The Role of Short Frenulum and the Effects of Frenulectomy on Premature Ejaculation

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. Gallo L, Perdona S, and Gallo A. The role of short frenulum and the effects of frenulectomy on premature ejaculation. J Sex Med 2010;7:1269-1276.