THE COMPLETE FRENULUM STUDIES
Treatment (Z plasty etc.)
treatment (Bryk, Luo Rites)
The HUMAN Studies
"The preputial and urethral folds fuse on the ventrum of the glans
as the frenulum. ... Failure of fusion of the urethral folds blocks
development of the prepuce ventrally, especially the frenulum."
Edited by Patrick C. Walsh (et al.),
Part IX Chapter 51: Normal and Anomalous Development of the Urinary
Tract Max Maizels, M.D.
Seventh Edition London W B Saunders 1998 page 1582-3
"... a short, thick frenulum that tends to pin and tie down the foreskin."
||Ohjimi T and Ohjimi H
Special surgical techniques for relief of phimosis
J Dermatol Surg Oncol 1981 Apr;7(4):326-30
This is a confusing condition especially for the
men who have it.
"Patients requesting circumcision frequently do so because of pain
associated with stretching and tearing of the frenum during coitus.
These patients attribute their symptoms to the presence of a redundant
prepuce. However, the prepuce itself is not usually the cause of their
pain. A tight frenulum and its tethering effect during penile erection
and penetration can be the basis for their complaints."
||Bradford B. Schwartz, M.D.
Lysis of frenum
Urology 1979 Feb;13(2):195
A short frenulum often rips
"Frenulum breve (When the band is too short)
||Prof. Dr. Med. Hartmut Porst
Was jedermann über Sexualität und Potenz wissen sollte - (German text)
What Everyman should know about Sexuality and Potency
Georg Thieme Verlag Stuttgart, Trias (1991) p.60
Among a percentage of men the band called "the frenulum"
(which runs between the foreskin and underneath the opening of the
urethra), is too short, so that on erection it tightens to its limit
and can even rip. To add to the confusion this usually happens during
the first sexual encounter causing a moment of great alarm for both
participants at the resultant bleeding."
"The tethering effect of the short frenulum during penetration was
presumably the cause of the injury."
||A Yip, et al,
Injury to the Prepuce
Br J Urol 1989 May;63(5):535-8
"Tearing the frenulum ... is not unusual. Such a tear may produce a
great deal of blood, but it usually heals spontaneously. These tears
require surgery only if any scar tissue that forms hinders movement
of the penile skin or causes discomfort."
|| June Reinisch.
The Kinsey Institute New Report on Sex.
Penguin (1990) p.39
It may rip repeatedly
"A tight frenulum can also cause dyspareunia. In the course of
healing, scar tissue forms which shortens the frenulum even more and
predisposes it to even more tearing and scarring, and a vicious cycle
is set up."
||Wabrek and Wabrek.
Journal of Sex and Marital Therapy Spring 1975: Vol.1, No.3, Pages:
Sometimes it leads to premature ejaculation.
"There is nothing which leads to premature ejaculation more often than
in those specific cases where the frenulum of the prepuce is too short.
If it is still present following the first sexual encounters this anomaly
frequently leads to premature ejaculation, however it is easy to cure
under local anaesthetic without being admitted to hospital. Therefore
it is the responsibility of every doctor and surgeon to detect this
and to enquire after the sexuality of the man concerned, because most
of the time, the patient himself will not dare confront the problem.
In this matter the doctor has a truly prophylactic role in averting
a catastrophic development."
Ejaculation prématurée - (French text)
J Urol (Paris) 1987;93(9-10):557-60
Quénu gives us a good summary and a few
"The rupture of the frenulum is an accident which, in certain circumstances,
can be very serious, even leading to death."
Cure chirurgicale des désordres fonctionnels liés aux
altérations du prépuce - (French text) Surgical treatment
of functional disorders related to changes in the prepuce
J Urol Nephrol (Paris) 85(10-11), 755-759 (1979)
"Certain ruptures are "successful" in the sense that no corrective
measure is necessary. The others leave a persisting shortness of the
frenulum and at the same time a fragile scar which may rip in a repeated
manner. In these cases it is necessary to operate."
"In the majority of cases, it is difficulty during copulation which
brings the patients (to me). It is rare that the shortness of the frenulum
is alone the cause. Generally speaking, that which is the cause is
an insufficient diameter of the preputial opening, preventing or hindering
retraction, and this is often associated with a shortness of the frenulum."
"In effect, the shortness of the frenulum plays an obvious role
in the inability to retract, by imposing a too great obliqueness at
the ring of the preputial opening. In certain cases "relative" phimosis
is due to a shortness of the frenulum."
Quénu's use of the word
"relative" in the above passage may be confusing. At times frenulum
breve may occur simultaneously with a relative phimosis (phimotic ring)
and this complicates the anatomical and sexual effects as any combination
of such conditions does. Quénu points out that the short
frenulum leads to an oblique effect which may be confused with a phimosis.
"Among older children, I have noticed that a short frenulum was
often the origin of an extensive symphysis around the neck (or collum),
of the glans penis and because of this, I have assumed that the shortness
of the frenulum plays a role in the emergence and perpetuation of the
balanoposthitis which creates and sustains the phimosis."
Grewel questions the effects during masturbation and coitus
"My attention was drawn to this anatomical configuration because in
the course of the years I have been consulted by men who mostly after
their first coition, showed an excoriation, a slight rhagade or even
a slight laceration of the frenum behind the margin of the corona,
or of the alae freni. ..." "Sometimes it was not during the first coition
that this phenomenon occurred but during a later one, that was experienced
as much more complete or more satisfactory than the foregoing. In a
single case the rhagade had developed during masturbation. These excoriations
may occur more than once."
The Frenum Praeputii and the Defloration of the Human Male
Folia Psychiatrica, Neurologica et Neurochirurgica Neerlandica 61(2)
"The excoriation is seen in cases of forced coition in older men
with a rigid frenum; a young man with phimosis developed a slight laceration
in a forced trial to cohabitate."
"Does it occur in people who have never masturbated, the frenum
being more rigid or less resilient than in men who practised masturbation?
When it occurs in masturbation the excoriation seems to be localised
especially in the alae freni."
"Is the fact that the alae are more manifest in younger men than
in older due to the constant stretching or elongation of these formations
in the course of adult life? Elasticity of the frenum seems to prevent
"Short, Tight Frenum
London W B Saunders
(1963) 2nd. edition p.1729; (1970) 3rd. edition p.1587;
This condition may sometimes cause penile incurvation, especially during
erections or may tear easily. Division of this distorting band is recommended,
with due attention to the underlying blood vessels, which may bleed
A better description would be that a short frenulum
causes penile incurvation when the foreskin is retracted.
Chitale and Whelan give some interesting but some
"Short frenum of the prepuce of penis is a common condition. It gives
rise to the following problems: 1) bleeding after sexual intercourse;
2) tear of frenum resulting in a small painful ulcer over the frenum,
which does not heal easily; 3) a small ventral chordee, which produces
pain after erection; and 4) all the above conditions cause psychoneurotic
||VR. Chitale, MS, FICS,
Z Plasty for Short Frenum of Prepuce of Penis
Ann Plast Surg 1991 Feb;26(2):196-7
" ... a short frenulum that becomes painfully tight on erection ...
Male dyspareunia due to short frenulum: an indication for adult circumcision.
Br Med J 1977 Dec 24-31;2(6103):1633-4
"Indications for circumcision in 48 patients 1975-76 and number
with pain on intercourse:
|No of cases
No with pain on intercourse
"The normal frenulum is a mucous membrane on the ventral surface
of the glans penis, through which runs the frenular artery. A short
frenulum may apparently be congenital, when it is of normal thickness,
or secondary to recurrent infection or trauma, when it can be felt
in the flaccid state as a thickened band. When the penis is erect the
short frenulum restricts the prepuce and causes downward curvation
of the glans. During intercourse this means that there is an element
of chordee and the abnormal position of the glans penis causes pain.
Tension in the short frenulum itself is also painful and the band may
be torn and then heal by fibrosis, thus aggravating the situation."
"Short frenulum should be sought as a cause for dyspareunia
in patients who do not have phimosis or questionable hygiene and who
may erroneously be labelled as having psychosexual problems."
Chitale and Whelan have a rather questionable
understanding of frenulum breve, suggesting it is the "ventral chordee,
which produces pain ..." and even that "the abnormal position of the
glans penis causes pain."
These conclusions are incorrect. Correct is that
the "tethering" effect of frenulum breve pulls the foreskin
forward. Pain, bruising, tension and soreness are caused by the foreskin
being pulled backwards straining the very sensitive frenulum.
This pain occurs principally through nerves in
the frenulum itself; rather than the underside of the glans which is
also usually very sensitive. I would like to establish from other men's
personal experience to what extent individual differences exist on
this point.. Please contact me personally about this.
The Specific Effects of Frenulum Breve
among Circumcised Men and Boys
"In 28 percent of our pediatric population undergoing elective circumcision
we have demonstrated a previously undescribed ventral chordee of the
glans, the result of a tethering effect of an unusually prominent frenulum."
... "Twenty of the 70 boys (28%) demonstrated a ventral glandular tilt
(glandular chordee) due to an unusually prominent frenulum."
||AS. Griffin and RL. Kroovand
Frenular chordee: implications and treatment
Urology 1990 Feb;35(2):133-4
Elective circumcision means when it is requested
rather than routinely performed etc. Therefore the statistics of 28%
are perhaps a guide to how often circumcision is requested when actually
frenuloplasty is necessary - It helps us little in any guess at the
"Persistent frenular chordee after circumcision may result in deformity
of the penis on erection making sexual intercourse difficult or uncomfortable."
This study suggests that among circumcised men
when there is no foreskin for the tension of a short frenulum to displace
and pull forward upon, during erection a short frenulum may cause the
glans to bend downwards. The study is called "... implications ..."
I feel sure that if this was a large problem the anti circumcision
groups would have recorded it. One
e.mail letter reports this
Age When Operated
"Fifteen patients (mean age 25.6 years, range 19- 41) were listed for
frenuloplasty, the majority of whom were experiencing trauma during
intercourse due to an excessively tight frenulum."
||Brough, Betts and Payne
EMLA cream anaesthesia for frenuloplasty
Br J Urol 1995 Nov;76(5):653-4
This is apparently the only study which indicates
the age when men are operated for frenulum breve. I suspect that special
permission would be required under 18 yrs. of age, and therefore such
may have been automatically excluded from the sample group.
There may be some difference in the age of the
patient and which type of specialist they seek for treatment. An urologist
told me that among his patients "basically the average age group is
around 17 to 27 years old" (Dr. for Urology Dieter Behling, Hamburg
July 1995 in conversation. Quoted with permission). On the other hand
a surgeon told me most of his operations were performed throughout
puberty and in old age (Dr. med. Markau Hamburg Aug. 1994).