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.

Treatments

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.

Side effects:

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?

Circumcision

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

CIRCUMCISION

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.

Infection

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.