Short frenum of the penis - Causes, symptoms and treatment. MF.

The bridle of the penis is the skin fold, which passes from the head of the penis to its foreskin. With the shortening of this skin strand, there is an insufficient straightening of the penis during erection. This prevents the normal implementation of sexual intercourse.

Causes of short frenum

A short frenum of the penis is considered a purely congenital pathology, which is present from the very birth of the child, but only during puberty. The fact is that before adolescence, when a young man still does not have an erection, and he does not live a sexual life, a short bridle does not affect his health in any way. But during sexual intercourse this anatomical formation prevents the penis from straightening up completely, which causes discomfort or even pain during sexual intercourse.

Symptoms of short frenum

Symptoms of a short frenulum of the penis depend on the degree of shortening of this skinny strand. If the bridle is too short, then the first symptoms can appear even during an erection, when the glans penis can not completely break out and the tension of the bridle causes pain. With a more moderate shortening, pain during the erection itself may not yet occur, but it is very well manifested during sexual intercourse. It is very difficult for a man to choose the right position, during which he will not feel pain during sex.

Anatomy of the short frenulum

The artery of a fairly decent diameter passes through the penis frenulum, therefore during sex, when, due to sudden movements, an erection or rupture of the frenulum occurs, serious bleeding can occur. Such a situation is a mandatory indication for hospitalization in a surgical hospital and for an operation.

As for uncomplicated cases, then an appeal to a urologist is an initiative of the patient alone. If during a sexual act even with a short frenum the man does not experience strong painful sensations, then at his request, he can not seek help from a urologist.

Diagnosis of short frenum

Diagnosis of a short frenum does not present special difficulties for the doctor. The diagnosis is made clinically, on the basis of patient complaints and examination data of the external genitalia. Quite often there is a situation where the symptoms of a short frenum appear only in the erect state, so the urologist may need to see the penis in this condition.

Treatment of a short frenum of the penis

Treatment of a similar pathology is the fate of urologic surgeons. The most reliable and widespread method of treatment is frenuloplastika .This surgical intervention, which is performed under local anesthesia, involves dissection of the penis frenum with a bandage of bleeding vessels.

This operation is performed in the overwhelming majority of cases, although there are situations when the amount of surgical intervention needs to be slightly expanded. For example, if such a pathology is complicated by increased sensitivity of the glans penis, which preterm ejaculates, then Z-shaped frenuloplasty should be performed. During this operation, the bridle is dissected in the form of two triangles, which are then stitched alternately. The scar, which is formed after a similar operation, does not stretch the postoperative wound.

Another surgical intervention, which is performed with a short frenulum of the penis, is circumcision of the prepuce. It is performed in the case when the anomaly of the development of the frenum is supplemented with an anomaly of development of the extremely flesh. For example, if a short frenum is combined with a narrowed foreskin, then in this situation it is advisable to perform circumcision of the latter.

Scheme of the operation for circumcision

Rehabilitation after operation

Patients with a short frenulum do not need to follow any diet, even in the case of surgery, since the latter is performed under local anesthesia. As for the way of life, before the full healing of the postoperative wound, the man must be kept from sexual contact, as this can lead to a divergence of the surgical sutures and in such a situation, a re-operation is simply inevitable.

Also very important is the hygiene of the external genital organs in the postoperative period. It should be done after each visit to the toilet. The postoperative wound is treated not only with water, but also with a solution of an unconcentrated antiseptic followed by a nasal deposition of an aseptic dressing.

The main goal of rehabilitation in the postoperative period is to prevent the development of a purulent infection, and also to ensure as soon as possible the healing of an operating wound with the formation of the smallest scar. As for prevention of purulent infection, modern antimicrobial agents are prescribed for this purpose. Since most of the cases, the operation is performed during adolescence, the use of fluoroquinolone drugs is contraindicated in patients. In this case, it is better to use funds from the group of macrolides, which include clarithromycin and azithromycin.

For fast healing of an operating wound and a small scar, it is recommended to perform daily treatment of the operating site with alcohol or iodine with the obligatory application of an aseptic dressing. If the wound is clean, then in no case can any ointment be used on a fat basis, since they are intended for the treatment of purulent wounds, and in regard to the pure can only prolong the healing process.

Treatment with folk remedies

With respect to folk treatment with the help of various ointments and poultices, it can only be said that they are absolutely inactive. Buying and using non-expensive herbs can only lose their time and money, because expecting any effect from such treatment is absolutely pointless.

Some folk healers have gone above such a science and offer a quick and painless operation. Many men and boys, embarrassed by their problems, go for help not to qualified specialists, namely to such "doctors".The consequences of such an operation, which at best is performed by an ordinary dangerous razor soaked in alcohol, are very different. And suppuration with the inevitable re-operation is not the worst outcome of such treatment. Sometimes, when the bridle is cut, the nerve, which innervates the glans penis, is damaged, which leads to a lack of sensitivity on the glans penis, followed by impotence and infertility.

Complications of short frenum

All the complications that occur with a short frenulum of the penis can be divided into those that arise directly from the disease itself and those that occur after an unsuccessful operation.

During intercourse with a short frenum, there is a very high risk of rupture of the latter. The bridle rupture itself can not be considered a formidable complication, but it must be remembered that in its thickness there passes a nerve, responsible for the sensitivity of the head and the artery, which blood supply this anatomical site. In the event of damage to the former, impotence may develop, and the second one may result in quite a decent bleeding. It is dangerous not only for the amount of blood lost, but also for the fact that it is difficult to stop bleeding at this site, since there are no solid anatomical structures to which the damaged artery can be pressed.

In addition, pain arising during sexual intercourse, leads to the emergence of a subconscious person, especially a teenager, a powerful psychological block that does not allow you to later engage in subsequent sexual acts. In psychology, this condition is referred to as "sexual neurosis".This situation is very dangerous, since it can lead to the onset of early impotence. It must be corrected at the dawn of development, which only a professional sex therapist or a psychologist who deals with problems of sexual disorders can do.

The only and cardinal method of eliminating a short frenum is an operation, but quite often it becomes the immediate cause of serious enough complications. In addition to that, during an operation, as well as during a rupture, the artery or nerve can be damaged, a scar may form in the postoperative period, which not only will interfere with normal sexual intercourse, but can deform the glans penis, which is corrected only by complex plasticoperation. To prevent this from happening, in the postoperative period it is necessary to adhere to all the doctor's recommendations and not to violate the terms for starting a sexual life after an operative intervention.

If in the postoperative period the attending physician does not receive adequate antibiotic therapy, then one of the purulent processes on the penis may develop. In the absence of antibacterial therapy, the development of purulent inflammation can also lead to poor hygiene of the external genital organs after surgery. Such complications are unpleasant because the patient needs a repeated surgery, the volume of which can not always be determined until the operation itself. In the most common and neglected cases, you have to resort to amputation of the penis, which makes a man disabled for the rest of his life. Fortunately, the percentage of such complications is measured by hundredth particles, but it rises sharply when performing operations by folk healers under antiseptic conditions.

Prevention of short frenum

Since the short frenum is a purely congenital pathology, it is necessary to prevent it before the birth of the child. Mothers need to remember that the occurrence of congenital malformations is caused not only by bad habits, but also by strong physical labor during pregnancy, and by the action of a variety of chemicals.

If the pathology still could not be avoided, then it is best to treat it in early childhood, so that the child does not have painful memories associated with his sexual organ. Moreover, the volume of surgical intervention is fundamentally different, depending on the age at which it will be performed. It is much better and safer to operate a child as a child.

Rev.the doctor the urologist, the sexologist-andrologist Plotnikov AN