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Fig 4. Penis with the loosened foreskin replaced over the glans. Surgical methods range from the complete removal of the foreskin to more minor operations to relieve foreskin tightness: Dorsal slit (superincision) is a single incision along the upper length of the foreskin from the tip to the corona, exposing the glans without removing any tissue.
This may be a complication of circumcision or a naturally occurring event. When it is a naturally occurring event, a short frenulum can restrict normal retraction of the foreskin during erection (a condition known as frenulum breve). The goal of treatment is to allow normal retraction of the foreskin.
Preputioplasty or prepuce plasty, also known as limited dorsal slit with transverse closure, is a plastic surgical operation on the prepuce or foreskin of the penis, [1] to widen a narrow non-retractile foreskin which cannot comfortably be drawn back off the head of the penis in erection because of a constriction which has not expanded after adolescence.
The diagnosis of severe frenulum breve is almost always confused with that of phimosis and a generally tight foreskin, since the symptom is difficulty retracting the foreskin. Most men with phimosis also have frenulum breve to a certain extent. [5] A milder frenulum breve may go unrecognized, since foreskin may retract over the glans variably.
This condition prevents the full retraction of the foreskin with or without an erection. [1] It is a simple and normally painless procedure that is performed in a urologist's office. First the physician applies a local anesthetic, such as lidocaine/prilocaine cream on the frenulum and surrounding area. If the patient retains any feeling there ...
In men who are not circumcised, it also connects the foreskin to the glans and the ventral mucosa. [1] [2] In adults, the frenulum is typically supple enough to allow manual movement of the foreskin over the glans and help retract the foreskin during erection. [3] [4] In flaccid state, it tightens to narrow the foreskin opening. [2]
In some cases the foreskin may become swollen as a result of paraphimosis (foreskin trapped behind the glans) or other conditions such as severe balanitis. Should reduction of the swelling by conservative methods be unsuccessful, a dorsal slit is a common intervention of choice since circumcision is almost always excluded in such cases.
Paraphimosis is usually caused by medical professionals or parents who handle the foreskin improperly.[4] [6] The foreskin may be retracted during penile examination, penile cleaning, urethral catheterization, or cystoscopy; if the foreskin is left retracted for a long period, some of the foreskin tissue may become oedematous (swollen with fluid), which makes subsequent reduction of the ...
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