Frenuloplasty and Circumcision
Frenulum is the band of skin on the underside of the head of penis extending from urinary opening to the inside of the foreskin. If it is tight, it can cause pain during erection or intercourse, and it may tear, causing bleeding and discomfort.
Frenuloplast is a simple procedure in which frenulum is divided under local or general anaesthesia ,Circumcision may be needed if frenuloplasty does not solve your problems.
Failure to resolve symptoms which may need conversion to circumcision( 2-10% cases)
Bleeding, infection or pain at scar site
Dissatisfaction from cosmetic outcomes
What are the alternatives?
Preparations before procedure
It’s a day care procedure. You will go home the same day. Make arrangements for transport as you may not be able to drive on your own.
Shaving of pubic hair
Stop any blood thinners 3-5 days before procedure after informing the doctor.
Inform the doctor about any pre existing medical conditions or allergies .
What can I expect when I get home?
Temporary swelling and bruising of the penis which may last several days
Stitches will dissolve on their own in 3-4 weeks
Dressing usually fall off within 24 hours; if it does not, or if it becomes soaked with urine, it should be removed
Keep the area dry and clean for 2-3 days/li>
Avoid swimming for two weeks
Avoid sexual activity for one month
Apply a little Vaseline at stitch site so that it doesn’t stick to clothing
Wear loose cotton clothing for 2-3 days
Retract foreskin daily to maintain benefits of the procedure
You may resume work the next day
What does this procedure involve?
The procedure involves complete removal of the foreskin leaving the head of penis permanently exposed.
Why is it needed?
- Phimosis: inability to retract foreskin which may be present since birth or as a result of some infection or skin condition.
- Paraphimosis: inability to pull back a tight foreskin once retracted. If left for a long it leads to swelling of head.
- Balanitis: recurrent infections of foreskin –often seen in diabetics and very often the first sign of underlying diabetes!.
- BXO(balanitis xerotica obliterans): A skin disease on the foreskin,glans or urethra(urinary passage) which leads to scarring and loss of elasticity of skin leading to its closure or evening narrowing of urinary passage.
- Warts or tumors of foreskin.
What are the alternatives?
Topical steroid creams are helpful mostly in children and very rarely in adults
Details of the procedure
- In children weprefer the procedure under a general anaesthesia. In adults it may be done under local,general or spinal anaesthesia
- An incision is made just below the head of the penis and whole foreskin is removed leaving the glans (head of the penis) completely exposed
- Dissolvable stitches used to stitch the skin of penis to glans .
Side effects of procedure
Swelling of penis for few days
Increased sensitivity of the head of penis for 2-4 weeks
Permanent altered or reduced sensation in head of the penis.
Bleeding from the wound, occasionally requiring a further procedure
Dissatisfaction with cosmetic results
Post circumcision: Do’s and Dont’s
Expect some swelling and bruising of the penis last several days
it can take 4-6 weeks before the penis returns to its final cosmetic appearance • increased sensitivity of the glans for 2-4 weeks.
Dryness and scab formation on glans for 2-4 weeks.
apply a little vaseline to reduce sensitivity and prevent wound from sticking to clothes
stitches self dissolve in 3-4weeks
dressing fall off within 24 hours; if it does not, or if soaked you should get it removed.
Keep the area clean and dry for 2days.
Avoid swimming for 2 weeks.
wear loose-fitting cotton clothing for two to three days .
In case of bleeding , press the area between thumb and forefinger for 5 minutes. It will generally stop; if it doesn’t then report back to emergency as a stitch or two may be required.
Avoid any sexual activity (intercourse or masturbation) for four weeks
During erections, you may feel some tightness or discomfort around the scar tissue; this will regain its normal elasticity within a few months
Does circumcision have any effect on ejaculation or infertility?
Circumcision has no effect on ejaculation or fertility.