Frenulum

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Pictured: Frenulum in the human penis.

A frenulum (or frenum, plural: frenula or frena, from the Latin frēnulum, meaning "little bridle") is a small fold of tissue that binds movable structures to non-movable structures in the body. In the human body, examples of frenula include the frenulum linguae, under the tongue, the frenulum labii superioris inside the upper lip, and the frenulum labii inferioris inside the lower lip. The word frenulum on its own is often used for the frenulum in the human penis, which is an elastic band of tissue under the glans penis that connects to the foreskin to the vernal mucosa, and helps contract the prepuce over the glans. This is sometimes colloquially known as the "banjo string".

The frenular artery passes though the frenulum.[1]

Sensation and stimulation

The frenulum and the associated tissue delta on the underside of the penis below the corona has been described in sexuality textbooks as "very reactive" and "particularly responsive to touch that is light and soft." The “underside of the shaft of the penis, meaning the body below the corona” is a “source of distinct pleasure.”[2] Crooks & Baur (1993) observe that two extremely sensitive specific locations that many men find particularly responsive to stimulation are the corona, and the frenulum.[3] Repeated stimulation of this structure will cause orgasm and ejaculation in some men. In men with spinal cord injury preventing sensations from reaching the brain, for example, the frenulum just below the glans can be stimulated to produce orgasm and peri-ejaculatory response.[4][5]

Pathology

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 be treated by manually expanding the shaft skin by stretching. The condition may also be treated by frenuloplasty, or frenectomy. Frenulum breve may contribute to frenular chordee, where the glans is pulled toward the vernal body of the penis.

The frenulum may be entirely missing in cases of first degree hypospadias.

It is possible for the frenulum to tear during sexual activities. The frenular artery, a branch of the dorsal artery, may be severed, causing significant bleeding.

In the event of frenulum breve or frenular chordee, or to ensure that the glans can be freely and completely exposed, the frenulum may be partially or totally removed. It is also often removed in a circumcision.[6][7][8] It has been noted that the wound where the frenulum was amputated is usually slower to heal than the wound where the foreskin was amputated.

Song et al. (2015) report that the frenulum may need to be lengthened after a circumcision amputates skin tissue from the penis.[9]

Lack of a frenulum

The frenulum may be missing in some males for a few reasons.

Rarely, boys are born without a frenulum. This condition causes no issues and permits unusually full retraction of the foreskin.

It may be missing in men who were circumcised at birth, as it is often crushed and cut away, or broken during infant circumcision. Men who are circumcised as adults may specify whether or not they wish to preserve their frenulum. The frenulum was reported to be cut in 26.7%, 20%, and 33.33% of circumcised patients in various surveys.[6][7]

Some men choose to have the frenulum removed as a form of treatment for frenulum breve, a condition in which the frenulum of the penis is short and restricts the movement of the prepuce, which may or may not interfere with normal sexual activity. Yet, others may choose to have the frenulum removed purely out of cosmetic reasons.

Frenulum comparison.jpg

Comparison of an intact frenulum vs. the frenulum remnant on a circumcised penis. Image used with permission of artist.

See also


External links

References

  1. REFweb Frenulum, The damage from circumcision. Retrieved 17 December 2019.
  2. REFbook Hass, K. / A. Hass (1993): Understanding Sexuality. pp. 99–100. St Louis: Mosby.
  3. REFbook Crooks, R. / K. Baur (1993): Our Sexuality. Edition: 5. p. 129. Redwood City: Benjamin/Cummings. ISBN 0534595677.
  4. REFweb Saulino, Michael F. (2006). Rehabilitation of Persons With Spinal Cord Injuries, WebMD.
  5. REFjournal Pryor, J.L. / Leroy / Nagel / Hensleigh. Vibratory stimulation for treatment of anejaculation in quadriplegic men. Archives of physical medicine and rehabilitation. 1995; 76(1): 59-64. PMID. DOI.
  6. a b REFjournal Griffin, A.S. / Kroovand, R.L.. Frenular chordee: implications and treatment. Urology. 1990; 35(2): 133-134. PMID. DOI. Retrieved 1 October 2019.
  7. a b REFjournal Preiser, Gary / Herschel, M. / Bartman, / Andersson, C. / Bailis, S.A. / Shechet, R.J. / Tanenbaum, B. / Kunin, S.A., et al. Circumcision - The Debates Goes On. Pediatrics. 2000; 105(3 Pt 1): 681-684. PMID. DOI.
  8. REFweb Neonatal Circumcision: An Audiovisual Primer, Stanford School of Medicine. Retrieved 1 October 2019.
  9. REFjournal Song, B. / Hou, Z.H. / Liu, Q.L. / Qian, W.P.. [Penile frenulum lengthening for premature ejaculation]. Zhonghua Nan Ke Xue. 1 January 2015; 21(2): 149-152. PMID. Retrieved 1 October 2019.