Frenuloplasty

Frenuloplasty may be recommended when the foreskin itself is healthy but the frenulum is the problem, for example:

• Pain or a pulling-down sensation at the tip of the penis during erections or intercourse

• Repeated tearing or splitting of the frenulum, sometimes with bleeding, followed by tightening scar tissue

• Difficulty retracting the foreskin because it is tethered by a short frenulum rather than by a tight foreskin ring

• A wish to avoid circumcision where the rest of the foreskin is normal; if the foreskin is also scarred or tight (phimosis), circumcision may be advised instead

The Procedure and Alternatives

The operation takes around 20 to 30 minutes as a day procedure under a brief general anaesthetic:

• Frenuloplasty: the tight band is divided across its width and re-stitched lengthways to lengthen it, using fine dissolving stitches

• Frenulectomy: complete removal of a badly scarred frenulum, with a similar recovery

• Circumcision: removal of the foreskin, considered when there is significant phimosis, scarring or recurrent infection alongside the short frenulum

• Non-surgical measures: gentle stretching and steroid cream can help mild tightness, although symptoms often return

Risks and Considerations

All procedures carry risks, which your surgeon will discuss with you in detail. These may include:

• Bleeding, bruising and swelling of the penis for a few days

• Wound infection, occasionally needing antibiotics

• Discomfort with early erections while the wound heals, and tenderness of the scar for a few weeks

• Recurrent tightness or scarring, and a small proportion of men later choose or need circumcision

• Altered sensation around the frenulum or glans, which is usually temporary but can occasionally persist

Recovery at a glance: Day surgery under short general anaesthetic; most men return to work within a few days, stitches dissolve over 2 - 3 weeks, and sexual activity can usually resume once fully healed at around 4 - 6 weeks.