The role of short frenulum and the effects of frenulectomy on premature ejaculation

J Sex Med. 2010 Mar;7(3):1269-76. doi: 10.1111/j.1743-6109.2009.01661.x. Epub 2010 Jan 14.

Abstract

Introduction: The role of short frenulum and the effects of frenulectomy on premature ejaculation (PE) were never investigated.

Aims: The aims of this study were to evaluate the prevalence of short frenulum in a population of patients affected by lifelong PE and to investigate the role of frenulectomy as first-line treatment for this condition.

Methods: We performed frenulectomy to patients complaining of lifelong PE in which we found the presence of a short frenulum at physical examination. We evaluated intravaginal ejaculatory latency time (IELT) and the score of a validated PE questionnaire at baseline and after frenulectomy.

Main outcome measures: We evaluated the change in mean IELT and in mean PE questionnaire score.

Results: We found the presence of a short frenulum in 59 out of 137 (43%) subjects who came to our center complaining of lifelong PE. Mean age of study population was 38.2 years (+/-5.3 standard deviation). At baseline period, mean IELT was 1.65 minutes (+/-1.15), and mean PE questionnaire score was 15.8 (+/-2.85). No complications related to surgery occurred. Mean follow-up time was 7.3 months (+/-3.18). After frenulectomy, mean IELT was 4.11 minutes (+/-1.77), and mean PE questionnaire score was 9.85 (+/-3.2). An increase in mean IELT of 2.46 minutes (P < 0.0001) and a reduction in mean PE questionnaire symptoms score of 5.95 (P < 0.0001) were noted.

Conclusion: Short frenulum is a genital anomaly found in 43% of individuals affected by lifelong PE in our data set. We suggest always ruling out at physical examination the presence of a short frenulum in all patients complaining of PE and to propose frenulectomy as first-line treatment in these cases.

MeSH terms

  • Adult
  • Ejaculation*
  • Erectile Dysfunction / etiology*
  • Erectile Dysfunction / surgery*
  • Humans
  • Male
  • Penis / abnormalities*
  • Penis / surgery*
  • Plastic Surgery Procedures / methods*
  • Surveys and Questionnaires
  • Time Factors