The frenulum of the penis, often known simply as the frenulum (from ) or frenum, is a thin elastic strip of tissue on the underside of the

glans The glans (, plural "glandes" ; from the Latin word for "acorn") is a vascular structure located at the tip of the penis in male mammals or a homologous genital structure of the clitoris in female mammals. Structure The exterior structure ...

and the neck of the

human penis The human penis is an external male intromittent organ that additionally serves as the urinary duct. The main parts are the root (radix); the body (corpus); and the epithelium of the penis including the shaft skin and the foreskin (prepuce) c ...

. In men who are not

circumcised Circumcision is a procedure that removes the foreskin from the human penis. In the most common form of the operation, the foreskin is extended with forceps, then a circumcision device may be placed, after which the foreskin is excised. Topic ...

, it also connects the

foreskin In male human anatomy, the foreskin, also known as the prepuce, is the double-layered fold of skin, mucosal and muscular tissue at the distal end of the human penis that covers the glans and the urinary meatus. The foreskin is attached to the ...

to the glans and the ventral mucosa. 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. In flaccid state, it tightens to narrow the foreskin opening. The penile frenulum is homologous to the clitoral frenulum in the female. It is similar to the

lingual frenulum The frenulum of tongue or tongue web (also lingual frenulum or frenulum linguæ; also fraenulum) is a small fold of mucous membrane extending from the floor of the mouth to the midline of the underside of the tongue. Development The tongue start ...

between the tongue's lower surface and the lower jaw, or the frenulum between the upper lip and the outside of the upper gum. 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 Chordee is a condition in which the head of the penis curves downward or upward, at the junction of the head and shaft of the penis. The curvature is usually most obvious during erection, but resistance to straightening is often apparent in the ...

, it may include

frenulectomy A frenectomy is the removal of a frenulum, a small fold of tissue that prevents an organ in the body from moving too far. It can refer to frenula in several places on the human body. It is related to frenuloplasty, a surgical alteration in a f ...

or frenulum lengthening.

Structure

The frenulum is a highly

vascularized Angiogenesis is the physiological process through which new blood vessels form from pre-existing vessels, formed in the earlier stage of vasculogenesis. Angiogenesis continues the growth of the vasculature by processes of sprouting and splitt ...

strip of

mucosal tissue A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It is ...

on the ventral side of the glans and the neck of the penis. It forms the interface between the outer and inner foreskin layers. 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. As part of the glans penis, the frenulum is innervated by divisions of the

pudendal nerve The pudendal nerve is the main nerve of the perineum. It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well as the motor supply to various pelvic muscles, including the male or fem ...

; the

dorsal nerve of the penis The dorsal nerve of the penis is the deepest division of the pudendal nerve; it accompanies the internal pudendal artery along the ramus of the ischium; it then runs forward along the margin of the inferior ramus of the pubis, between the superio ...

and a branch of the

perineal nerve The perineal nerve is a nerve of the pelvis. It arises from the pudendal nerve in the pudendal canal. It gives superficial branches to the skin, and a deep branch to muscles. It supplies the skin and muscles of the perineum. Its latency is t ...

. Blood supply to the frenulum is provided by branches of the

dorsal artery of the penis The dorsal artery of the penis is an artery on the top surface of the penis. It is a branch of the internal pudendal artery. It runs forward on the dorsum of the penis to the glans, where it divides into two branches to the glans penis and the ...

that curve around each side of the neck to enter the frenulum and the glans from its ventral surface. It is uncertain whether the frenular artery is single or paired. Veinous drainage is thought to occur around the neck of the penis from smaller paired venules. The frenulum occurs on the ventral midline of the glans, where the two glans wings merge forming the septum glandis.

Research

The role of the frenulum in penile erection has been studied in cases of men with short frenula and

premature ejaculation Premature ejaculation (PE) occurs when a man expels semen (and most likely experiences orgasm) soon after beginning sexual activity, and with minimal penile stimulation. It has also been called ''early ejaculation'', ''rapid ejaculation'', ''r ...

. Short frenulum may sometimes be associated with unsatisfied intercourse. 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. 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.

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. Surgical treatment includes

frenuloplasty Frenuloplasty is the surgical alteration of a frenulum when its presence restricts range of motion between interconnected tissues. Two of the common sites for a frenuloplasty are: * Frenuloplasty of tongue * Frenuloplasty of prepuce of penis {{su ...

(frenulum lengthening or reconstruction),

frenectomy A frenectomy is the removal of a frenulum, a small fold of tissue that prevents an organ in the body from moving too far. It can refer to frenula in several places on the human body. It is related to frenuloplasty, a surgical alteration in a f ...

, or

circumcision Circumcision is a procedure that removes the foreskin from the human penis. In the most common form of the operation, the foreskin is extended with forceps, then a circumcision device may be placed, after which the foreskin is excised. Top ...

. There are a variety of different circumcision techniques in which the frenulum can be spared and left completely intact. It is possible for the frenulum to tear during sexual activities. This type of injury usually heals by itself. In more severe cases, the frenular artery may be injured causing bleeding. The frenulum may be entirely missing in cases of first degree

hypospadias Hypospadias is a common variation in fetal development of the penis in which the urethra does not open from its usual location in the head of the penis. It is the second-most common birth abnormality of the male reproductive system, affecting abou ...

Frenectomy and frenuloplasty

As a treatment for frenulum breve or frenular chordee, a

or ''frenulectomy'' can be performed to excise the frenulum from the penis. This is a form of genital frenectomy. 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

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.

Gallery

File:Penisfrenulum.jpg, A human frenulum displaying frenular

File:Frenulum and frenular delta on erect circumcised penis.JPG, Frenulum on erect circumcised penis

References

External links

{{DEFAULTSORT:Frenulum Of Prepuce Of Penis Circumcision debate Human penis anatomy Mammal male reproductive system