Penile frenulum
Frenulum of the penis | |
---|---|
Details | |
System | Male reproductive system |
Artery | Dorsal artery of the penis |
Vein | Dorsal veins of the penis |
Nerve | Dorsal nerve of the penis |
Identifiers | |
Latin | frenulum preputii penis |
TA98 | A09.4.01.012 |
TA2 | 3676 |
FMA | 19647 |
Anatomical terminology |
The frenulum of the penis, often known simply as the frenulum (from
The penile frenulum is
In some men, the frenulum may appear shorter than normal, a phenomenon known as frenulum breve. Treatment of frenulum breve may be non-surgical, or in other cases, especially with penile chordee, it may include frenulectomy or frenulum lengthening.[7][8]
Structure
The frenulum is a highly vascularized strip of mucosal tissue on the ventral side of the glans and the neck of the penis. It forms the interface between the outer and inner foreskin layers.[2] During gestation, it forms as the lateral edges of the preputial lamina approach in the ventral midline. The two sides of the lamina do not fuse in the midline but remain separated by a thin septum of mesenchyme that will create the preputial frenulum.[9] As part of the glans penis, the frenulum is innervated by divisions of the pudendal nerve; the dorsal nerve of the penis and a branch of the perineal nerve.[10][11] Blood supply to the frenulum is provided by branches of the dorsal artery of the penis that curve around each side of the neck to enter the frenulum and the glans from its ventral surface.[12] It is uncertain whether the frenular artery is single or paired.[13] Veinous drainage is thought to occur around the neck of the penis from smaller paired venules.[14] The frenulum occurs on the ventral midline of the glans, where the two glans wings merge forming the septum glandis.[15]
Research
The role of the frenulum in penile erection has been studied in cases of men with short frenula and premature ejaculation. Short frenulum may sometimes be associated with unsatisfied intercourse.[8] Treatment with lengthening or reconstruction of the frenulum in uncircumcised and circumcised men was reported to have positive results in satisfied intercourse, prolonged erection and time of ejaculation.[16][17]
For individuals with spinal cord injuries preventing sensations from reaching the brain, the frenulum just below the glans can be stimulated to produce orgasm and peri-ejaculatory response. It is often a way for those with spinal cord injuries to engage in sexual activities and subsequently feel pleasure.[18][19]
Clinical significance
Frenulum breve is a condition in which the frenulum is short and restricts the movement of the foreskin, which may or may not interfere with normal sexual activity. Frenulum breve may also contribute to frenular chordee, where the glans is pulled toward the ventral body of the penis. The condition can be treated with surgical and non surgical treatment. Non surgical treatment includes stretching exercises and steroid creams.[3] Surgical treatment includes frenuloplasty (frenulum lengthening or reconstruction), frenectomy, or circumcision.[4] There are a variety of different circumcision techniques in which the frenulum can be spared and left completely intact.[20]
It is possible for the frenulum to tear during sexual activities. This type of injury usually heals by itself.[21] In more severe cases, the frenular artery may be injured causing bleeding.
The frenulum may be entirely missing in cases of first degree hypospadias.
Frenectomy and frenuloplasty
As a treatment for frenulum breve or frenular chordee, a frenectomy or frenulectomy can be performed to excise the frenulum from the penis.[7] This is a form of genital frenectomy.[7] This procedure results in a smooth surface. A less invasive treatment which often retains the natural appearance and function of the frenulum to some degree is a frenuloplasty or frenulum lengthening. This procedure involves a (partial) incision of the frenulum and realigning the edges to gain more length. This makes the frenulum longer, effectively relieving pain and discomfort.[22][23]
Gallery
-
A human frenulum displaying frenular chordee
-
Frenulum on erect circumcised penis
See also
References
- ISBN 9781848502468.
- ^ a b c "Male circumcision: Global trends and determinants of prevalence, safety and acceptability" (PDF). World Health Organization. 2007. Archived (PDF) from the original on 2015-07-15. Retrieved 2009-06-12.
- ^ a b "Penis Frenulum: Location, Function & Conditions". Cleveland Clinic. Retrieved 2023-01-01.
- ^ a b "Short Frenulum - Frenulum Breve | Metromale Clinic & Fertility Center". 2020-01-21. Retrieved 2023-01-01.
- ISBN 978-3-03037-621-5. Retrieved October 29, 2023.
- PMID 28856075.
- ^ PMID 2305537.
- ^ a b "What should I do if my penis is torn?". nhs.uk. 2018-06-26. Retrieved 2023-01-01.
- PMID 30245194.
As development proceeds the lateral ventral edges of the preputial lamina approach the ventral midline. The ventral edges of the preputial lamina do not fuse in the midline but remain separated by a thin septum of mesenchyme [...] destined to form the preputial frenulum.
- PMID 10037378.
The dorsal nerve of the penis innervates the glans, including the frenulum which is also innervated by a branch of the perineal nerve.
- PMID 30247841, retrieved 2023-01-01
- PMID 2033699.
The blood supply to the frenulum arises from the dorsal artery of the penis. Branches of the dorsal artery curve around each side of the distal shaft to enter the glans and the frenulum ventrally.
- PMID 30386085.
It is unclear whether the frenular artery is single; in our experience, paired arteries were often evident, lying in the frenular bed
- PMID 30386085.
- PMID 29201519.
- S2CID 32268548.
- PMID 25796689.
- ^ Saulino MF (2006). "Rehabilitation of Persons With Spinal Cord Injuries". WebMD.
- PMID 7811177.
- PMID 26816940.
- ^ "Frenulum tear: Causes, first aid, and when to see a doctor". www.medicalnewstoday.com. 2020-05-29. Retrieved 2023-06-23.
- ^ "Frenuloplasty | what is it and how is it performed?". Top Doctors. Retrieved 2023-06-23.
- ^ "Lengthening of the penile frenulum (frenuloplasty)". Cambridge University Hospitals. Retrieved 2023-06-23.