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Does A Short Penile Frenulum Require Medical Attention?

Posted on Wed, 5 May 2021

Question: My penis has a short frenulum, and I'm trying to figure out if I should get a frenulumectomy or a frenuloplasty done. I don't know which one would be better for my situation, and I have a few questions about each, but it doesn't seem like there's a lot of information out there to go off of to figure this out, and I don't want to make the wrong decision.

Answered by Dr. Dr. P. T. Patil (10 hours later)

Brief Answer:
Upload photograph of your penis both in flaccid state and after erection

Detailed Answer:
Hello
Thanks for query .

Based on the facts that you have posted you seem to have tight frenulum making erection painful .

I shall be happy if you can post me more details to help me in making precise comments
1) Do have have pain after erection ?
2) Is there curvature of penis on erection?
3) Are you married ? and have difficulty in penetration of vagina during intercourse with your female partner ?

Please revert back .Feel free to ask if you have more questions ?I shall be happy to address your concern

Thanks and \regards.
Dr Patil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (2 hours later)

I don't have pain after an erection, but if I pull down on the shaft when the frenulum has already run out of length, it hurts.

No curvature of the penis during erection, but the frenulum does pull the head down with it if I pull too much.

I'm not married, but have never had any pain during intercourse. I'm just very careful.

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
Excision of band of adhesion will resolve the issue

Detailed Answer:
Hello
Thanks for follow up and feedback.
You seem to have a band of adhesion between Glans Penis and coronalsulcus causing this issue

Consult qualified Urologist for clinical assessment . You may need to get this band excised .

This is a simple surgery done under local anaesthesia as a outdoor procedure and offers permanent solution .

Thanks and Regards
Dr. Patil

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. P. T. Patil (9 hours later)

Can you please clarify what you mean by band of adhesion, because I do not believe I have an adhesion. When you say band, are you saying that the frenulum is adhered to the penis? Perhaps I can send you more pictures from different angles to help.

When I'm flaccid, I can pull my foreskin back completely with no issues, and the frenulum only pulls the head forward slightly once the skin is pulled all the way back, because it's short.

When I'm erect, I can still pull the foreskin back behind the glans, but I can only go so far before I can't go any further due to the frenulum not having enough length to allow further retraction.

I do have a couple of questions regarding mobility after a frenulectomy in comparison to a frenuloplasty. If I understand correctly, a frenuloplasty is a lengthening of the frenulum, which allows for normal mobility of the foreskin, but you still have the frenulum. Also if I understand correctly, a frenulectomy is simply the removal of the frenulum, which allows complete mobility, but involves the complete removal of the frenulum.

Is it possible to have a frenulum that's too short for a frenuloplasty, to where it still wouldn't be long enough after the procedure?

Is it possible that I could still have mobility issues if I get a frenuloplasty instead of a frenulectomy?

Does a frenuloplasty involve higher risk than a fenulectomy?

If I get a frenulectomy done to completely relieve the issue, would that take away the ability for the foreskin to stay pulled back since the frenulum is no longer present?

Would this also mean that the foreskin wouldn't stay back during sexual activities?

Thank you.

Answered by Dr. Dr. P. T. Patil (11 hours later)

Brief Answer:
You have tight (Short)Frenulum

Detailed Answer:
Hello
Based on the photographs that you have uploaded you have short frenulum .
It should get corrected by surgery of Frenuloplasty .

During Frenuloplasty a frenulum is lengthened and kept intact which helps to resolve the issue .Frenulum plays important role in sensation of sexual pleasure hence normally we to do frenulectomy unless it is very very short and must needed to be when one is unable to penetrate vagina during intercourse .

Thanks and Regards.
Dr Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (14 hours later)

It sounds like it would be better to go with the frenuloplasty over the frenulectomy.

Could you answer the other questions I had though about the frenulectomy?

If I get a frenulectomy done to completely relieve the issue, would that take away the ability for the foreskin to stay pulled back since the frenulum is no longer present?

Would this also mean that the foreskin wouldn't stay back during sexual activities? I really need to know this.

How much loss of pleasure and sensation are we talking about? Would it be a large noticeable difference in what I feel during sex if I don't have a frenulum? Like 20% loss in pleasure? 50% loss? 80% loss?

Thank you.

Answered by Dr. Dr. P. T. Patil (8 hours later)

Brief Answer:
It makes no difference as far as Foreskin covering glans

Detailed Answer:
Hello
Thanks for follow up .

During sex Foreskin acts like a sleeve covering the glans penis during forward and backward movements of the penis in vagina.

Foreskin and frenulum both contain sensory nerve ending involved in sense of sexual pleasure hence removing only frenulum by Frenulectomy does not affect as Foreskin is intact.

sexual pleasure to great extent .However no scientific studies have been carried out to estimate the loss in terms of percentage of pleasure of sex by doing Frenuloplasty .

Doing Frenuloplasty will not affect the foreskin covering the glans either during or after sex .

Thanks and Regards/
Dr Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (10 minutes later)

My foreskin pulls back automatically when I'm erect, and stays back when I'm erect, I'm assuming because of the frenulum is keeping it pulled back. If I had the frenulum removed, would that mean my foreskin wouldn't pull back automatically anymore? Would it mean that the foreskin wouldn't stay back while erect, since the frenulum isn't holding it back?

Thank you.

Answered by Dr. Dr. P. T. Patil (27 minutes later)

Brief Answer:
It is the thrusting movements that keep Foreskin covering over glans

Detailed Answer:
Hello
Thanks for follow up .

It is the trusting movements during sex that covers the foreskin over glans penis .Foreskin would come back to normal position of covering the glans penis after sex when the penis becomes flaccid .

Thanks and Regards.
Dr Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (9 minutes later)

That's where I'm confused though. I thought the foreskin was supposed to stay back during sex. When I'm having sex, my foreskin stays pulled back. It does not move back over the glans. I thought this was because the frenulum kept it pulled back. Is the foreskin not supposed to do that?

Answered by Dr. Dr. P. T. Patil (7 minutes later)

Brief Answer:
Do not get confused

Detailed Answer:
Hello
Thanks for follow up .

During sex one does not feel the position of Foreskin It is the friction of foreskin and glans against the vaginal wall and sexual pleasure that does not make to feel the position of Foreskin whether it is back or covered over glans .

Do not go in too much details as long as you are enjoying sex .

Thanks and Regards.
Dr XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (18 minutes later)

Thank you.

I've been reading about the two different procedures, and they both seem like they offer the same type of outcome, but with the frenuloplasty, you get to keep the frenulum, which is what I would prefer. I don't want to lose that sensitivity.

It does seem like the frenuloplasty is more involved though. It looks like they would put me under to do the procedure. Why do you have to be put under for a frenuloplasty but not a frenulectomy?

Answered by Dr. Dr. P. T. Patil (8 hours later)

Brief Answer:
Can not follow your query .

Detailed Answer:
Hello
Thanks for follow up .
I could not follow what you mean by."They would put me under to do the procedure."

We Urologist in XXXXXXX do both procedures under local anesthesia .

Thanks and Regards.
Dr Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (2 hours later)

From what I've been reading, and it could be wrong, here in the US they do local anesthesia for the frenulectomy, but they put you to sleep for the frenuloplasty. I was wondering why that would be. To me that sounds like the frenuloplasty is a more involved procedure, or presents a higher risk. I'm really not too sure.

One of my issues is that the information available online is so limited, and it has been extremely hard for me to figure out any details about these two procedures. I can't even seem to find pictures that would show me before and after shots for patients, so I'm really in the dark on a lot of this.

I am feeling very confident however that a frenulectomy would be the best way to go, so that's what I would like to get done.

If the frenuloplasty doesn't end up fixing the problem entirely, would I still have the option of a frenulectomy, or would I have to get circumcised?

Is there a difference in success rate for the frenulectomy vs the frenuloplasty?

Answered by Dr. Dr. P. T. Patil (11 hours later)

Brief Answer:
Success rate of both the pocedures is same .

Detailed Answer:
Hello
Thanks for follow up .

Both the procedures are simple and similar the choice and feasibility of surgery is decided on the clinical examination by an operating surgeon .

There is no difference as far has success is concerned .

Local anesthesia is given, in Frenulectomy as it is very short and less time consuming .Surgeon has to just excise the frenulum in Toto where as in Frenuloplasty frenulum is incised (Opened) and redesigned to lengthen it and to keep it intact taking care of keeping cosmetic appearance of gland and penis as normal as possible .

Hope this will allay your anxiety .

Thanks and Regards.
Dr Patil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (31 hours later)

Thank you so much for your assistance.

You have made me feel so much better about this whole situation.

I have an appointment scheduled with my primary care physician on Tuesday to discuss the frenuloplasty I would like to have done, and see if he can get me in with a good uroligist that he trusts to do the procedure as soon as possible.

I may have further questions for you after I see him, but I want to thank you so much for all you have done for me up to this point.

Answered by Dr. Dr. P. T. Patil (51 minutes later)

Brief Answer:
O.K Bye Do write if you need my help .

Detailed Answer:
Hello
Thanks for follow up and appreciation .
Do not hesitate to write after you see your Primary Care Physician and Urologist and need any help from me .

Thanks and Regards.
Dr Patil

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Above answer was peer-reviewed by : Dr. Raju A.T