Q: I am a 31 years old man and my frenulum get cuts frequently during intercourse with my partner. I do not have any other problem of tight foreskin and my frenulum is not short either. What is the cause of this problem? Please suggest me an ointment so that the cuts can be cured.

A:

The frenulum may not be tight, but it may be short and this prevents proper retraction of the foreskin. A frequent injury is for this fold of skin to tear and if this happens an area of white scar tissue may form. Scar tissue does not stretch and once this tearing process has occurred it is liable to happen again and again. Whether the problem is a tight frenulum or tearing of the frenulum the best treatment is often a small plastic operation to try to lengthen the frenulum. Essentially the band of scar tissue is cut across and then some very small self dissolving stitches are placed to close the skin edges in the opposite direction to the line of the cut and this has the effect of lengthening the frenulum. The operation is a minor one and can be done with either local or general anaesthesia and as a day case. No surgeon can guarantee that surgery will always give good results or be free of risk. Usually the results of frenuloplasty are good but sometimes the scar tissue can tighten up again and if this happens sometimes the only cure is a complete circumcision.

The penis is an area of the body with a very plentiful blood supply and sometimes there can be bleeding after the operation and rarely this is enough to require hospital attendance and a further operation. There are also some general precautions you can take to lessen the chance of problems. You should spend as much time as possible in the first three postoperative days lying down so that the penis is the highest point in your body. This takes the pressure off the area. Sitting is bad. However you should not spend all the time lying down and every so often you should walk about e.g. getting meals or visiting the toilet. Keep the area dry for 24 hours and then take showers. After 5-6 days one can take twice daily hot salt baths and this will help any swelling or discomfort to finally settle down. The operation wound is closed with self-dissolving (vicryl rapide) stitches. These are self-dissolving and therefore you do not have to go to have any stitches taken out. Avoid any sport or strenuous activity, and also sexual intercourse for two to three weeks. The wound is up to about 70% full strength by 7 days but is not at full strength for about 3 weeks. It often helps to use condoms for sexual intercourse the first few times as this gives the newly healed skin a little more protection.

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