The Frenum Praeputii and
the Defloration of the Human Male
Folia Psychiatrica, Neurologica et Neurochirurgica
Neerlandica 61(2) 1958 p123-126
It is a remarkable fact that the description of the surface anatomy
of human individuals is not complete. An example is the frenum of the
prepuce, the median fold of skin that passes from the urethral surface
of the glans penis, behind the orificium urethrae externum to the deep
surface of the prepuce. Exact inspection shows that at each side of
the frenum a small fold can be seen between the radix of the prepuce
and the proximal side of the corona glandis; in other words the prepuce
is inserted on the under side of the corona, at both sides of the frenum.
These folds are nameless; they may be called alae freni praeputii or
plicae praeputii. At both sides of the frenum a niche is formed under
these folds which may be named recessus freni praeputii. In this region
the sebaceous glands of the prepuce are most clearly discernable
As a rule the alae freni praeputii are more developed or better
discernable in younger than in older men.
My attention was drawn to this anatomical configuration because
in the course of the years I have been consulted by men who mostly
after their first coition, showed an excoriation, a slight rhagade
or even a slight laceration of the frenum behind the margin of the
corona, or of the alae freni. Sometimes it was not during the first
coition that this phenomenon occurred but during a later one, that
was experienced as much more complete or more satisfactory than the
foregoing. In a single case the rhagade had developed during masturbation.
These excoriations may occur more than once.
The phenomenon is not fully unknown, and general practitioners as
well as dermatologists may be consulted for these rhagades, especially
when a secondary inflammation complicates the picture ... The excoriation
is seen in cases of forced coition in older men with a rigid frenum;
a young man with phimosis developed a slight laceration in a forced
trial to cohabitate. The occurrence of the phenomenon is mentioned
in older textbooks of surgery and in textbooks of dermatology; in the
most severe cases it may cause a serious bleeding and in rare cases
a suture may be necessary. This must be a very rare occurrence indeed
as the phenomenon is not mentioned in modern handbooks of urology and
not even in a monograph on diseases of the penis 1).
Several questions arise. Probably the phenomenon is not so rare
as one would presume, taking in account that practitioners seldom see
it. It may be rather frequent or even ubiquitous. Does it occur in
circumcised men? I have found no answer to the question. Does it occur
in people who have never masturbated, the frenum being more rigid or
less resilient than in men who practised masturbation? When it occurs
in masturbation the excoriation seems to be localised especially in
the alae freni.
Is the fact that the alae are more manifest in younger men than
in older due to the constant stretching or elongation of these formations
in the course of adult life? Elasticity of the frenum seems to prevent
That anatomical conditions play a part in the causation of traumata
durante coitu is shown by the occurrence of lacerations of the underside
of the orificum urethrae externum in cases where the frenulum reaches
that point. ...
In view of the fact of the disruption of the anatomical continuity
of the frenum during (the first) coition in some (or most?) human males,
it is necessary to compare the embrology of the frenum with that of
the female hymen. Embryologically the hymen develops from a fold at
the point where the vaginal portion of the fused Müllerian tubes
opens into the vestibulum vaginae. The frenum on the contrary is of
ectodermal origin, the penis being derived from the genital eminence,
as the clitoris is.
Therefore a similarity between the defloration of the female and
erosion or laceration of the frenum of the prepuce does not depend
on embryological identity.
It is as remarkable that a part of the surface anatomy of the man
received no name, as that the phenomenon of the erosion or laceration
of the frenum and its alae, though not unknown, receives so little
attention, and is even manifestly neglected in medical literature.
One is tempted to assume that psychological factors must play a part
in both facts: not primarily prudery, but the castration complex of
Prudery and anxiety on the part of the "patient" is an other, and
probably an even stronger factor. A lesion of the penis during coition
causes feelings of shame and self-reproach because of the supposed
uncouth and aggressive behavior, resulting (in the opinion of the man)
in an unheard of trauma; guilt feelings produce a resuscitation, the
"wound" itself a revival of the castration complex.
Men are manifestly proud of the penis (a fact insufficiently mentioned
in the literature), not only during their development but during an
important part of their adult life, men being as proud of this organ
as women are of well formed breasts. When this important organ, this
source of masculine pride, is menaced, fear and anxiety arise. The
"patients" are afraid to consult a doctor and await with tense fear
the further development of the trauma. The speedy recovery allays their
fears and may contribute to faith in the invulnerability and recuperative
powers of this organ. But before this reassurance is reached their
fear restrains them from consulting a physician and they are confronted
with the patent possibility of castration.
As has already been mentioned, there must be a psychological reason
for the fact that older men especially consult the physician concerning
this lesion. The rigid frenum is not a remarkable coincidence, but
merely the result of their neurosis, on account of which they have
postponed the first coitus, and probably had little or no experience
of masturbation. They are therefore seen by the psychiatrist as well.
However, the fact that an apparently buoyant young man confided the
secret of this trauma to me in his anxiety, demonstrates that he knew
unconsciously that more than his penis was injured and that his castration
complex was also. It is significant that he did not consult the family
doctor but the psychiatrist.
In view of the great importance attached by the human male to his
penis, it is surprising that so few young and older men consult the
physician over these rhagades (an inquiry confirmed this opinion).
It is probable that the normal man waits to see how the "disorder"
develops; this does not mean that he does not ascribe any importance
to it. It cannot therefore be the exaggerated importance some neurotics
attach to the penis, which causes them to consult a physician after
this excoriation. Only those who are haunted by a hypochondriacal fear
or by panic are unable to adopt the philosophical attitude of the normal
man. The shame and guilt feelings may be stronger than normal, and
sudden revival of castration fear drives them to the physician.
The psychiatric aspect of this little known symptom, repressed as
it has been by the medical profession itself, has never been mentioned.
That excoriation of the frenum praeputii has also been neglected by
psychiatrists and psychoanalysts is even more remarkable. The parallelism
with the defloration of the female is too obvious to be ignored.
The psychodynamics of this repression on the part of the physicians
is a striking phenomenon in itself. It cannot be masculine pride alone
for this invulnerable organ and rejection of any comparison with feminine
defloration which has caused the phenomenon to be neglected by male
physicians and psychoanalysts, and caused it to be forgotten in dermatological
literature. Probably rhagades of this anatomical region have caused
a resuscitation, a revival of the castration complex in the life history
of many physicians, resulting in a general or collective repression
of the phenomenon.
The psychotherapist will do well to remember a symptom which may
engender a real reactivation and actualization of castration fear.