Frenulotomy
The term frenulotomy (syn. Frenuloplasty) describes a urological surgical technique in which a shortened foreskin ligament ( frenulum breve ) is cut transversely and the subsequently existing mucosal defect is sutured lengthways.
Surgical technique
When performing a frenulotomy on adult patients, local anesthesia is applied to the foreskin ligament. For this purpose, a local anesthetic (narcotic agent) can be injected or an anesthetic ointment can be applied.
After careful disinfection and sterile covering, the artery that runs through the frenulum is tied above and below the planned incision or clamped with a clamp to avoid excessive bleeding. Then the frenulum is cut with a scalpel or scissors . The cut that has now been made is sewn lengthways. Self- dissolving threads with a short dissolution time of usually 10 days are used here. At the end, an ointment can be applied to prevent sticking and to keep the threads supple.
After disinfection and local anesthesia, the frenulum can also be cut with an " ammeter ". This knife separates the frenulum and at the same time obliterates the blood vessels. The operation usually takes place on an outpatient basis.
In children, the procedure is performed under anesthesia . The frenulum is cut electrosurgically or after bipolar coagulation with scissors. If it is more pronounced, the artery is also tied off. No further seams are required.
Aftercare
The follow-up treatment consists mainly of regular ointments and cleaning. Mechanical stress should be avoided for three weeks.
Body-temperature chamomile baths of 10 to 15 minutes also support healing. They have a slightly disinfectant effect and thus help to prevent infections. Cleaning with soap should be avoided at all costs .
Complications
Complications can be wound infections , secondary bleeding and severe scarring . Cutting too deeply can injure the urethra , but this is extremely rare.
Synthetic self-dissolving threads have been used since the ban on threads made from catgut . However, these often do not dissolve after 10 days and then have to be removed manually by the urologist.
Individual proof
- ↑ Mayor G., Zingg EJ: Urological operations , Thieme Verlag, 1973, p. 419.
