Exercises to stretch the frenulum of the tongue; consultation on speech therapy (senior group)

Problem: for a consultation with the Dial-Dent speech therapist T.B. Zukor was contacted by a 22-year-old man. His wish: “We urgently need to trim the frenulum of the tongue! The surgeon needs a referral from a speech therapist to perform the operation!” The reason for this urgent treatment was unbearable pain in the tongue area when kissing!

Solution: myofunctional examination confirmed the need for frenuloplasty of the tongue (surgery to trim the frenulum of the tongue). The man received a referral for an operation, which was performed by surgeons at the clinic. Frenuloplasty of the tongue was successful, the pain was completely eliminated.

The speech therapist of the Family Dental T.B. talks about the short frenulum of the tongue, how to identify it, and what to do with it. Zukor in his article.

Reasons for the development of pathology

In the vast majority of cases, a short frenulum is a consequence of a developmental abnormality and is combined with phimosis - a narrowing of the foreskin with the impossibility of exposing the head of the penis. According to statistics, up to 5% of uncircumcised men suffer from insufficient extensibility of the folds of skin on the penis. This anomaly is accompanied by a number of painful and unpleasant symptoms:

• curvature of the penis in an erect state;
• pain during sexual intercourse;
• premature ejaculation;

• the frenulum breaks as a result of active movements during intercourse.

With normal development, the frenulum is of sufficient length and can stretch significantly, providing comfortable and painless movement of the foreskin. A fold of skin that is too short causes a lot of trouble and can cause serious complications.

What is a short frenulum of the penis?

The frenulum is a skin bridge, a cord that holds the foreskin so that it does not go far beyond the coronary groove. A shortened frenulum of the penis often does not allow the head to be completely exposed (phimosis), as a result of which it is impossible to wash out accumulated discharge (smegma) from the resulting fold. Inflammation (balanoposthitis) often develops on this basis. Hard formations (smegmalites) may also appear. If the infection gets into the urethra and begins to rise along its walls, urethritis, cystitis, and prostatitis will develop.

During an erection, the short frenulum is strongly stretched, causing pain. Sexual intercourse, even with a condom, will be very painful. It is necessary to restrain the frictions, since a tense frenulum is easily torn, which is accompanied by severe pain and bleeding. Healing sometimes fails - it becomes even shorter, becomes deformed, and then surgery cannot be avoided.

Interview on the topic “Short frenulum of the foreskin” with Nika Dzhumberovich, Doctor of Medical Sciences, Professor of the Department of Urology at Sechenov University, Head of the Department of Male Sexual and Reproductive Medicine at the European Medical Center Akhvlediani

A short frenulum can cause premature ejaculation. Not only blood vessels, but also nerves pass through the thickness of this skin fold. During tension, the sensitivity of this area intensifies.

A short frenulum can also affect the shape of the penis, pulling the head down. As a result, during an erection it cannot fully straighten and looks shorter.

Deformation of the penis with a short frenulum

A short frenulum may be this way from birth or deformed due to injury. In the latter case, the problem most often arises due to too active sex or masturbation. The frenulum tears, then grows together, but the connective tissue is no longer so elastic. As a result, the foreskin ceases to completely expose the head.

Possible triggers

Other possible causes of pathology are:

• Chronic inflammatory diseases of the penis
  . Balanitis and balanoposthitis, in most cases occurring with the presence of pathogenic microflora, lead to structural tissue changes in the area of ​​the head of the penis.

• Chronic injuries to the foreskin
  . Even microdamages to the delicate skin of the penis without proper and timely response can lead to improper tissue fusion. Such injuries occur when playing certain sports or wearing too tight underwear and clothes.

• Diabetes mellitus in the stage of decompensation
  . In this case, tissue changes are caused by a characteristic sign of the disease - a disruption of the regeneration process, as a result of which cicatricial deformities begin to appear in the tissues of the frenulum.

Most often, the pathology is diagnosed when a man begins to have an active sexual life. That's when the real problems begin. Especially if the disease is not detected and treated in time.

Reviews about the treatment

Judging by the reviews on the forums, the result of frenulum correction depends on the skill of the doctor. For some, the sensitivity of the head disappears and its blood supply is disrupted. An example of a review and the doctor’s response is below.

UVT and other procedures did not help the guy. Most clinics also do not undertake microsurgical operations.

Due to the unprofessionalism of doctors or poor hygiene, the operation has to be redone. After the first failure, many turn to famous doctors - Petrovich R. Yu. and Bakirkhanov S. K., as in the review below.

Bakirkhanov’s answer to the question about sensitivity after surgery:

For most men, the correction is successful.

Causes of pathology in children

It is not possible to identify a pathological condition in a small child. The main symptoms appear only during puberty. Indirect indications of the presence of an anomaly are:

• Phimosis
  . Although physiological phimosis is present in almost all newborns, by the 3rd year of life in 90% of boys the head opens completely. Only in 1-5% of children the pathology persists until adulthood - and, as a rule, is accompanied by a short frenulum.

• Heredity
  . Genetic factors influence the transmission to subsequent generations of most abnormal deviations, including those in the structure of organs and systems. If one of the parents has such a pathology in the family, there is a high probability that the anomaly will manifest itself in the child.

It is possible to detect the presence of a pathological condition of the frenulum of the penis in a boy only by indirect signs, since the child prefers to endure discomfort. However, if you regularly cry while urinating, a thorough examination of the penis is necessary. Possible signs of pathology are:

• redness or swelling in the foreskin area;
• the presence of phimosis - the inability to expose the head;
• the appearance of bloody discharge during water procedures;
• accumulation of smegma (preputial lubricant), causing pain and burning.

All these symptoms indicate the possible presence of pathology in the genitals. The presence of alarming signs requires mandatory medical consultation. And in case of diagnosing a pathology - timely treatment.

Causes of pathology in adolescents

At the age of 13-18 years, rapid development of the genital organs occurs and the reproductive system is formed. This period is characterized by the possible occurrence of hormonal imbalances, as well as disruption of the normal functionality of certain systems and organs.

It is during puberty that there is a high probability of a discrepancy between the growth rate of skin tissue and the rapidly developing cavernous bodies in the penis.

As a result of the rapid onset of puberty, the frenulum of the penis becomes short in comparison with the size of the organ itself and is unable to painlessly perform its functions - to help the foreskin cover the glans.

If a teenager in this state begins to have sex (masturbation), there is a high probability that the skin fold will rupture or cracks will appear on it. Mini-damages of this kind must be treated with an antiseptic and consult a doctor.

Otherwise, not only mechanical damage, but also psycho-emotional discomfort may occur.

In the long term, this can lead to a decrease in confidence in one's sexual capabilities. And even cause impotence. During adolescence, not only puberty occurs, but also psychological foundations are formed. Therefore, the young person is especially vulnerable.

What to do in case of a breakup?

When a frenulum ruptures, it is important to provide first aid correctly. The injury is usually accompanied by severe bleeding, which should be stopped as quickly as possible.

• The wound should be pressed with your fingers and not released for at least 15 minutes. During this time the bleeding should stop. You can do it differently - press the bridle to the head and hold for a quarter of an hour. In any case, it is important to regulate the degree of pressure, since there is a risk of developing head ischemia.
• After the blood stops flowing, it is recommended to treat the wound with an antiseptic.
• At the final stage, apply a sterile cotton bandage. It should not be too tight, otherwise blood stagnation may occur.
• If a man is experiencing severe pain, a cold compress can be applied. It will not only eliminate discomfort, but also relieve swelling.

Even with a quick recovery and no pain after injury, a consultation with a urologist is necessary. He will conduct an examination and select the optimal treatment method to avoid problems in the future. As a rule, the doctor recommends frenulotomy.

Methods of treating the pathological condition

Although a short frenulum is not an independent disease, such an anomaly requires qualified help and drug treatment. As a method of correcting the situation, traditional medicine offers exclusively surgical intervention.

It is emphasized that the earlier the pathology is identified, the less traumatic the treatment will be: the volume of surgical intervention in childhood is minimal, and the psyche adapts much better than in a mature man.

For adult men, the main sign by which an anomaly can be suspected is pain and discomfort of the penis during an erection.

In addition to a visual examination, the specialist conducts laboratory and hardware tests, after which he individually selects the most optimal type of surgical operation.

Frenulotomy or frenuloplasty

Dissection of the frenulum or frenulotomy is the most effective type of surgical intervention used in medical practice. Although it lasts no more than 20 minutes. and is performed under local anesthesia on an outpatient basis (for adolescents - with general anesthesia), requires full preparation for surgical intervention:

• blood and urine tests;
• passing tests for allergies to painkillers;
• additional blood tests (Rh factor, group, clotting rate).

2-3 days before surgical treatment, it is recommended to switch to a diet. It is necessary to stop drinking alcoholic beverages. Immediately before the operation, hair in the intimate area should be removed and careful hygiene should be carried out.

How is frenulotomy performed?

On the day of the operation, you need to come to the clinic in advance (about an hour) in loose outer clothing. The patient is asked to assume a supine position on the operating table. After that:

• the genital area is disinfected;
• local or general (injection into a vein) anesthesia is performed;
• the doctor makes a transverse incision on the frenulum, straightening the fold to the desired size;

• if there are scars, the surgeon excises them during the operation;
• the edges of the incisions are stitched with threads that dissolve during the rehabilitation process;
• the final stage is applying a napkin with an antiseptic (for at least 12 hours).

This is what the operation looks like using a regular scalpel. However, advances in technology have made it possible to expand the variability of frenuloplasty offerings. Clinics offer frenuloplasty using the following tools:

At the end of the medical procedures, the patient goes home, having first listened to the doctor’s recommendations. The hygienic bandage should be removed after 12-24 hours. A longer period (days) is preferable, but you should not leave the bandage on the wound too long.

Rehabilitation period

After this, it is necessary to carry out regular hygiene of the operated area and ensure that you do not develop new injuries or cracks in the skin of the penis:

• exclude increased physical activity;
• refuse sexual intercourse and masturbation;
• temporarily stop visiting baths and saunas.

The rehabilitation period lasts up to 3 weeks. This type of intervention has another important advantage - the cosmetic effect in this case is maximum. There are practically no scars or seams left.

When is VUplasty used?

The method is rarely used because it leaves noticeable scars on the penis that cannot be hidden by the foreskin. The surgeon makes a V-shaped incision in the frenulum, then sutures the edges in such a way as to increase the length of the fold.

In addition to cosmetic discomfort, this type of intervention can provoke phimosis, since after the operation there is a narrowing of the foreskin.

However, VU-plasty is performed in cases where other types of intervention are contraindicated.

But only after examination and doctor’s recommendation.

In what cases is circumcision recommended?

The cutting technique is similar to frenulotomy. The preparatory period, duration of the operation, anesthesia, and postoperative care are the same. The differences are as follows:

• Problem solving mechanism
  . In this case, not only the frenulum is cut, but the entire fold of the foreskin is removed - the doctor leaves a small area of ​​skin around the circumference (0.5-1 cm) so that there is no strong tension during an erection.
• Duration of rehabilitation
  . With circumcision, the recovery period is longer (up to 8 weeks), since a large area is injured.

The doctor recommends trimming the foreskin in cases where signs of phimosis are present. During one surgical procedure, a specialist can solve two problems at once: trim part of the skin fold, while simultaneously lengthening the frenulum. And forever rid a man of self-doubt.

Contraindications to surgical treatment

During preparation for surgery, a number of studies are required. However, the doctor may not be aware of any pathology in the patient. Therefore, it is necessary to familiarize yourself with the list of contraindications:

• diseases that cause decreased blood clotting;
• functional disorders in the liver and kidneys;
• oncology;

• injuries or ulcers in the operated area;
• inflammation of the MPS organs and STDs (sexually transmitted diseases).

The last contraindication is relative. It may be removed from the list after preliminary treatment.

Non-surgical methods

Traditional medicine categorically denies the effectiveness of such techniques. However, if there are contraindications to surgical treatment, it is worth trying home methods for stretching the skin fold. There are several of them:

1. The thumbs are carefully inserted into the prepuncial sac and begin to slightly stretch the skin. In this case, the feeling of discomfort should not develop into pain.

2. Before the procedure, take a warm 15-minute shower or hot bath to soften the skin. Then the foreskin is retracted as much as possible and fixed for several minutes - this slightly stretches the frenulum and makes it more elastic.

Like any unconventional methods, such treatment will only work if used for a long time - more than 3 months minimum. The effectiveness will also depend on the individual characteristics of the organism. Such as age, physiology, regularity and correctness of execution.

What to do if the frenulum of the foreskin is torn?

As a result of careless movements or sudden entry into the vagina, injuries or tears in the skin fold are possible. If there is pain near the frenulum or there is a rupture, do not panic. The actions should be as follows:

• First of all, stop the bleeding. To do this, it is enough to press the gap with your fingers for at least 15 minutes. At the same time, try to fix only the damaged area, without completely pinching the vessels of the penis.
• The second step is treatment with an antiseptic. Hydrogen peroxide is most suitable, since alcohol can burn delicate skin.
• Seek advice from a specialist who will assess the extent of the damage and give recommendations on further actions.

In most cases, if the frenulum is torn, the doctor will refer you for surgery. Anyone who has torn it once may be injured in the future. And with consequences of varying complexity.

Short frenulum of the tongue

The frenulum of the tongue is a special fold of the oral mucosa, which stretches in the form of an arc from approximately the middle of the tongue to the base of the gums in the area of ​​the lower front incisors. The frenulum of the tongue serves as an additional means of attaching the tongue to the floor of the mouth. Shortening of the frenulum of the tongue is an anomaly in which the upper end of the frenulum is not in the middle of the tongue, but much closer to the tip or even at the very tip of the tongue. It can be complete when the tongue is completely attached to the floor of the mouth and partial when the frenulum is shortened.

A short frenulum of the tongue in medical terminology is called Ankyloglossia.

Sign of a short frenulum of the tongue:

• Heart-shaped tongue in an elevated position
• Inability to extend the tongue so that the tip is sharp
• The tongue curls down when it moves forward
• Difficulty in the act of swallowing, the chewing process (in children, impaired sucking function)
• Impaired pronunciation of sounds and changes in diction
• Bite pathology
• Periodontal diseases

Determining on your own whether you have a tongue tie or not can be difficult because... with a slight shortening of the frenulum, the symptoms are “erased.” Therefore, it is better to undergo an examination by a dentist or orthodontist in our dental center and make sure that everything is in order.

Indications for lingual frenuloplasty:

A short frenulum of the tongue in infancy leads to various disorders: impaired breastfeeding, poor weight gain, early cessation of breastfeeding and, as a consequence, significant retardation in growth and development. This pathology in infants can be detected in the maternity hospital by a pediatric neonatologist. In infants, the lingual frenulum, which is an avascular and muscleless cord, is cut with scissors without suturing, followed by placing the child to the chest for better wound healing.

After simply cutting the frenulum of the tongue with scissors, a rough scar may form, which will also require plastic surgery of the frenulum of the tongue when the child grows up.

In older children, the structure of the frenulum changes (it becomes more dense, vessels appear in it), so they are indicated for surgical intervention - plastic surgery of the frenulum of the tongue.

In preschool children, frenulum pathology is usually detected by a speech therapist. This is due to the organic type of dyslalia, in which the child does not pronounce palatal, hissing and whistling sounds due to limited tongue mobility. A speech therapy examination reveals that the child cannot stick out his tongue or reach the upper incisors with the tip of his tongue. It should be understood that after plastic surgery of the frenulum of the tongue, independent normalization of speech does not occur, therefore, children with speech pathology require a course of corrective speech therapy classes.

Orthodontic indications for plastic surgery of the lingual frenulum include restraining the growth of the lower jaw due to ankyloglossia, which can cause the incisors to tilt inward. In addition, the high attachment of the lingual frenulum makes it difficult to use orthodontic structures. Therefore, before starting orthodontic treatment, tongue frenuloplasty is recommended.

Correction of the tongue frenulum can also be indicated for an adult patient at the stages of orthopedic treatment. Excessive mobility of sublingual tissues can lead to the removal of dentures from the lower jaw during speaking and chewing. Currently, plastic surgery of the lingual frenulum is very relevant when planning prosthetics on implants, because Ankyloglossia can lead to the development of peri-implantitis - disruption of tissue nutrition around the implant, exposure of the implant coils and subsequent loss.

In case of periodontal diseases associated with an abnormal development of the lingual frenulum, namely pathological pockets in the anterior part of the lower jaw, recession, pathological mobility of teeth, plastic surgery of the lingual frenulum may be necessary for preventive purposes.

Plastic frenulum of the tongue

Surgeries for ankyloglossia include frenulotomy (dissection of the lingual frenulum) and frenuloplasty (plasty of the lingual frenulum).

Plastic surgery of the lingual frenulum can be performed either traditionally or using a surgical laser. Tongue frenuloplasty is performed on an outpatient basis using local anesthesia.

In the classic version of lingual frenuloplasty, careful excision of old scars (if the frenulum was cut in infancy) and mucous cord is performed, the formation of a submucosal flap and the transfer of the attachment site of the lingual frenulum. At the conclusion of surgical plastic surgery of the frenulum of the tongue, several self-absorbing sutures are applied. In the process of plastic surgery of the lingual frenulum, it is necessary to monitor the condition of the mouths of the ducts of the sublingual and submandibular salivary glands in order to avoid their damage during incision and suturing.

Laser treatment has a number of clinical advantages compared to traditional dentistry, such as bacteriological and bacteriostatic effects, coagulation (no postoperative bleeding), ergonomics, precision, filigree, no need for sutures and the possibility of performing microsurgical operations, more comfortable conditions for the patient, providing rapid recovery, and most importantly, a sharp decrease in pain response and rapid wound healing compared to traditional methods.

The operation involves local anesthesia. In the process of laser plastic surgery of the frenulum of the tongue, the doctor directs the tip of the device onto the frenulum, which forms a focused light beam that “dissolves” the fold. The duration of the operation without anesthesia is 3-5 minutes. No seams are used. A bandage is applied to the wound (medicines that accelerate healing).

The operation performed using a laser provides comfortable and extremely safe conditions for obtaining the best treatment results for patients. This is especially important when it comes to children's health.

Recommendations after surgery:

• In the first 2 hours after frenuloplasty, you are not allowed to eat;
• In the next 3-4 days, it is recommended to exclude irritating foods (sour, spicy, salty, hard) from the diet and maintain speech rest;
• For 7 days, treat the oral cavity with antiseptic solutions after meals. Solcoseryl, sea buckthorn oil, etc. are placed in the wound area.

Why have surgery?

Some men live happily with a short frenulum all their lives because they do not experience discomfort. However, the appearance of pain, especially at an early age, is an alarming signal.

Indeed, in the future, discomfort during sex can become a trigger mechanism for the development of impotence. If the anomaly is acquired (due to balanoposthitis or other inflammatory diseases), then surgical treatment is the only way to avoid further injuries.