or pain.
• Take off any dressing within 24 hours; if it becomes soaked with urine, it should be removed earlier.
• Keep the area dry for 48 hours; avoid taking a bath for ten days
• No swimming or any exercise for two weeks
• Please try to keep your wound clean and dry after passing urine
• Apply a little Vaseline to the tip of your penis and around the stitch line to stop it from sticking to your clothing
• Wear tight-fitting clothing for two to three days
• It would be best if you retracted your foreskin daily to maintain the benefits of the surgery after three days.  
• You will be given a copy of the GP letter, which should be given to your doctor.
• Get prescribed cream from any pharmacy and keep the antibiotics tablets prescription safe.
• You should refrain from sexual activity (intercourse and masturbation) for up to four to six weeks.
• Please stop smoking before and after any procedure. Smoking can delay wound healing and make complications more likely after the operation.

What are the risks, consequences and alternatives associated with you having a frenuloplasty?

Most operations are straightforward; however, as with any surgical procedure, there is some chance of side effects or complications, such as:

Most operations are straightforward; however, as with any surgical procedure, there is some chance of side effects or complications, such as:

Bruising or swelling commonly happens and will settle within 2-3 weeks.

Bleeding from the wound site (which occurs in some patients) is usually minimal and settles quickly.

Infection can arise and is usually minor but possibly severe with rare incidence—tenderness of the scar at the site of your frenulum. You are dissatisfied with the cosmetic result.

Failure to improve your symptoms may result in the need for full circumcision.

Redo operation or full circumcision: foreskin becoming tight again due to scarring or previous hidden tight foreskin.

The best alternative for tight foreskin is circumcision (full)

Three days after the operation, you must retract your foreskin each day to avoid the foreskin becoming tight again due to scarring. If you are concerned about these risks or have further queries, please get in touch with us immediately.

This information contains evidence-based information about the proposal by the British Association of Urological Surgeons (BAUS 2017)

Ref: https://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Frenuloplasty.pdf

Note: This information is for guidance only; it is not a replacement for professional advice. Please get in touch with Dr Khan for £150 for a video consultation at +447527314081