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Frenulum

2,636 bytes added, 01:32, 22 November 2023
Pathology: Delete inappropriate reference.
{{GraphicWarning}}
[[File:Frenulum_IntactWiki.jpg|200px|thumb|right|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.<ref name="damege1">{{REFweb
==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.”<ref name="hass1993">{{REFbook
|last=Hass
|first=K.
|init=K
|last2=Hass
|first2=A.
|init2=A
|year=1993
|title=Understanding Sexuality
|last=Crooks
|first=R.
|init=R
|last2=Baur
|first2=K.
|init2=K
|year=1993
|title=Our Sexuality
|accessdate=
|note=
}}</ref> 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.<ref>{{REFweb
| quote=
| url=http://www.emedicine.com/orthoped/topic425.htm
}}</ref><ref>{{REFjournal
|last=Pryor
|firstinit=J.L.JL
|last2=Leroy
|last3=Nagel
|issue=1
|pages=59-64
|url=https://www.archives-pmr.org/article/S0003-9993(95)80044-1/pdf
|quote=
|pubmedID=7811177
|DOI=10.1016/S0003-9993(95)80044-1
|date=1995
|accessdate=2021-03-11}}</ref> <ref name="taylor2003">{{REFjournal |last=Taylor |first=John R. |init= |author-link=John R. Taylor |etal=no |title=Evidence sketchy on circumcision and cervical cancer link |trans-title= |language= |journal=Can Fam Physician |location= |date=2003-12 |volume=49 |issue= |article= |page=1592 |pages= |url=http://www.cirp.org/library/sex_function/taylor3/ |archived= |quote= |pubmedID=14708921 |pubmedCID=2214164 |DOI= |accessdate=2021-03-11}}</ref> Cepeda-Emiliani et al (2023) state:<blockquote>One circumcision technique [91] has been proposed to protectas much tissue as possible ventrally due to the sexual functionsattributed to this region. Concerningly and antithetically to theformer technique, the frenular area has been intentionallytargeted during [[adult circumcision]] by some urologists inthe belief that its total and permanent denervation usingmonopolar current might be a definitive treatment for lifelongpremature ejaculation. These urologists concluded thattheir circumcision technique resulted in “a consistent reductionin penile sensitivity” and “is a strong weapon in the hands ofurological surgeons, which must be used very carefully, as itseffects on male sexuality can be devastating and irreversibleif performed in the wrong patient. Thus, the caveat must beright circumcision in the right patient using the correctsurgical technique’”. To the extent thatthis type of circumcision may impair sexual function bydenervating a neurologically permissive substrate through whichsexual sensation enters the central nervous system, we agreewith Jannini [93] that denervation of the frenular region is apotentially dangerous intervention.<ref name="cepeda2023">{{REFjournal |last=Cepeda-Emiliani |first= |init=A |author-link=Alfonso Cepeda-Emiliani |last2=Gándara-Cortés |first2= |init2=M |author2-link= |last3=Otero-Alén |first3= |init3=M |author3-link= |last4=García |first4= |init4=H |author4-link= |last5=Suárez-Quintanilla |first5= |init5=J |author5-link= |last6=García-Caballero |first6= |init6=T |author6-link= |last7=Gallego |first7= |init7=R |author7-link= |last8=García-Caballero |first8= |init8=R |author8-link= |etal=no |title=Immunohistological study of the density and distribution of human penile neural tissue: gradient hypothesis |trans-title= |language= |journal= Int J Impot Res |location= |date=2023-05-02 |volume=35 |issue=3 |article= |page= |pages=286-305 |url=https://www.nature.com/articles/s41443-022-00561-9 |archived= |quote= |pubmedID=35501394 |pubmedCID= |DOI=10.1038/s41443-022-00561-9 |accessdate=2023-11-21
}}</ref>
</blockquote>
==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 [[tissue expansion| 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]].<ref name="Griffin-Kroovand1990">{{REFjournal
|last=Griffin
|firstinit=A.S.AS
|last2=Kroovand
|first2init2=R.L.RL
|title=Frenular chordee: implications and treatment
|journal=Urology
|last=Preiser
|first=Gary
|init=G
|last2=Herschel
|first2init2=M.
|last3=Bartman,
|first4init3=T. |last5last4=Andersson |first5init4=C. |last6last5=Bailis |first6init5=S.A.SA |last7last6=Shechet |first7init6=R.J.RJ |last8last7=Tanenbaum |first8init7=B. |last9last8=Kunin |first9init8=S.A.SA |last10last9=Hodges |first10init9=F.M.FM |last11last10=Fleiss |first11init10=P.M.PM |last12last11=Antonopoulos |first12init11=J. |last13last12=Rockney |first13init12=R. |last14last13=Taylor |first14init13=A. |last15last14=Stang |first15init14=H. |last16last15=Snellman |first16init15=L. |last17last16=Fontaine |first17init16=P. |last18last17=Condon |first18init17=L.M.LM |last19last18=Lannon |first19init18=C.M.CM
|etal=yes
|title=Circumcision - The Debates Goes On
|DOI=10.1542/peds.105.3.681
|accessdate=
}}</ref><ref>{{REFweb |url=http://med.stanford.edu/newborns/professional-education/circumcision.html |title=Neonatal Circumcision: An Audiovisual Primer |last= |first= |publisher=Stanford School of Medicine |website= |date= |accessdate=2019-10-01 |format= |quote=}}</ref> 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]].<ref>{{REFjournal
|last=Song
|firstinit=B.
|last2=Hou
|first2init2=Z.H.ZH
|last3=Liu
|first3init3=Q.L.QL
|last4=Qian
|first4init4=W.P.WP
|title=[Penile frenulum lengthening for premature ejaculation]
|journal=Zhonghua Nan Ke Xue
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 complete 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.<ref name="Griffin-Kroovand1990"/><ref name="Gary2000"/>
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.
[[File:Frenulum_comparison.jpg]]
Comparison of an [[intact ]] frenulum vs. the frenulum remnant on a [[circumcised ]] [[penis]]. Image used with permission of artist.
{{SEEALSO}}
* [[Circumcision]]
* [[Foreskin]]
* [[Frenulum breve]]
* [[Frenuloplasty]]
* [[Phimosis]]
* [[Ridged band]]
 
{{LINKS}}
 
* {{REFbook
|last=McGrath |first=Ken |firstinit=McGrathK
|author-link=Ken McGrath
|year=2001
|url=http://www.cirp.org/library/anatomy/mcgrath1/
|work=
|editoreditors=Denniston GC, Hodges FM, Milos MF
|edition=
|volume=
|note=
}}
 
{{REF}}
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