The frenulum is the thin fold of skin on the underside of the penis that connects the head of the penis (glans) to the foreskin. When it is short from birth or has been shortened by scarring, it pulls the head of the penis downwards during an erection and can tear during sex. The condition is known as a short frenulum and is more common than people think.
Frenulotomy is a short outpatient operation in which Dr Penev releases and lengthens the short frenulum. It is done under local anaesthetic, takes about 15–20 minutes and does not require a hospital stay. The incision is made with a scalpel or, depending on the indications and the equipment available, with a surgical laser; the aim and the result are the same.
When it is recommended
- pain, tightness or downward bending of the head of the penis during an erection;
- tearing of the frenulum with bleeding during sex, especially if it happens repeatedly – every further tear leaves a scar and shortens the frenulum even more;
- difficulty pulling the foreskin back even though the opening is normal and not narrowed;
- limitations in your sex life and avoiding intimacy for fear of pain.
If the short frenulum goes together with a narrowed foreskin, that is, with phimosis, frenulotomy on its own is not enough, and Dr Penev will suggest a circumcision, which solves both problems in one operation.
A torn frenulum can bleed heavily because of the small artery inside it. If the bleeding does not stop after 10–15 minutes of firm pressure with clean gauze, go to an emergency department rather than waiting for an appointment.
How it is done
- Examination. At the urology consultation the diagnosis is confirmed and phimosis, inflammation or a skin condition are ruled out.
- Local anaesthetic. The anaesthetic is injected with a fine needle at the base of the frenulum – a brief stinging, after which the area goes completely numb.
- Releasing the frenulum. The tight band is cut across and the incision is stitched lengthways – this lengthens the frenulum so that the head of the penis is no longer pulled downwards. Dissolvable stitches are used, which fall out on their own.
- Finish. After a short period of observation you leave on your own; the local anaesthetic does not stop you from driving.
Preparation
No special preparation is needed. Have a shower on the day of the procedure and wear comfortable cotton underwear. Tell Dr Penev if you take blood-thinning medication or have had an allergic reaction to a local anaesthetic. If there is active inflammation or a fresh tear, the procedure is postponed until it has healed.
After the procedure
Mild soreness and swelling are normal for the first two to three days and are controlled with ordinary painkillers. Night-time erections may be uncomfortable at first, but they do not damage the stitches. Wash the wound with water without rubbing; the stitches dissolve within two to three weeks. Avoid sex and masturbation until the wound has fully healed, usually three to four weeks, which is confirmed at the follow-up check. Most men go back to work the next day.
Once the tissue has healed, the tightness and pain during erections disappear and the risk of a new tear drops considerably. Call the practice if you have bleeding that does not stop, pus or a temperature.
Where it is done
The examination takes place at Dr Penev’s urology practice at 5 Anri Barbyus St, Plovdiv, and the procedure itself is done as an outpatient, either at the practice or at the Department of Urology at Kaspela University Hospital (UMBAL Kaspela), Plovdiv, as the doctor decides. Patients from Karlovo can be seen at Vita Med Medical Centre, Karlovo; the place and the technique of the procedure are agreed at the examination, depending on the equipment available.
Price
Initial consultation – €50, follow-up consultation – €30. The price of the frenulotomy is confirmed when you book.
Pain during sex is not something you have to get used to – book an appointment with Dr Penev and find out whether one short procedure can solve the problem.
Frequently asked questions
How can I tell whether I have a short frenulum or phimosis?
With a short frenulum the foreskin pulls back freely, but during an erection the frenulum tightens and bends the head of the penis downwards. With phimosis the opening of the foreskin itself is narrowed. An examination by a urologist tells the two conditions apart within minutes.
Will my penis look different after frenulotomy?
Not significantly. Only the tight band of tissue is released, and a small scar remains on the underside just below the head of the penis, which fades over time.
Can the frenulum tear again?
After a frenulotomy that has healed properly, a new tear is rare because the frenulum no longer pulls tight. If a thick scar forms, the follow-up check will assess whether further correction is needed.
Does frenulotomy affect sensitivity or how long sex lasts?
No lasting change in sensation is expected. Frenulotomy is not a treatment for premature ejaculation on its own – that complaint needs a separate consultation.
The information on this website is for general education and does not replace an examination and consultation with a doctor. If you have urgent symptoms, seek medical help immediately or call 112.