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Overview

Frenulum breve is the medical term given for a short frenulum of the penis. The frenulum is a supple tissue located under the head of the penis that connects to the foreskin and its function is to help the foreskin contract over the penis head.

With frenulum breve, the pliable tissue is too short and restricts movement of the foreskin. The frenulum should be long enough to allow the foreskin to be able to retract completely so that it is positioned comfortably over the shaft of an erect penis. 

Symptoms 

A shortened frenulum of the penis may be confused with phimosis which is narrowing of the foreskin which can be severe enough to restrict retraction of the tissue over the head of the penis. 

The diagnosis of frenulum breve should be made by a physician in order to rule out any other problems and to avoid confusion between these two similar conditions.  

Complications

Sexual activity with a shortened penile frenulum may cause some discomfort since the foreskin is restricted to a point. The frenulum may also tear which can cause moderate to severe pain in the affected individual.

The silver lining in this complication though is that the torn frenulum heals and forms scar tissue which is longer than the initial tissue and this may solve some of the problems.

Management

Although surgical intervention is the norm regarding management of the condition, there are non-surgical methods that can be attempted before heading towards the surgical route.

The use of stretching exercises and the application of steroid creams to the shortened frenulum may help to lengthen the tissue.

Stretching exercises may include holding the frenulum between the thumb and index finger and then slowly and gently pulling on the tissue up until a point that is comfortable for the affected individual. The frenulum is held in that stretched out position for five to 10 minutes and then released. This technique should be repeated another four to five times throughout the day and the person performing the technique should make sure not to hurt themselves.

Some caution needs to be exercised though when performing stretching exercises as being too rough may end up causing a tear in the frenulum. Also, prolonged use of steroid creams on the frenulum and head of the penis may lead to issues such as thinning of the frenulum to the point where it can tear and opportunistic fungal infections.

Surgery

Surgical intervention may involve something as simple as passing a suture through the frenulum and then tying the material off to restrict blood flow to the tissue. The strangulated tissue will then separate after a few days and this will help release tension on the foreskin. 

If the conservative and minor surgical methods are ineffective, then major surgical procedures may need to be performed. These include a frenuloplasty where the short frenulum is repaired if it's torn and a frenectomy where the frenulum is completely resected. The latter can be done in the presence or absence of a circumcision. 

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