THE COMPLETE FRENULUM STUDIES
Treatment (Z plasty etc.)
treatment (Bryk, Luo Rites)
Z plasty for frenulum breve was first reported in 1954
|| Drs. Jack Davis y Rufino J. Flores-Belaunde
Frenillo de Pene. Plastica con "Z"
Frenulum of the Prepuce; "Z" shaped plastic surgery
Rev. argent. urol 23:144-145 Mar-Ap 54 S
In figure 1 the principles of plastic surgery are outlined. The
movement of two areas of healthy skin formed by two isocoleses triangles.
One is designated with spots the other with stripes. By moving the
free extremety of point B to point B', at the same time the other extremity
A automatically moves to A' As a result of this transposition the skin
areas obtain a greater vertical diameter and a zig zag scar.
Figure 2 shows the geometrical application on an area of skin whose
folds run transversally, where a scar line (CICATRIZ)
cuts them perpendicularly. To correct this scar line it is necessary
to divide and divert this straight vertical line. The most effective
way of doing this is the "Z" as described above.
Applying this method to the frenulum of the penis has given excellant
results (figures 3 and 4) without any cases being unsuccessful or needing
to be repeated. Notice that in figure 4 the vertical cut is hidden
in the preputial fold and that the slanting cuts lie independantly
on the glans and prepuce.
"Z plasty for short scarred frenum of prepuce of penis is presented
as a useful new technique."
||VR. Chitale, MS, FICS,
Z Plasty for Short Frenum of Prepuce of Penis
Ann Plast Surg 1991 Feb;26(2):196-7
"Previously we used to perform circumcision or frenoplasty with
a transverse incision sutured vertically to treat this condition. Circumcision,
however, was thought to be too big a procedure for this condition,
and transverse incision sutured vertically did not give a satisfactory
result. Hence a Z plasty was performed on the patient presented."
"The two triangles slid very easily, and suturing was done with
6-0 chromic catgut. The result was very satisfactory. The patient had
satisfactory sexual intercourse 15 days after operation."
"Lysis of the frenum may be utilised. ... ... A disposable battery-operated
cautery device has been found to be useful and efficient for the lysis.
The frenum, while on tension, is incised with the glowing tip of the
cautery. Small superficial vessels and bleeding points may be immediately
coagulated. ... The sides of the incision may be approximated with
fine absorbable suture ... "
||Bradford B. Schwartz, M.D.
Lysis of frenum
Urology 1979 Feb;13(2):195
"Abstract - A new technique to achieve, elongation of frenulum is described.
The procedure is simple, exsanguine, and can be performed quickly.
The results obtained with this procedure is similar to those obtained
with traditional techniques."
||Hernaez Manrique, et al,
Elongación del frenillo balanoprepucial con una técnica
muy sencilla - (Spanish text)
Elongation of the balano-preputial frenulum using a very simple technique
Arch Esp Urol 1990 Jan-Feb;43(1):78-9
"1. Anaesthetic injection at the base of the frenulum. 2.
The placement of two vascular clips as shown in figure 1." (one
under the glans, the second parallel near the foreskin. 3. Section
of the frenulum as in figure 2 and pulling the end of the clips away
from each other) "4. When the frenulum is stretched as shown
in figure 3, it is covered with a dressing for twenty four hours."
"The operation took place without bleeding and in no case took
longer than five minutes. The clips released spontaneously after three
or four days."
During a description on a possible preparatory step for circumcision:
... "a second incision is marked, following the outlines of the corona
and the V of the frenulum on the ventral side. The frenulum usually
retracts into a V. In some cases, the frenulum can be lengthened by
closing the edges of the V in a longitudinal orientation for a short
length (frenuloplasty). If frenoplasty is done, the proximal incision
does not need to follow the V of the retracted frenulum in that the
ventral skin is straight"
Edited by Patrick C. Walsh (et al.),
Part XIV Chapter 107: Surgery of the Penis and Urethra Gerald H. Jordan,
M.D., et al,
Seventh Edition London W B Saunders 1998 Page 3333
||Brough, Betts and Payne
EMLA cream anaesthesia for frenuloplasty
Br J Urol 1995 Nov;76(5):653-4
"Abstract - Objective: To evaluate the use of a eutectic mixture of
local anaesthetics (EMLA) cream as the sole anaesthetic for frenuloplasty.
Patients and Methods: Fifteen patients . were given topical EMLA cream
30 min before frenuloplasty; a Tegaderm dressing was applied to keep
the anaesthetic in place. The level of anaesthesia was assessed on
arrival in theatre using pin-prick testing and the patients were asked
to grade their level of pain ...
Results: Fourteen patients had pain scores of zero and were fully anaesthetized
during the procedure. One patient's Tegaderm dressing was displaced
soon after application and he was inadequately anaesthetized on testing,
... and required infiltrative lignocaine ...
Conclusions: EMLA cream is a well-tolerated and reliable anaesthetic
for frenuloplasty. Using a condom to keep the cream in place would
reduce the small failure rate associated with the displacement of the
Four studies refer to the sensitivity in the area of the frenulum.
They largely discuss vibratory stimulation for impotence
||Everaert and Oosterlinck
Diagnosis and treatment of psychosocial induced anejaculation
or anorgasm by vibratory stimulation
Acta Urol Belg 1997 Mar;65(1):59-61
||JL. Pryor et al.
Vibratory stimulation for treatment of anejaculation in quadriplegic
(Arch Phys Med Rehabil 1995 Jan;76(1):59-64)
||Sarkarati, Rossier and Fam|
Experience in vibratory and electro-ejaculation techniques in spinal
cord injury patients: a preliminary report
J Urol 1987 Jul;138(1):59-62
Studies 18 men suffering premature ejaculation, none had frenulum breve.
||Paick JS, Jeong H, Park MS
Penile sensitivity in men with premature ejaculation.
Int J Impot Res 1998 Dec;10(4):247-50
Two studies on neuroanatomy.
"Genital end bulbs are present throughout the glans, but are most numerous
in the corona and near the frenulum."
||Halata and Munger
The neuroanatomical basis for the protopathic sensibility of the human
Brain Res 1986 Apr 23;371(2):205-30
"The penile dorsal nerve innervates the glans penis except for the
area of the frenulum, which is innervated by the penile dorsal nerve
and a branch of the perineal nerve."
||Yang CC, Bradley WE
Innervation of the human glans penis.
J Urol 1999 Jan;161(1):97-102