Frenuloplasty बैंगलोर में : Procedure & Benefits

Frenuloplasty is a term given to the surgical alteration of a frenulum when its presence hampers the normal range of motion between interconnected tissues. A frenulum is a tissue present beneath your penis, that resembles a bridge of tissue connecting your foreskin (a thin layer of skin covering the penis glans) to the head of your penis (glans). This urological procedure is performed for a short penile frenulum that may restrict movements of the penis, causing pain during erection and sexual intercourse. Frenuloplasty is done under local or general anesthesia by dividing the skin and re-stitching it lengthwise.

Frenuloplasty is a surgical procedure that involves removing the frenulum or creating an incision (cut) on the frenulum to stretch and lengthen it. It also removes the excess skin to create a more aesthetically satisfying result while restoring the functionality of the penis at the same time. 

The procedure is usually performed under general anesthesia, as a daycare surgery. A large incision is made that is either Z-shaped, Y-shaped, or a single horizontal cut. 

Recently, laser frenuloplasty has emerged as an advanced, minimally invasive (does not involve extensive incisions or bleeding) alternative to the traditional frenuloplasty that facilitates shorter hospital stays, minimal bleeding, quick recovery, and reduced post-op complications.

A frenulum is a band of connective tissue that connects the foreskin to the glans of the penis and is the most sensitive part. A short frenulum can cause restricted movements during sexual intercourse and may also be prone to tears. 

• Frenuloplasty is recommended to help relieve the tightness and movement restrictions caused by a short and tight frenulum and facilitate a painless erection. 
• A frenuloplasty may be needed if you have:
  • Difficulty retracting the foreskin during an erection.
  • Frenulum scarring due to any injury during sexual intercourse.
  • A frenulum tear accompanied by excess bleeding.
  • Persistent pain in the penis during erection and after sexual intercourse.
• It is also used as an additional surgical intervention if you are undergoing circumcision (a procedure to remove the foreskin covering the head of the penis).

Preoperative preparation is an important component of a surgical procedure that helps prevent any complications during or after the surgery. 

• On your first visit to a urologist (a doctor specializing in the diseases of the genitals and the urinary tract), your doctor will record your medical history to:
  • Discuss your symptoms (erectile dysfunction, etc.) associated with a tight frenulum.
  • Rule out any other medical conditions like diabetes (increased blood sugar levels), asthma, hypertension (high blood pressure), or other disorders related to the heart, lungs, kidneys, or thyroid glands.
  • Evaluate your history of allergy to anesthesia, previous surgeries, or injuries. 
  • Determine the type of medications that may include blood thinners, anti-inflammatory drugs, antidepressants, or other herbal supplements.
• Your urologist will conduct a physical examination to check the foreskin and frenulum of your penis to evaluate the severity of the condition.
• You will be recommended to undergo a few tests like blood tests, urine analysis, chest X-ray, and ECG (electrocardiogram) to check your overall health.
• Once your urologist considers you a suitable candidate for a frenuloplasty, you will be given certain pre-op instructions that include:
  • Discontinue medications like blood thinners, etc., at least 2 to 3 weeks before the surgery to prevent the risk of excessive bleeding during the procedure.
  • Avoid smoking and alcohol consumption for a period of 3 weeks before frenuloplasty.
  • Fast for 6 to 8 hours before the procedure since general anesthesia may cause aspiration of food particles into the lungs. This may lead to breathing difficulties. 
• Arrange for someone to drive you back home after the procedure.
• You will be asked to sign a consent form on the day of your surgery. This is a legal permission given to the surgeon to perform the surgery.

Frenuloplasty is an outpatient procedure which means you will not require hospitalization and will be sent home the same day.

• On the day of your surgery, your nurse will prep you for the procedure by removing excess hair around your surgical site and cleaning the area with an antiseptic solution to remove surface contaminants.
• An IV (intravenous) line will be started to administer general anesthesia, antibiotics (if needed), and fluids during and after the surgery. 
• Your anesthesiologist will insert a tube in your throat to help you breathe during the procedure.
• The procedure is carried out through one of the following methods:

Traditional frenuloplasty

• In this method, your surgeon will make a single incision, either Z-shaped, Y-shaped or a horizontal cut, on the penile frenulum.
• The surgeon will slowly divide the frenulum, lengthen it, and re-stitch it length-wise with resorbable sutures (stitches) that will disappear within 2 to 3 weeks.
• The procedure takes around 60 to 90 minutes.

Laser frenuloplasty

• Here, your surgeon will target a carbon-dioxide laser beam on your penile frenulum.
• The heat generated through the laser beam dissolves or vaporizes the tissues to correct the frenulum.
• Laser frenuloplasty usually takes 20 to 30 minutes.
• The wound will be covered with a surgical dressing for protection that eventually falls off.

Frenuloplasty is a daycare procedure; hence you will be sent home once you recover from the effect of the anesthesia and can walk. However, an overnight hospital stay may be necessary if the wound is bleeding.

• It is normal to experience mild pain, soreness, and discomfort around the surgical site that may resolve gradually. However, your surgeon will prescribe painkillers to help ease the pain.
• It is normal to notice mild swelling and bruising of the penis; hence do not panic.
• Once you are back home, rest the whole day and the day following the surgery for your body to heal.
• The surgical dressing will likely fall off after 24 hours; if it does not, you must remove it.
• Keep the area dry and clean, and avoid soaking in bathtubs and swimming pools until your surgeon advises.
• You must wear loose, comfortable clothes and preferably apply Vaseline on the tip of your penis to stop it from sticking to your clothes.
• You must retract your foreskin gently and repeat this every day until advised by your surgeon to maintain the benefits of the surgery.
• You must refrain from any sexual activity for a period of 4 weeks following the surgery.
• Avoid lifting heavy objects and strenuous exercises for at least 4 weeks post-frenuloplasty.
• Complete recovery may take around 4 to 6 weeks for traditional frenuloplasty and 3 to 4 weeks for laser frenuloplasty.

Frenuloplasty is the most effective and standard treatment that helps lengthen the penile frenulum. The procedure offers benefits such as:

Benefits

• Preserves the foreskin compared to the circumcision procedure.
• Increases the range of motion of the penile skin.
• Boosts your self-confidence by enhancing your sexual function.
• Facilitates an easy retraction of the foreskin.
• Reduces the chances of incorrect penile curvature.
• The laser method used to perform frenuloplasty is an incision-less and bloodless procedure with quick recovery.

Risks 

Frenuloplasty is associated with a few risks, which include:

• A wound infection that may lead to pus discharge 
• Excess bleeding during the surgery
• Prolonged swelling and bruising of the penis
• Tenderness of the scar post traditional frenuloplasty
• Dissatisfaction with the cosmetic result
• Reduced sensation in the operated penis, thereby affecting its functionality.
• Allergic reactions to anesthesia cause skin rash, hives, itching, bumps, nausea, dizziness, and breathing difficulties.
• Failure to improve symptoms that may require additional procedures like circumcision.

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