Tight Frenulum – A Cause of Penile Pain and Bleeding During Sex – Frenulum Breve
The frenulum of the penis is a band of tissue located underneath the penis, sometimes casually called the “banjo string”.
When the frenulum is tight or short, this is called a frenulum breve. This can result in tension on the frenulum during erections, which can rip and tear during vigorous activities such as sex, causing pain and bleeding, which in turn can cause men to lose their erections.
Some men go through their entire lives suffering from pain and bleeding unaware that there is a cure.
The degree of tightness and thickness of the frenulum varies from man to man, but any man affected by an overly short frenular band should seek a consultation for a possible procedure to end uncomfortable tightness with erection.
The issue can be addressed by removing or lengthening the penile frenulum.
A Tight Frenulum May Cause Premature Ejaculation
Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration. It happens with minimal sexual stimulation and before the person wishes.
It may result in unsatisfactory sex for both partners. This can increase the anxiety that may add to the problem. It is one of the most common forms of male sexual dysfunction. Between 30% and 70% of men have PE. While it is more common in younger men, it can happen at any age.
Having an orgasm too soon is not always cause for concern. However, clinical diagnosis is made when a man exhibits the following symptoms:
Ejaculation occurs too quickly, often in the first few minutes of intercourse, or in other sexual situations, even during masturbation.
Inability to delay ejaculation most of the time.
Feelings of anxiety, or avoidance of sexual intimacy as a result.
Both psychological and biological factors can play a role in premature ejaculation. Although many men feel embarrassed talking about it, premature ejaculation is a common and treatable condition.
Premature ejaculation can be classified as:
Lifelong (primary). Lifelong premature ejaculation occurs all or nearly all of the time beginning with your first sexual encounters.
Acquired (secondary). Acquired premature ejaculation develops after you’ve had previous sexual experiences without ejaculatory problems.
Some studies report that a short frenulum is found in up to 43% of individuals affected by premature ejaculation. It is thought that the frenulum plays an important role in penile erection and when frenulum tension exceeds a certain limit, orgasm and ejaculation may be accelerated. When the frenulum is lengthened, penile tension and sensitivity may be decreased.
Penile frenulectomy has been shown to be effective in some but not in all cases of premature ejaculation (see source study).
Common Questions at Our Ireland Frenuloplasty Clinic
Can the problems associated with short frenulum get better on their own?
No, unfortunately a short frenulum generally does not get better on its own.
Some physicians suggest stretching exercises, but the frenulum is a rather tough tissue that is not easily stretched. A penile frenulectomy is usually necessary to release the tight band of tissue creating painful downward traction on the glans.
What is the best treatment for a short frenulum?
A frenulectomy is a specialized technique that treats this condition by removing the tight restriction, allowing increased penile skin range of motion. It is done under local anaesthesia in our Ireland clinic in and takes only about 30 minutes to perform.
The goal of the procedure is functional, so that the tight frenulum is released, allowing improved sexual pleasure without fear of pain or bleeding.
Is a penile frenulectomy or frenuloplasty painful?
We perform procedures under long-acting local anaesthesia and those men who have undergone this procedure usually describe it as virtually painless.
What are the risks of the frenectomy procedure?
The risks associated with the procedure are generally similar to any minor procedure, and include:
Swelling and bruising at the site of the procedure 1/100.
Infection requiring antibiotics 1/500.
Bleeding (usually mild) 1/100.
Scarring at the site of the operation 1/100.
Meatal stenosis due to injury to the frenular artery requiring a meatotomy (rare) 1/500.
Suboptimal cosmetic or functional effect requiring a second procedure 1/100.
Chronic pain at the site of the surgery 1/500.
Vasovagal reaction causing light-headedness after the procedure 1/200.
How long does it take to recover?
Recovery from penile frenulectomy is fairly fast and painless. Most men do not require additional pain medications after the procedure and are able to return to office work in the next days. If your work requires heavy or physical activity, you will need a few more days off.
After penile frenulectomy, when can I have sex again?
We generally recommend no sex for at least 5-6 weeks to allow the surgical site to heal optimally and sutures, if required at the time of the procedure, to dissolve.
How will this affect my sex life?
After a frenulectomy, because the tight band is released, sex becomes more pleasurable due to less pain and worry from tearing and bleeding.
How will penile frenulectomy affect my foreskin?
Frenulectomy does not affect your foreskin and you will remain uncircumcised if you are not circumcised. Because the procedure only involves releasing the tight band of tissue underneath the penis where it attaches to your foreskin, your foreskin will be preserved.
Before & After Penile Frenulectomy or Frenulolplasty
Patient Instructions Before Frenulectomy
Please research frenulectomy and consult with one of our doctors, and your own, so you are confident and informed about your decision.
For one week prior to your procedure, do not take any aspirin or Non-Steroidal Anti-Inflammatory Drugs such as ibuprofen, naproxen, or diclofenac.
Please avoid any alcohol the day before the procedure.
On the day of your surgery, eat a normal breakfast or lunch before your procedure to avoid becoming lightheaded. Take 2 tablets of extra-strength paracetamol just before leaving your home to come to the clinic.
You are asked to arrive at least 15 minutes prior to your appointment. You are welcome to drive yourself to the office and back home unless you have a history of easy fainting.
Our staff will usher you into one of our surgical rooms and then one of our doctors will administer the local anaesthetic. It is then time for your procedure.
Patient Instructions After Frenulectomy
Most men do not require any additional pain medication after the procedure, but you may take up to 2 extra-strength paracetamol tablets every 6 hours as needed for pain control. After 48 hours, you should take ibuprofen 400mg every 6 hours as needed for pain control if needed.
There may be a small amount of bleeding at the surgical site. This is normal and will stop in a few days. If it does not, call our office or emergency number.
Continue applying antibiotic ointment at the site for 1 week.
You may return to office work in the next days but if your work requires a lot of activity you should take at least 2-3 days off.
We recommend no sexual activity for about 5-6 weeks or until the sutures come out completely.
Patients who are traveling more than 3-4 hours away may want to stay at a local hotel overnight.