Urological Concerns: Insights on Frenulum and Urethral Issues

Q: Urological Concerns: Insights on Frenulum and Urethral Issues

Hello： <br>Q1. <br>Regarding the small indentation on the "right side" where my frenulum connects to the glans, you replied： "It may be adhesions," and "the foreskin and glans are not separated." However, the small indentation on the "right side" where my frenulum connects to the

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Dear Dr.
Du,
Thank you very much for your responses to my inquiries in articles #187444 and #187389; I have truly benefited from your insights.
I would like to ask you a few more questions:
Q1.
Regarding the small indentation on the "right side" where my frenulum connects to the glans, you mentioned that it could be due to "adhesion" and that the foreskin and glans are not separated.
However, the small indentation on the "right side" appears to be non-adherent, and there is a separation between the foreskin and the glans.
In contrast, the skin on the "left side" where the frenulum connects to the glans is indeed adherent.
Could you please clarify which side is normal and which side is abnormal?
Q2.
My urethral opening is clearly visible at the tip of the glans, and urination is normal.
In your opinion, could the small indentation on the "right side" where my frenulum connects to the glans be indicative of "hypospadias"? Given that I have a clearly visible urethral opening and that the indentation is located on the right side of the frenulum and glans connection, rather than in the midline of the coronal sulcus, and that urine does not seem to flow from this indentation, is it still possible that my condition could be classified as "hypospadias"?
Q3.
I have a history of genital herpes, which occasionally flares up, typically located on the right side of the glans near the aforementioned small indentation.
Could the formation of the small indentation on the "right side" where my frenulum connects to the glans be related to genital herpes? Specifically, could the herpes lesions (blisters) in that area, through repeated "rupture and healing," over time lead to the gradual separation of the skin on the "right side" of the frenulum and glans connection, resulting in the appearance of a small indentation? Is this a possibility?
Thank you, Dr.
Du.

Axiang, 40~49 year old female. Ask Date: 2022/10/10

Dr. Du Shixi reply Urology

Hello:
Q1.
Regarding the small indentation on the "right side" where my frenulum connects to the glans, you replied: "It may be adhesions," and "the foreskin and glans are not separated." However, the small indentation on the "right side" where my frenulum connects to the glans does not appear to be adhesed, and there is a separation between the foreskin and the glans; whereas on the "left side," the skin where my frenulum connects to the glans is not separated, and the skin is attached.
Dr.
Du, based on your description, is the right side normal and the left side abnormal? --> According to your description, the right side is normal.
Q2.
My urethral opening is clearly visible at the front of the glans, and urination is normal.
Dr.
Du, in your opinion, could the small indentation on the "right side" where my frenulum connects to the glans possibly indicate "hypospadias"? Since I have a clearly visible urethral opening, and the small indentation is located on the right side of the skin where the frenulum connects to the glans, not in the midline of the coronal sulcus, and it seems that urine does not flow from this small indentation, could my condition still be considered "hypospadias"? --> If there is no urine flowing from this area, it should not be classified as hypospadias.
Q3.
I have genital herpes that occasionally flares up, with lesions typically located on the right side of the glans near the aforementioned small indentation.
Dr.
Du, could the formation of the small indentation on the "right side" where my frenulum connects to the glans be related to genital herpes? Specifically, could the herpes lesions (blisters) in that area, through repeated "rupture and healing," over time cause the skin on the "right side" where my frenulum connects to the glans to gradually separate, resulting in the appearance of a small indentation? Is this a possibility? --> This may require a physician's examination for proper assessment.
Wishing you good health.

Reply Date: 2022/10/10

More Info

Understanding urological concerns, particularly those related to the frenulum and urethral issues, can be complex and often requires careful evaluation by a healthcare professional. Let's address your questions one by one, providing insights based on medical knowledge.

Q1: Frenulum and Urethral Connection
You mentioned that the frenulum on the right side appears to be separate from the glans (the head of the penis), while on the left side, there is a connection. The frenulum is a band of tissue that connects the underside of the penis to the glans, and variations in its appearance can be normal. If the frenulum on the right side is not adhered to the glans and appears normal, it may not be a cause for concern. However, if there is any discomfort, pain, or difficulty during sexual activity, it would be advisable to consult a urologist for further evaluation.

Q2: Urethral Opening and Possible Hypospadias
You indicated that your urethral opening is clearly visible at the tip of the glans and that urination is normal. Hypospadias is a condition where the urethral opening is not located at the tip of the penis but rather along the underside. Given that your urethral opening is in the correct position and you do not experience any urinary issues, it is unlikely that you have hypospadias. The small indentation you described on the right side of the frenulum is likely a normal anatomical variation rather than a sign of hypospadias.

Q3: Impact of Genital Herpes on Frenulum Appearance
You mentioned having genital herpes, which can cause lesions in the genital area. It is possible that recurrent herpes outbreaks could lead to changes in the skin, including scarring or alterations in the tissue structure. If the herpes lesions were located near the frenulum, repeated cycles of ulceration and healing could potentially contribute to the appearance of a small indentation. However, this would typically not cause a significant structural change unless there was extensive scarring or tissue damage.

Additional Considerations
1. Normal Variations: The human anatomy can exhibit a wide range of normal variations. What you describe may simply be a normal anatomical difference rather than a pathological condition.

2. Symptoms to Watch For: If you experience any pain, bleeding, or changes in urination, it is essential to seek medical advice. These symptoms could indicate an underlying issue that requires attention.

3. Regular Check-ups: Given your history of genital herpes, regular check-ups with a urologist can help monitor any changes and ensure that any potential complications are addressed promptly.

4. Education and Awareness: Understanding your body and recognizing what is normal for you is crucial. If you have concerns about any changes or symptoms, do not hesitate to reach out to a healthcare provider for personalized advice.

In conclusion, while the variations you describe may be concerning, they often fall within the realm of normal anatomical differences. However, maintaining open communication with your healthcare provider is essential for managing any urological concerns effectively. Regular evaluations can help ensure that any potential issues are identified and treated early, promoting overall urological health.

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