Short Frenulum: Causes, Symptoms, and Treatment Options

Shortened foreskin requires reconstruction?

Dear Doctor,
Hello.
Before I had a girlfriend, I never thought there was anything wrong with my penis.
However, after recently engaging in sexual activity, my partner has expressed discomfort during intercourse.
I underwent a circumcision when I was in sixth grade, and now it appears that the skin at the pubic area is being pulled towards the shaft of the penis when not erect.
During an erection, it feels slightly tight, but the skin connecting the scrotum and the shaft is being pulled upwards, creating a membrane that prevents full penetration (excessive penetration causes discomfort for my partner).
This week, I visited a cosmetic surgery clinic and was informed that I would need a skin graft, which costs 150,000 TWD.
I was quite shocked.
Does this type of surgery need to be performed at a major hospital? Is there any health insurance coverage for this? Thank you for taking the time to respond.
Wishing you peace and joy.

Xieqi Nan, 30~39 year old female. Ask Date: 2013/08/31

Dr. Li Yilun reply Urology

Non-disease factors that are not covered by health insurance often cause vaginal discomfort in women, primarily due to anxiety.
Insufficient vaginal secretions and lubrication are less commonly related to issues with the penile foreskin.
If there are concerns about phimosis or similar problems, it is important to understand that a simple description cannot determine the condition.
It is still advisable to consult a professional physician for evaluation and examination.
However, since different patients have varying conditions, physicians often need to conduct a thorough medical history inquiry, visual examination, palpation, and tests to establish a diagnosis and treatment plan.
If there is a medical issue, it is recommended to seek examination and treatment from a nearby plastic surgeon or urologist.

Reply Date: 2013/08/31

More Info

Understanding a short frenulum, also known as frenulum breve, is essential for addressing the discomfort it can cause during sexual activity. The frenulum is a band of tissue located on the underside of the penis that connects the glans (the head) to the shaft. When this tissue is too short, it can restrict the movement of the foreskin or cause discomfort during erections and sexual intercourse.

Causes
The exact cause of a short frenulum is not always clear, but it is often a congenital condition, meaning it is present at birth. Some individuals may not notice the issue until they become sexually active, as the increased friction and movement can highlight the limitations imposed by the short frenulum. In your case, the discomfort experienced by your partner during intercourse may be due to the frenulum's inability to allow for full penetration without causing tension or discomfort.

Symptoms
Symptoms of a short frenulum can include:
- Discomfort or pain during erections.

- Pain during sexual intercourse for both partners.

- A noticeable pulling sensation at the base of the penis during erections.

- Difficulty retracting the foreskin fully, especially if the individual is uncircumcised.

Treatment Options
Treatment for a short frenulum can vary based on the severity of the condition and the level of discomfort it causes. Here are some common options:
1. Conservative Management: In some cases, gentle stretching exercises may help alleviate discomfort. However, this approach may not be effective for everyone.

2. Frenuloplasty: This is a surgical procedure that involves cutting and lengthening the frenulum. It is typically performed under local anesthesia and is a relatively quick procedure. This option may be more suitable for those who experience significant discomfort or pain.

3. Circumcision: In some cases, circumcision may be recommended, especially if there are other issues with the foreskin, such as phimosis (tight foreskin). This procedure removes the foreskin entirely, which can eliminate the problem of a short frenulum.

4. Skin Grafting: If the frenulum is very short and requires significant lengthening, a skin graft may be necessary. This is a more complex procedure and may involve a longer recovery time.

Insurance and Healthcare Coverage
Regarding your concern about the cost of the procedure, whether it is covered by health insurance can depend on several factors, including your specific insurance plan and whether the procedure is deemed medically necessary. In many cases, procedures like frenuloplasty may be covered if they are performed to alleviate pain or discomfort during sexual activity. It is advisable to consult with your healthcare provider and insurance company to understand your options and any potential out-of-pocket expenses.

Conclusion
If you are experiencing discomfort due to a short frenulum, it is essential to consult with a urologist or a qualified healthcare provider who specializes in male sexual health. They can provide a thorough examination, discuss your symptoms, and recommend the most appropriate treatment options for your situation. It is important to address these issues not only for your comfort but also for the well-being of your partner during sexual activity. Remember, open communication with your partner about any discomfort can also help in finding solutions together.

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