Tear in the frenulum: What you need to know

What is a frenulum?

The frenulum is a small band of tissue that connects the underside of the penis head (glans) to the shaft. It helps the foreskin move smoothly over the glans during sexual activity.

What are the causes and symptoms of a tear in the frenulum?

Frenulum tears, or a torn frenulum, can manifest during sexual intercourse, especially during vigorous sexual activity. Culprits might include wearing tight pants or engaging in vigorous masturbation. Those with a short frenulum often find themselves at elevated risk.

Will a frenulum tear cause a lot of pain?

Indeed, when the penis, especially the frenulum, undergoes a tear, the individual may experience varying degrees of pain. This can range from a subtle aching pain to intense pain, which can be especially distressing given the incredibly sensitive nature of the area.

Will the torn frenulum tissue heal properly?

It's essential to note that while many frenulum tears can heal, recurrent tearing in the same area might lead to the formation of white scar tissue. This scar tissue can impede healing, potentially causing long-term complications and impacting sexual activity.

How can Dr. Calleja help?

Dr. Calleja is a Sussex based urology consultant. Working with patients across Sussex and UK wide through his online consultations, Dr. Calleja can provide expert advice on frenulum tears and whether surgery may be required.

To book an online consutlation, simply use our online booking system or contact Dr. Calleja's secretary on: 01424 757 458

Immediate actions and treatments

Upon experiencing a frenulum tear, the urgency in seeking medical attention cannot be stressed enough. The affected area should be cleaned gently, and in instances of infection, applying an antibiotic cream or ointment as prescribed by a healthcare provider is paramount.

Direct pressure might be necessary to curb heavy bleeding. A clean bandage secured with medical tape can shield and protect the tear. Wear loose attire, applying antibiotic ointment, and avoiding sexual activities. However, in specific scenarios, light sexual activity could be permissible after a few hours, provided more vigorous activities, such as horse riding or contact sports, are steered clear of.

What is the surgical procedure recommended for a tight frenulum?

For those plagued by recurrent issues or the presence of white scar tissue that affects the frenulum's natural retractor function, a surgical procedure known as frenuloplasty might be prescribed. Post-procedure care is essential; it's advised to wear loose cotton garments considering the sensitive nature of the area and abstain from vigorous sexual activities for an initial period of three weeks.How is a frenuloplasty performed?

Frenuloplasty is a surgical procedure specifically designed to lengthen the frenulum and alleviate the tension that might cause it to tear during sexual or other vigorous activities.

1. ‍Preparation: The patient is prepared for surgery, which often means cleaning the area and ensuring it's infection-free. Local anaesthesia is generally used, but in some cases, general anaesthesia might be administered depending on patient or surgeon preference.‍
2. Incision: The surgeon makes a small incision or cut in the frenulum. There are different techniques used, but two of the most common are the "Z-plasty" and "V-Y advancement". Both are methods that reconfigure the frenulum to give it additional length.‍
3. Suturing: Once the necessary incisions are made and the frenulum is adjusted, the surgeon will use dissolvable stitches to close the incisions. These stitches usually dissolve within a few weeks.‍
4. Post-Operative Care: After the procedure, patients are generally advised to abstain from sexual activity and masturbation for a period (usually around 4-6 weeks) to allow the surgical site to heal properly. The area might be tender, swollen, or bruised initially, but this should subside within a few days to a week. It's essential to keep the area clean to prevent infection. Antibiotic ointment may also be necessary as directed by the healthcare provider.

It's worth noting that, as with all surgical procedures, frenuloplasty carries certain risks. These can include infection, excessive bleeding, adverse reactions to anaesthesia, and the potential for scarring. Individuals must discuss potential risks and benefits with their healthcare provider before deciding on the procedure.

Will a patient always need surgery for a frenulum tear?

Not always. Many minor tears heal with appropriate care and the usage of antibiotic ointments. However, recurring tears or complications might necessitate surgical intervention.

Preventing torn frenulum and ensuring proper healing

Post-tear, the priority is granting the penis and the frenulum sufficient time to recuperate. This often means abstaining from sexual intercourse and other rigorous activities for a few weeks. To mitigate the risk of further tears, using silicone-based lubricants and evading tight-fitting garments like tight pants can be beneficial.

Can the frenulum be completely removed?

Complete removal of the frenulum, known medically as a "frenectomy", is possible. This surgical procedure involves excising the frenulum tissue to prevent recurring issues, particularly in cases where the frenulum is excessively short (a condition known as "frenulum breve") or causes recurrent tearing and pain.

However, a frenectomy is not a one-size-fits-all solution and isn't commonly performed without a solid medical rationale. There are a few reasons for this:

1. Preservation of Sensation: The frenulum is an incredibly sensitive area of the penis, and for many, it plays a significant role in sexual pleasure. Its removal might alter the sensation experienced during sexual activities.
2. Natural Function: The frenulum serves a purpose in the natural mechanics of the penis, aiding in the movement of the foreskin over the glans penis. Removing it might change this dynamic, especially in uncircumcised individuals.
3. Potential Complications: Like all surgical procedures, a frenectomy carries risks. These can include infection, scar tissue formation, and complications with the healing process. There's also the potential for the wound to heal in a manner that creates a tight or uncomfortable sensation during erections.
4. Aesthetic Considerations: Post-surgical scar formation might alter the visual appearance of the penis, which is a concern for some individuals.

Anyone considering a frenectomy must consult with a urologist or andrologist.

Are there natural remedies for a tight frenulum that tears?

While natural remedies might offer some relief, they cannot replace medical interventions. Some might suggest stretching exercises and certain creams, but always seek a healthcare provider's advice before attempting self-treatments.