Hello doctor, I am aged 46 years. I am having a HbA1c of 7 (recently tested a few days back) and has a problem of tearing my frenulum during intercourse with my partner. I have consulted two urology doctors. The first one says I need a circumcision as there are frequent infections in glans due to sugar levels. Whereas second doctor recommends a frenuloplasty. I am confused. The first doctor says since I have frequent infections due to frequent raised sugar levels, I get smegma quite often in my glans. Please advise me if I need to go for the frenuloplasty or circumcision.
Hi. First of all, I appreciate you for providing elaborate history which will help in making diagnosis and advising treatment plan. Now, coming to your health query, I can understand your concern and will try to help you. Your diabetes is quite well controlled as per your HbA1c. However, the cause of tear in frenulum occurs due to short frenulum and not always due to infection. Though chances of infection are high in diabetes, usually it causes balanoposthitis and difficulty in retraction of foreskin, which is not the case with you. Smegma is normal secretion under the foreskin and is not a cause for concern, as long as you keep cleaning it. As far as proposed surgery is concerned, though frenuloplasty is sufficient surgery for short frenulum, circumcision can get rid of both short frenulum as well as smegmatic collection under foreskin. Hence, my advise is circumcision.