Short frenum repair (frenulotomy)
Bridle - an elastic skin band that fixes the head of the penis with the foreskin. It is abundantly equipped with nerve endings and vessels. The main function of this formation is the retraction of the foreskin with the maximum exposure of the head during intercourse, facilitating the rhythm of excitation and the release of sperm.
Pathologies associated with shortening or rupture of the frenum are a serious threat to the health and personal life of a man. But it is solved quickly (up to 30 minutes) and painlessly.
In FNCC FMBA, various methods of surgical treatment of the frenulum of the foreskin of the penis are used, taking into account the indications for each patient. For an experienced urologist, the procedure is simple, performed on an outpatient basis, under local anesthesia, does not require preliminary additional diagnosis of the pathology. Timely surgery performed completely relieves the man of the problem, eliminates relapse and complications (subject to the recommendations of the doctor).
Information about how much the plastic of the frenulum of the foreskin costs is presented below in the table.
Indications for correction of the frenum of the foreskin
If the bridle is shortened, too much tension is created during an erection. A pronounced deviation of the head down is reflected in the following complaints:
soreness of intercourse,
tears, cracks or complete rupture of the frenum,
Shortening the bridle is common enough. The causes of abnormalities include intrauterine growth disorders, injuries, cicatricial changes due to inflammatory processes.
With pronounced shortening, the manifestation of pathology is noted in adolescents with regular erections, masturbation. With moderate - during the first sexual intercourse. Tears or a complete rupture of the anatomical formation causes severe pain, bleeding, sometimes quite profuse. If the strain heals independently, then scar tissue forms in this place, which further shortens the cord. There is also a risk of infection of the wound and the spread of inflammation to the genitourinary system.
The consequences of this anomaly are painful sensations, short sexual intercourse, early ejaculation, depressive disorders. It is recommended to solve this problem in advance, before the appearance of tears and scars.
Penile frenum plastic surgery is performed in men who have encountered the following indications:
difficulty in exposing the head (tension, soreness),
tilt of the head when exposing the foreskin to an angle of about 20 °,
rupture or tears of the bridle,
If the frenulum rupture has occurred, then you should contact the urologist as soon as possible before scar tissue begins to form. With concomitant phimosis, paraphimosis, partial or complete circumcision of the foreskin is first performed, followed by plastic surgery.
How is the frenum plastic surgery performed?
If there are no already existing complications (gross cicatricial changes), concomitant phimosis, balanoposthitis, then frenum plastic surgery takes 10-30 minutes. For absolute painlessness, local anesthesia is sufficient, since the procedure is simple and short. General anesthesia is used only for children. Plastic surgery does not require hospitalization and special preparation. The patient arrives at the appointed time and returns home the same day.
The sequence of stages of this minor surgical procedure:
standard treatment of the surgical field,
restoration of the anatomical structure,
if there are scars - their excision,
The operation is carried out by different methodological techniques of plastic and methods of dissection of tissue:
The choice of methodology is determined by the clinical indications, the degree of shortening, the age of the patient. Each method has advantages and disadvantages.
The classic version of plastic. Used most often. The bridle is dissected across with a scalpel. The artery is pinched by a ligature. Cicatricial lesions are removed. Then, the edges of the wound are stitched in the longitudinal direction. A sterile dressing is applied. Self-absorbable suture material is commonly used. If part of the thread has not resolved, it can be removed after a week at a doctor's appointment. As a result, a thin elastic scar forms on this site, naturally continuing the line of the penis.
The advantage of the method is a more reliable fixation by threads of a postoperative wound. Since the genital organ involuntarily changes in size, the edges of the tissue without seams can diverge with an erection. The disadvantages include a small blood loss and a slightly longer duration of the operation.
With the existing complications associated with the long-term existence of pathology or concomitant disorders, more complicated plastic surgery is performed with the formation of structures that contribute to the restoration of a sufficient erection.
Laser plastic. Laser scalpel surgery has several advantages:
reduction of intervention time,
no risk of infection,
seamless wound closure.
The disadvantages include the following risks:
discrepancies of the edges welded together by the laser (in this case, it is necessary to re-burn the wounds, which is fraught with new scars),
possible minor tissue burns,
the difficultly controlled depth of laser penetration can damage the urethra, since this organ is close to the area of operation.
Radio wave plastic. This method involves dissecting tissues non-contact in several stages with a radio knife. In this case, thermal damage to the tissue is reduced. High frequency radio waves can simultaneously trim and sterilize the bridle, stop the bleeding. There is also no need for suturing and therefore there is a risk of wound divergence, as with the laser technique.
The use of modern techniques requires considerable skill of the urologist, reliability and quality of the equipment. In order to avoid complications from the medical procedure, the decision on where to perform surgery on plastic surgery of the flesh of the foreskin should be approached thoroughly and make a choice in favor of large, time-tested centers that have a good reputation.
Preparation for plastic frenum of the penis
Given that cutting is a simple procedure and is performed under local anesthesia, complex preoperative preparation is not required.
A small list of tests, the results of which must be brought before the operation, includes:
general urine analysis,
blood coagulation indicators (to exclude possible bleeding during the intervention),
clinical blood test,
HIV test, syphilis, hepatitis.
If the patient insists on general anesthesia, then the preliminary examination is more expanded, since a rather serious load on the body is provided. In this case, an ECG is performed with the conclusion of a therapist, a lung scan, a detailed biochemical blood test (all indicators of kidney, liver, glucose, cholesterol, protein fractions).
On the day of surgery, it is recommended:
thorough hygienic cleaning
shaving the operation area,
If the patient is too worried, the doctor prescribes sedatives at night and before surgery. A few days before the plasty, you should stop taking drugs that affect blood coagulability, reduce the intensity of physical activity, and also give up smoking, alcohol and drinks containing high doses of caffeine.
In the final calculation of the cost of plastic surgery and correction of the frenulum of the foreskin of the penis, the complexity of the defect, the cost of anesthesia, and concomitant diseases are taken into account. All questions are best discussed in advance, after a doctor’s examination.
A short bridle in the form of a longitudinal fold is located between the head and the movable flesh of the penis. In this area, nerve fibers, blood vessels and lymph nodes are focused, providing irritability to the organ.
The sensitivity of the frenulum is much higher than in the head of the penis, which increases excitability and brings orgasm closer. It acts as a natural regulator of man’s erection, is responsible for tightening the flesh during sexual contact, directs the bending of the head, determines the displacement of prepuce.
Most men are sure that it is possible to solve the problem of the organ’s working capacity in such a situation if circumcision of the foreskin is done, but doctors recommend this operation only in a hopeless situation.
A positive result is achieved by simple surgical intervention - a plastic surgery of a short frenulum or frenulotomy. This is the name of the dissection of the frenulum of the foreskin or, in some cases, the removal of altered tissue resulting from scarring.
Plastic surgery of frenulotomy is recommended for the following indications:
- changes and injuries of the penis,
- pain during sexual intercourse,
- bleeding due to mechanical damage,
- violation of the flesh of the head in case of insufficiency of secreted secretion (rush, crack),
- uncontrolled ejaculation caused by the congenital structure of a short frenum,
- incorrect position of the penis when excited,
- prolonged feeling of discomfort in the head area (tension, tension),
- scarring of the skin at the site of gusts,
- development of phimosis (narrowing of the opening of the foreskin).
With close contact in case of pain and the development of bleeding, a person, trying to prevent a second break, often restrains himself. In both physical and psychological terms, this leads to the difficulty of completing an orgasm. Against this background, an irreversible consequence develops - a complete or partial violation of the erection. Therefore, if these symptoms are detected, you should consult a doctor for advice.
Frenulotomy of a short frenulum is considered a simple surgical operation. However, there are contraindications, which are diseases or inflammation occurring in the body:
- kidney or liver failure,
- acute infectious diseases, inflammatory processes accompanied by fever,
- disorders of the genitourinary system,
- diseases associated with a violation of the coagulation process,
- scarring of the foreskin,
- oncology of organs,
- sexually transmitted infections
- complex diseases of the immune system (HIV),
- temporary decompensation.
Advantages of the technique
To eliminate the problems encountered with the function of the short frenulum, the surgical method is used. The magnitude of the skin cord can be changed only with the help of surgical intervention. No folk remedies or conservative methods will bring positive results.
The procedure itself for lengthening the bridle in time is short. Patients of different ages seek help from a doctor. As part of the preliminary preparation, the delivery of appropriate analyzes and preparatory measures are necessary. These include:
- blood test to assess the general condition of the body,
- research on the presence of diseases of the hepatitis group, immunodeficiency, sexually transmitted infections,
- blood coagulation diagnostics.
It is important to take measures to stabilize the level of blood pressure in order to prevent changes in indicators. In case of injury with heavy bleeding, blood reserves of a suitable group are needed.
In older men, there is a risk of developing hypokalemia (potassium deficiency). In this case, preparations containing potassium are prescribed.
At the preparatory stage for frenulotomy, the patient has no restrictions on food or fluid. It is recommended to categorically refuse alcoholic beverages two to three days before the operation.
Frenulotomy Procedure Algorithm
- At the first stage, the skin of the patient’s inflamed area is carefully treated with a disinfectant.
- Then anesthesia is administered. Anesthesia takes into account the age-related characteristics of a person. For adolescents under 12 years of age, the drug is administered intravenously, for older patients - directly into the penis.
- When anesthesia begins to act, the surgeon begins the operation. The bridle is transversely dissected with a scalpel, a bandage (ligature) is applied to the section artery, then longitudinal sutures are applied to the resulting wound.
- If there is an old scar formed for one reason or another, it is immediately removed.
- A gauze bandage is applied at the end.
The frenulotomy procedure and the preparatory stage for it take only half an hour. After which the patient returns to daily affairs, as hospitalization is not required.
In plastic surgery, there is another method for dissecting a short frenulum - Y-Plastic. Differs in a way of drawing a cut. But it is not popular with doctors. When it is carried out, in addition to an unaesthetic incision, narrowing of the flesh is also possible, leading to physical complications. As a result of using this technique, the risk of developing phimosis is high.
After the operation, the patient is recommended to follow preventive measures to prevent the development of inflammation that occurs as a result of infection in the operated place. These include compliance with the following recommendations of the attending physician:
- the use of disinfectants for treating wounds,
- abstinence from sexual intercourse or masturbation until complete healing,
- personal hygiene, constant care of the genitals,
- refusal to visit a bath or sauna, an excessively hot bath.
Frenulotomy is performed in a network of clinics and centers located in Moscow and the Moscow region, whose contacts are listed on our website. A full range of services is offered for patients of all ages: diagnosis, plastic procedures, postoperative care. Qualified urologists, embryologists and other doctors specializing in this area work.
Detailed information, address and working hours are available on the sites of clinics, where you can make an appointment for a preliminary examination, the required medical procedures.
Prices for frenulotomy vary between 5-10 thousand rubles. The cost depends on the volume of the examination, the complexity of the operation, as well as the qualifications of the doctor and the status of the hospital where the treatment is planned.
Reviews of men who did frenulotomy are positive. Mostly, they note painlessness, quick healing of the wound, elimination of the risk of scarring, a short rehabilitation period, and the full restoration of impaired penile functions.
What is frenulotomy?
Frenulotomy is a simple operation, is shown with such a feature as a short frenum of the penis. During this operation, the bridle is transversely dissected, and then sutured in the longitudinal direction.
Thus, it stretches to a normal length. As a result, only a thin shovchik is visible from the inner surface of the foreskin, everything looks quite natural. All the operation lasts no more than 20 minutes, it does not apply to complex surgical interventions, performed under local anesthesia.
It is advisable to consult a qualified doctor with extensive experience, as the result of an improperly performed operation may form a rough scar. Do not be afraid of frenulotomy, everything goes quickly and painlessly for the patient.
That is why an urgent recommendation for all those who have such a problem is not to postpone until the last, decide finally and consult a doctor, you will receive expert help and no more pain or any discomfort during intercourse will not bother you .
Hospitalization is not required, after a very short time after surgery, you can already go home. The wound heals pretty quickly usually after 2-2.5 weeks after the operation, the man does not remember what bothered him.
Thus, usually the worst thing is to decide on a frenulotomy, the process itself will not cause you any inconvenience and soon the patient will be able to leave the clinic.
When to spend
I would like to talk about specific indications for plastic short frenum:
- Pain, discomfort in the area of the frenulum of the penis during sexual intercourse, causing the man to interrupt and not allowing him to have a full sexual life.
- Lowering of the genitals during an erection.
- Permanent frenum injuries during intercourse followed by bleeding.
If you notice the symptoms described above, it is better to consult a doctor immediately.
Before the operation, the patient will be asked to take a series of tests. Usually this is: a coagulogram, tests for hepatitis B and C, for syphilis and HIV.
The goal of frenulotomy is to lengthen the frenum of the penis to normal length. For this, the andrologist carries out incisions on the bridle in the transverse direction, thus the skin fold is stretched. Seams are laid in the longitudinal direction.
All this is done under local anesthesia, completely painlessThe patient does not feel any discomfort or pain. In time, too, not very long - 15-20 minutes.
After surgery, a wet dressing is applied to the wound for approximately 12 hours. After half a day, it can be safely removed and in the future simply observe hygiene, and still do not forget to wear fresh linen every day. After 8-9 days, the seams will gradually begin to fall away. The patient will be able to return to an active sex life in about 2-2.5 weeks.
It happens that the patient gets to the andrologist already with a torn bridle, which of course is very unpleasant, but still solvable. The difficulty specifically in this case is that on the bridle as a result of trauma, connective tissue has already formed, which contributes to additional shortening of the bridleas well as premature ejaculation.
In any case, despite the fact that this situation is a more neglected case, you should not despair, you should contact your surgeon as soon as possible. Through a simple cosmetic operation, this problem is usually simple and elementary, the connective tissue is excised, everything is restored.
Of course withonce after surgery, the bridle should beware and in no case lead a sexual life for 2-2.5 weekswhile healing of the wound surface occurs. On the day of surgery peace must be kept and cold applied to the wound.
Thus, you can be sure that there will not be postoperative bleeding. Well, in order to avoid infection, the doctor may prescribe an antibacterial cream. If you fully comply with all the doctor's prescriptions, then no undesirable consequences will occur.
The main thing to remember is that frenulotomy is a very simple operation, but at the same time effective, after a few weeks you can enjoy life in all its manifestations without thinking about pain and without suffering from bleeding during intercourse.
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What is useful frenulotomy
- The operation is 100% guaranteed that the man will not have a rupture of the frenum during sexual intercourse, and hence subsequent infection and inflammation.
- The operated person will no longer experience any discomfort or pain during an erection and the act itself. Sexual life will improve and will take place without overlays.
- During an erection, the penis will not be abnormally lowered.
The intimate sphere is very delicate for any man, sometimes because of this, a person launches his illness, is afraid to go to the doctor, does not believe in a positive treatment result. But all this comes only from ignorance, misunderstanding of the true state of things.
When a man knows that he has to go through, how difficult it is, he makes the right decision much faster, which consists in the fact that when he finds in himself such a feature as a short frenulum of the penis, you should seek qualified help without waiting until the frenum ruptures.
But even in case of its tear, you need to know that the problem is solvable, restoring the frenum to the norm is feasible and does not present any particular difficulty for the andrologist.
From the next video you can find out even more information about foreskin frenulotomy.
PHOTO BEFORE AND AFTER
- 2078 patients underwent frenulotomy in our clinic. 175 of them came from other clinics because they could not help them there. We carry out the procedure according to the technique developed in our clinic.
- Doctors of the ABC clinic not only carry out the procedure, but also the only clinic in Russia with their own program.
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Recovery after frenum repair
The rehabilitation period, after plastic surgery of the flesh of the foreskin was performed, takes at least a month. During this time, a scar is fully formed, blood circulation in the head area is restored. The operation is simple, complications occur only when the patient ignores the doctor's recommendations for the recovery period.
loss of head sensitivity
excessive scarring of the seam,
constriction of the foreskin.
In order to quickly return to a normal intimate life and prevent complications, a number of simple doctor's prescriptions should be followed:
care for the forming scar (7-9 days) - treat with solutions,
abstain from sexual intercourse for 2 weeks,
make sure that urine does not enter the wound (bend the head when urinating),
reduce physical activity for a week,
take medications prescribed by your doctor.
After the wound has completely healed, it is necessary to use lubricants for at least a month to soften the friction of the postoperative scar during sex.
If the prescriptions are not followed and complications develop, repeated operations, already more complex, will lead to the formation of scar tissue, which reduces the normal functioning of the organ.
Plastic surgery of the flesh of the foreskin at the Federal Drug Control Center of FMBA in Moscow
FNCC FMBA has been treating patients from all regions of the country for many years, conducting research and successfully introducing the latest technologies in the field of medicine. Logistical equipment with high-precision equipment allows for the most complex operations and rehabilitation measures.
Urology is one of the most demanded specializations of the center among patients of any age group.
Advantages of FNCC FMBA:
impeccable reputation among colleagues, patients, insurance campaigns,
wide experience and knowledge of doctors,
high quality of asepsis, minimal risk of infectious complications,
reliable equipment and tools for diagnostics and surgical interventions,
delicate approach and confidentiality to solving intimate issues of men.
The urologist of the center chooses the method of surgical intervention taking into account the clinical recommendations for each patient. With the high quality of the doctor’s work, the price of plastic surgery of the frenum of the penis is acceptable for any man who values his health.
The structure and functions of the foreskin
The main function is to protect the sensitive mucous membrane from mechanical damage and external irritants. In an unexcited state, a fold of skin completely or partially covers the head. With an erection, it shifts back to the base of the penis.
- Phimosis - narrowing is congenital or acquired, for example, due to trauma and the inflammatory process. With this disease, the head either does not expose at all, or opens with difficulty. For treatment, plastic of the foreskin is used.
- Postit - inflammation localized on the head and inside of the skin fold, often manifests itself as redness.
- Paraphimosis - occurs when the constricted flesh is forcibly pushed back. There is an infringement of the head of the penis.
The foreskin is connected to the head through the frenulum - a narrow skin fold located along the underside of the penis. During intercourse, it stretches and bends the penis, due to this, there is a more pronounced stimulation of erogenous zones in both partners.
Congenital short bridle can interfere with normal sex life. Often this pathology is detected only at the onset of puberty, after the first sexual contact. During intercourse, a man feels pain. Often there are tears and bleeding. Against this background, psychological disorders and associated erectile dysfunction may develop.
Rupture of the frenum is very painful, it is accompanied by heavy bleeding, which can threaten a person’s life. If untreated, permanent injuries contribute to the growth of scar tissue. As a result, the longitudinal skin fold is roughened and shortened even more. During frictions, the penis bends noticeably, very strong stimulation occurs, causing premature ejaculation.
In order to avoid unnecessary problems and torment, men with this pathology are recommended to make a simple cosmetic operation on the frenum of the foreskin. The price of such a surgical procedure ranges from 5 to 15 thousand rubles.
Causes of pathology and treatment
In the vast majority of cases, the cause of a short bridle is congenital. Almost all boys are born with narrowed foreskin. Physiological phimosis is often combined with a shortened bridle. Over time (5-6 years), everything comes back to normal. The head opens freely and painlessly. For about 5% of children, this somehow does not happen.
If the child has such a pathology, it is recommended to make a correction of the foreskin and frenum at an early age. This will help get rid of possible problems in the future.
Acquired reasons for a short bridle:
- Member injuries arising during intercourse. For example, hard sex with too active frictions or the defloration process.
- Constant wearing tight underwear and tight pants.
- Sports injuries.
- Tattoos and piercings in an intimate place, as well as self-administration of Vaseline or balls under the skin, leading to damage to the penis.
- Venereal diseases.
- Diabetes mellitus, which caused circulatory disorders.
Pathology of the frenulum is not treated by conservative methods. All self-extension tips that can be easily found on the World Wide Web are a hoax or a delusion. The only effective and effective remedy that is known today is frenuloplasty. This small surgical procedure, carried out under local anesthesia, lasts only 20-30 minutes.
If sexual intercourse is accompanied by unpleasant sensations in the bridle, do not wait for a break, because it is very painful and dangerous. The right decision - as soon as possible to go to the appointment with a urologist.
Frenulotomy and indications for surgery
Frenulotomy is a surgical procedure for excising a bridle to lengthen it. It consists in applying a transverse shallow incision and the subsequent stitching of the edges of the wound in the longitudinal direction.
Indications for surgery:
- The erect penis is bent so that the head bends down.
- Retraction of the skin fold is difficult, pain and a feeling of tightness occur.
- Painful frictions cause discomfort and interfere with normal sexual intercourse.
- Frequent tears of the frenum and bleeding.
- Phimosis or paraphimosis.
- Early ejaculation.
Frenulotomy is a simple operation and is often performed on an outpatient basis. Usually local anesthesia is sufficient, but in some cases general anesthesia may be necessary. The procedure does not last long, about half an hour.
Before the operation, the patient passes all the necessary tests, including HIV and undergoes examination. After that, if there are no contraindications, he gets into the operating room. The surgeon makes a transverse incision 5 mm deep in the middle of the frenum. If necessary, excess scar tissue is removed. Then the edges of the resulting wound are connected longitudinally using a special self-absorbable suture. A sterile dressing is applied to the dissection site, which cannot be removed for 12 hours.
Often, the pathology of the frenulum is combined with phimosis. In this case, circumcision is performed in parallel - an operation to remove the foreskin.
In many modern clinics, a laser is offered as an alternative to a scalpel. The cost of this method is higher, but a laser knife has its advantages:
- lack of bleeding
- minimal trauma
- there is no risk of infection and postoperative inflammation,
- no seams
- jewelry accuracy
- after healing there are no traces left
- recovery occurs 2 times faster than with conventional surgery.
After the operation, the patient does not need hospitalization and can safely go home. Edema lasts for several days, and urination is accompanied by unpleasant sensations.
Recovery and risk of complications
Recovery does not last long and takes from 2 weeks to a month. The first few days after surgery, the patient must perform daily dressings and use a special antimicrobial ointment.
Be sure to follow the doctor's recommendations:
- the use of antibiotics or anti-inflammatory drugs,
- analgesics are used to relieve pain,
- during the month it is forbidden to play sports, go to the sauna or pool, or take a bath,
- briefs should be comfortable, not too loose, but not tight,
- until the postoperative wound heals, an erection should be avoided, there is a risk of seam divergence.
Impeccable fulfillment of all the requirements of a doctor is the main condition for a successful recovery. Their neglect and irresponsible attitude to their health can have adverse consequences for the patient.
Complications after frenulotomy:
- pronounced pain in the penis,
- bleeding at the suture site,
- severe swelling of the body of the penis,
- postoperative scarring
- poor appearance
- penetration of infection into the reproductive organ.
In most cases, complications are not dangerous and are treated on an outpatient basis.
Contact with water should be avoided for a week after a frenulotomy. To do this, while swimming on the penis, you can put on a condom. Sex is permitted only after complete healing, when a pink scar forms at the site of the wound. Sexual intercourse should be carried out carefully during the first month, it is recommended to use a lubricant.
Causes of the appearance of pathology
Most often, the pathology of the frenulum is congenital, and it can be seen even in infancy. In rare cases, it develops in boys aged 14-15, when puberty begins, and organs grow quickly and unevenly.
In addition to the anatomical developmental anomalies, the malfunction of the frenulum may be due to some external reasons:
- Mechanical damage. Injuries can affect the elasticity of an organ and disrupt its integrity. For example, tight clothing can cause microcracks, which can lead to fusion of the head with prepuce. Rupture of the frenum can occur during intimacy, while healing it forms scars that reduce tissue elasticity and cause pain.
- Chronic balanitis and balanoposthitis cause deformation of the tissues of the penis, which causes phimosis and other problems.
- Diabetes mellitus, which is not adequately treated, causes a narrowing of blood vessels, which also cause a violation of the functionality of the bridle.
Pathologies of the frenulum can entail not only the absence of harmonious relations, but also much more serious troubles. Here are just a few of them:
- premature ejaculation
- heavy bleeding (with rupture of tissues),
- organ inflammation due to frequent injuries,
- tissue scarring
- the development of paraphimosis and phimosis, causing pinching of the head and impaired blood supply.
Rupture of the frenum can occur during rough sex, when thin skin simply can not withstand tension. Due to the abundance of blood vessels and nerve endings in this area of tissue, a man feels severe pain, which can lead to pain shock. In addition, bleeding of this kind may not go away on its own. If these symptoms appear, you should immediately consult a doctor.
If you let things go by chance and let the bridle heal on their own, then the problem can only worsen. Scars and growths will appear. This is because, on the penis, healing takes place rather slowly, and wearing clothes will only add microcracks to the existing gap. As a result, scars will appear that reduce the elasticity of the organ, and therefore cause new injuries.
Another nuisance that a short bridle can provoke is premature ejaculation. This is due to the fact that most of the nerve endings are located just in this area, and it is he who is responsible for the onset of orgasm. Therefore, due to strong tension, early ejaculation occurs. This can lead to impotence, erectile dysfunction and fear of intimacy - erotophobia.
Symptoms and manifestations of phimosis
Another pathology that causes problems when exposing the head is phimosis. This is a narrowing of the foreskin. Usually, the pathological form of the disease is diagnosed in boys over 7 years old, because up to this age, a physiological form can be observed in which the head is not completely exposed due to insufficient mobility of prepuce.
All forms of phimosis diagnosed after seven years of age are pathological. During treatment, this does not matter, since a complication can occur in both cases.
Physiological phimosis occurs due to the bonding of the head of the penis with the inner leaf of the foreskin. Pathological may not be congenital, most often it appears due to injuries or inflammatory diseases. Another reason is the uneven development during puberty. The causes of the disease, which developed without injuries or inflammation, are not fully known.
The main symptom pointing to this pathology is the inability to expose the head of the organ. Children may experience anxiety when urinating. In adults, in some cases, a decrease in potency begins due to the appearance of pain during intercourse and its constant expectation before it. Degrees of development:
- I degree: the head is exposed without effort in a calm state and with little effort during an erection.
- II degree: in a calm state, the head is exposed with little effort, in an erection state this can not be done.
- III degree: the head is not exposed at all or with significant effort at rest, in a state of excitement, exposure is not possible. Urination is not difficult.
- IV degree: exposure is impossible in any state, urination is very difficult. Urine is excreted in drops or a thin stream.
There are complications, such as paraphimosis, balanoposthitis, and fusion of the head with prepuce. All of them are extremely painful and require immediate plastic surgery of the foreskin.
The only way to resolve these problems is through surgery. Plastic surgery of the foreskin frenum or circumcision takes very little time, about 20 minutes, hospitalization is not required. These operations can solve the problem with pathology in one hundred percent of cases. They are performed under local anesthesia (for patients under 12 years of age, it is administered intravenously, older - directly into the organ).
Before surgery, the patient should consult a surgeon and discuss the treatment. Then the patient is given a direction to prepare for the operation, and he must undergo the necessary examinations. This is aimed at identifying contraindications and assessing health status in order to minimize complications. The following tests are prescribed:
- blood type and rhesus examination,
- blood biochemistry
- general analysis of urine and blood,
- determination of the concentration of PSA in the blood in men older than 55 years.
In addition, a functional examination is prescribed, which includes fluorography, ultrasound duplex scanning (SPL) of blood vessels and an electrocardiogram. In some cases, ultrasound of the scrotum, pelvic organs and abdominal cavity is added to them.
In addition to the examination, other recommendations should be followed. For example, two weeks before surgery, you should quit smoking, and two days later the patient is prescribed antibacterial drugs, the use of which helps to reduce the risk of suture inflammation.
The hairline in the area of the organ is removed to prevent hair from getting into the wound. This can be done both at home and in the hospital before the operation itself. The main thing is to be careful not to damage the skin.
Types of operations
There are several types of operations, selected on the basis of the underlying disease and related complications. The most popular type is surgery after rupture of the frenulum of the foreskin and frenulotomy, that is, plastic that will help avoid it. The most popular types are:
- Sewing after tearing. If the bridle is torn, then waiting for healing at home is far from a good idea, because it will cause only complications. A tight bandage should be applied and consult a doctor immediately. The doctor closes the wound, applies a bandage with an antiseptic and prescribes medications that will speed up the regeneration and help to avoid infection.
- Plastic short frenum. The doctor makes a transverse incision, removes scar tissue, if any, and sutures it in the longitudinal direction. Thin self-absorbable sutures are usually used, the operation lasts about 10 minutes.
- The operation to lengthen the frenum. It is made similar to plastic short. The difference is only in the form of incisions: the incision in the frenum is made in the form of V, and sewn in the form of Y. This helps to lengthen it by 1-1.5 cm. This method has not gained popularity due to poor efficiency. After it, the appearance of phimosis is possible, since a narrowing of the prepuce is formed. In addition, an ugly scar appears.
- In the case when, due to frequent tears and independent fusion of tissues, many scars appear, the frenum is removed. This operation is called frenulectomy.
The operation is considered cosmetic, but you should not neglect a visit to the doctor, so as not to aggravate the situation and not get much more serious problems.
Rehabilitation takes about a month. At this time, it is desirable to exclude sexual intimacy, physical activity and very carefully care for the body. A few days after the operation, you need to do dressings with a sterile tissue, use antibacterial ointments. In some cases, the patient is prescribed baths with oak bark or chamomile. During the week, do not wet the organ with plain water. When taking baths, you should put on a condom and tighten it at the base so that no water gets inside. It is important not to transmit so that the blood supply is not disturbed.
After the operation, lubricants should be used during intimacy for at least a month so that friction does not damage the delicate scar.
Methods and rehabilitation
First you need to decide which way is best to carry out the operation. To do this, you need to know all the pros and cons. There are two methods:
- The classic method using a scalpel. This is the most common way. Its disadvantage is that there is significant blood loss and there is a risk of tissue infection during the operation.
- With a laser or radio wave instrument. These methods are almost painless. Blood loss is much less, because under the influence of a laser, coagulation of cells and blood vessels occurs, and the liquid evaporates. With this method, rehabilitation is much easier and there are practically no traces left.
In practice, the classical method of operations is more effective. This is due to the fact that during recovery in the postoperative period, the organ should be completely at rest, but the penis is mobile, and the slightest erection can lead to the divergence of the laser-sealed sutures. Because of this, until the healing is required to fix the position of the edges of the wound. Otherwise, a scar may occur that will return the problem. In addition, when using a laser or any other radio wave instrument, there is a chance to touch other internal and external organs.
The benefits of laser surgery are no risk of infection. It is worth considering this, because about 10% of complications after frenulotomy are due precisely to infections and inflammations.
Other complications may occur regardless of the method of operation. They can appear both in the process of intervention, and during rehabilitation:
- severe pain
- pronounced edema of the genital organ,
- unaesthetic seam.
All complications are also treated on an outpatient basis. The unaesthetic appearance of the penis can also be corrected, but such issues are decided with the doctor individually.
Reviews about the plastic are mostly positive, because the operation eliminates the main problem. Negative responses happen, but mainly from those men who are dissatisfied with the aesthetic result of the operation.
Frenulotomy Prices at ABC Clinic
|Bridle plastic||8,200 rubles|
|Urologist andrologist surgeon appointment||1500 rubles|
|Frenuloplasty (plastic frenum of the penis)||11495 rubles|
|Syphilis TPHA (AT for Treponema pallidum, RPGA)||450 rubles|
|Conduction anesthesia||3000 rubles|
|HIV 1-2 AH / AT (HIV Ag / Ab Combo) (IHLA)||450 rubles|
|Day hospital (1 day)||1880 rubles|
|General urine analysis||250 rubles|
|General clinical blood test + Leukocyte formula + ESR||700 rubles|
Symptoms of a shortened frenum of the penis
In most paintings, the etiology of a short frenulum is based on malformations of the penis. They are often combined with a congenital form of phimosis. If physiological phimosis is not leveled in boys up to 10-12 years of age, then they talk about the pathological form of the disease. Sometimes a short bridle appears during puberty - boys puberty. The immediate reason is that the cavernous bodies of the reproductive organ grow much faster than the skin of the penis.
The appearance of the reproductive organ does not in any way indicate any abnormality, therefore, a boy is often diagnosed with a problem by chance, for example, during a routine examination by a surgeon or pediatric urologist. However, when a man begins to live sexually, the symptoms of pathology worsen.
A shortened bridle when men are excited does not allow the penis to straighten up sufficiently. In some cases, excessive tension in the penis leads to a violation of the erection - the penis is not filled with blood, respectively, does not harden. Against the background of sexual intercourse, if possible, an adult man is constantly forced to look for a position that does not cause discomfort. Otherwise, he experiences pain in the head area.
It is worth knowing: the shorter the bridle of a man, the stronger the pain syndrome. Intense frictions during intimacy can lead to tearing of the frenum, resulting in bleeding.
A surgeon, urologist or andrologist can determine the presence of a pathological condition. In the presence of the problems described above, their visit is recommended immediately. To determine the deviation from the norm, a visual inspection is enough.
Objective signs of a pathologically short frenulum:
- When you try to push the foreskin with your hands, severe pain appears,
- Exposure of the glans penis is not complete,
- The head of the penis in an excited state "looks" down.
Surgery helps to solve the problem - plastic surgery of the short frenum of the foreskin is performed. In some situations, the involvement of a psychologist and sexologist is required, since a man has serious problems in the intimate sphere.
Price comparison for frenulotomy in Moscow clinics
Here we see the average prices for frenulotomy surgery in clinics that are located in the area of the indicated metro stations, but in accordance with the Federal Law “On Advertising”, we do not indicate the name of the clinics.
- Modern, absorbable suture material
- Individual approach to each patient
- The use of an ultrasonic scalpel, which allows for minor injuries
- The use of conduction anesthesia
Why there is a need for frenulotomy
The need for frenulotomy occurs due to:
- Congenital features in the structure of the penis. Parents may notice a violation when the child is still very small.
- Rapid and uneven growth in adolescence.
- Received injuries, mechanical damage. Microcuts, damage and cracks can lead to tissue fusion. Sometimes tears occur during intimacy. Their healing is fraught with the formation of scars that make the skin fold inactive.
- Balanoposthitis and chronic balanitis. Inflammatory damage to the front of the penis leads to deformation, often causing phimosis.
Another common cause of pathology is diabetes, which is ill-treated. With this diagnosis, the blood vessels can noticeably narrow. As a result, violations occur in the functioning of the site.
Krymkin Yuri Mikhailovich
Head of the urological department of the medical center "Clinic ABC". Well-known urologist, andrologist. Conducts surgical practice for more than 27 years. Engaged in the accurate diagnosis and treatment of male infertility, erectile dysfunction. He is an experienced specialist in the field of urology, andrology and sexopathology. Fully owns andrological and urological surgical equipment.
Karmoliev Rustam Rafikovich
Specialist of the urological department of the medical center "Clinic ABC". Well-known urologist - has experience in the hospital and clinic. Scientific papers were published in Russia and abroad.It uses proprietary treatment methods that are patented, which allows to achieve high results in treatment.
Korneeva Larisa Nikolaevna
Urologist of the highest category, candidate of medical sciences.
What difficulties can be encountered if you do not do frenulotomy with a short frenulum of the foreskin? The condition does not just interfere with an active sexual life. It leads to serious and dangerous complications, so you should treat the problem with all responsibility. Here are the most common disorders that develop if the patient tries to avoid treatment:
- premature ejaculation,
- frequent tears and heavy bleeding,
- penis inflammation
- the formation of numerous scars, narrowing prepuce,
- the occurrence of phimosis and paraphimosis, in which the head of the penis is pinched and local blood supply is disturbed.
A short frenulum of the foreskin can rupture during rough sexual intercourse - a thin skin fold does not always withstand strong tension. Since there are a lot of nerve endings and vessels in it, in such a situation a man experiences sharp pain. It is not excluded even the development of pain shock. It is not always possible to stop bleeding at home.
If you suspect a problem, it is important to immediately make an appointment with a urologist in Moscow. The doctor will examine and establish a diagnosis, quickly select the appropriate therapy. Timely frenulotomy of the frenulum of the foreskin will prevent the formation of unsightly scars and growths, reduce elasticity, and will provide reliable prevention of the appearance of new injuries.
A specialist consultation is also required with frequent premature ejaculation. This is one of the symptoms of the disease. The fact is that it is in this area that there are most of the nerve endings responsible for achieving orgasm. With excessive tension, the sensations obtained from sexual intercourse increase at times and early ejaculation occurs. Subsequently, this situation leads to various erectile dysfunctions, psychological fear of sex and even impotence.
Preparation and progress of frenulotomy surgery
So that everything goes well and the patient recovers quickly, during the preparation period it is necessary to strictly follow the medical recommendations. So, for 14 days you should abandon bad habits (primarily smoking and alcohol). For 2 days, you must start taking the antibacterial drug prescribed by the doctor (to minimize the risk of inflammation of the postoperative suture).
The hair in the operated area is shaved. Where to carry out a hygienic procedure for their removal - in the walls of a medical center or at home - the patient chooses himself.
The operation frenulotomy is performed by the doctors of the ABC Clinic in Moscow under general or local anesthesia on an outpatient basis. The duration of the operation is no more than 30 minutes. Preoperative measures are also included at this time.
Intervention begins with a transverse incision. Due to this, every millimeter of processed tissue is maximally straightened. Sewing is carried out in the longitudinal direction. The result is the effect of lengthening the treated area to a healthy size. If there are scars or scars formed as a result of frequent tears, they are eliminated.
During the operation of frenulotomy, the doctor will use self-absorbable sutures, which are not subsequently removed. At the end of the operation, a bandage is applied to the wound. It is worn for one day.
Recovery after treatment of a shortened foreskin frenum
When the frenulotomy operation is completed and the anesthesia ceases to function, the patient goes home. In the first few days after the intervention, pain may disturb him. To stop them, you can take pain medications prescribed by a urologist.
Mandatory after the operation should:
- strictly observe the rules of intimate hygiene,
- treat the wound with an antiseptic solution,
- exclude sexual contact and refuse to perform complex physical work until the doctor removes these restrictions.
Appointment to the urologist after a frenulotomy operation is scheduled for 8-10 days. Usually, after 14 days, the man returns to his usual way of life.
With inflammation of the operative suture, the release of pus, it is important to immediately visit a doctor. These symptoms indicate complications after surgery, so it is not recommended to wait for the scheduled day of the scheduled examination by the surgeon.
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Holding a frenum plastic
Frenulotomy of the foreskin is not a complicated technique. It is carried out under local / general anesthesia, takes up to 40 minutes in time, taking into account the preoperative preparation of the patient, the procedure is performed on an outpatient basis.
- The patient is on the couch, the anesthetist introduces anesthesia. In some cases, general anesthesia is done, sometimes local anesthesia is administered.
- After the anesthesia begins to act, the doctor makes an incision of the transverse direction on the frenum, as a result of which the skin fold on the penis straightens to the required length.
- Then the bridle is sutured in the longitudinal direction.
- If a man has scars on his penis, which are a consequence of past tears of the frenulum, they must be eliminated.
- Sew through a special thread, which resolves independently after a certain period of time.
- A sterile dressing is then applied to the wound surface. It must not be touched for 12 hours. At the end of this time, the dressing is removed or changed to another.
After about 7-10 days, doctors must visit. It should control the healing process of the skin, to exclude the development of an infectious or inflammatory process. Also, the man is given recommendations for rehabilitation in order to exclude possible complications after cutting.
Recommendations after frenulotomy
After surgical manipulation, the man is in the clinic for several hours under the supervision of a doctor and a nurse. If he feels well, then in two hours he can go home.
Important: the first few days after the operation, pain and discomfort in the penis are detected - this is normal. To stop the pain, take painkillers - Ketanov, Ibuprofen.
To prevent the development of the inflammatory process, local antiseptic agents are used. For example, ointment Levomekol. If the wound surface does not heal for a long time, then drugs that accelerate the regeneration of the skin can be recommended.
In the postoperative period, you must adhere to the following rules:
- Exclude any physical activity for two weeks,
- Give up intimacy for 2-4 weeks,
- Refrain from masturbation until the penis is fully restored,
- Regularly treat the wound with the drugs prescribed by the doctor,
- Hygienic procedures are carried out through baby soap and boiled water. Other cosmetics are strictly prohibited.
If a man wants to take a shower, then a condom must be put on the genitals to prevent getting wet. Up to 2 months after the intervention, lubricants and lubricants should be used during sex to exclude organ injury due to severe friction.
Possible complications after surgery
Plastic surgery of the foreskin frenum is a simple procedure. Reviews of men after surgery indicate the absence of complications. However, if during the manipulation the doctor made a mistake or the man did not follow the recommendations after the intervention, then negative consequences develop:
- Infection due to which an inflammatory process occurs,
- Intense bleeding from a wound
- Allergy to medicines for anesthesia.
The likelihood of blood loss is present during any operation, but in a situation with a frenulum graft, this pathological condition does not pose a threat to life. There are no large blood vessels in this area, so it is not difficult to stop the bleeding.
After frenulotomy, the following symptoms may occur:
- Genital hyperemia,
- Swelling and suppuration of the wound surface,
- Acute pain in the perineum
- Increase in body temperature,
- Constant discharge of blood exudate from the wound.
If such clinical signs are identified, you need to visit a doctor. Lack of timely help can lead to relapse of adhesions, cosmetic defects, deformation of the head of the penis and other consequences that negatively affect the quality of intimacy.
Complications can be avoided if you choose a reliable medical institution and follow all the doctor’s recommendations. The cost of the procedure is directly determined by the reputation of the clinic and the experience of the surgeon who performs the operation. The price varies from 150 to 400 $.