Dr. med. Dirk Manski



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Frenulum Breve (Short Frenulum)

Definition of Frenulum Breve

The frenulum is located at the ventral side of the glans and attaches the prepuce to the glans [fig. uncircumcised penis]. A short frenulum (frenulum breve) gets stretched during erection.

fig. uncircumcised penis with visible frenulum  

Uncircumcised penis with visible frenulum. Public domain-figure from http://commons.wikimedia.org

Signs and Symptoms of Frenulum Breve

A frenulum breve leads to ventral deviation of the glans and pain during erection. Sometimes, tearing of the frenulum causes heavy bleeding. The tearing of frenulum breve occurs particularly during sexual activity of young man.

Diagnostic Work-Up

Frenulum breve is a clinical diagnosis. Important is the exclusion of a phimosis before surgical treatment.

Treatment of Frenulum Breve

Tear of the Frenulum Breve

Mild compression of the blood supply is usually sufficient to stop the bleeding after tearing of the frenulum. Further treatment depends on the glans mobility after healing. In case of heavy bleeding, hemostatic sutures (after local anesthesia) are necessary, frenuloplasty can be done in the same setting.

Frenuloplasty

Frenuloplasty is the surgical division of a frenulum breve. Frenuloplasty is only indicated in frenulum breve without phimosis. After local anesthesia, the frenulum is completely divided in transverse direction (frenulotomy) to allow sufficient mobility of the glans. The mucosal defect is sewn in longitudinal direction.

Circumcision

Frenulum breve with phimosis should be treated with a circumcision.








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