Frenulum Tear During Coitus

What Is Frenulum?

A frenulum is a skin tag that is beneath the penis between the foreskin and the penile shaft. The main function of the frenulum is to act as a natural retractor of the foreskin over the glans. The penis is a crucial organ of the male reproductive system that reaches its maximum size during puberty. In addition, it allows the urine to leave the body. It consists of several parts, including the head known as the glans, the skin covering the glans, known as the foreskin, and a tip. The frenulum, also known as a banjo string, might tear during sexual intercourse. Sometimes, the frenulum becomes tight, and the tear might not heal properly. The problem arises when the penis gets torn again at the same place during sexual intercourse.

Why Does the Frenulum Tear?

The penis is a delicate organ and might get easily damaged. However, the frenulum is more vulnerable to damage and tear because it is a tiny narrow piece of tissue that connects the penile shaft to the head. The frenulum tear might occur due to the following causes:

• Vigorous Sexual Activity and Masturbation - Normally, when the penis is erect, the blood flows into the penile arteries making it less flexible. However, vigorous sexual activity can create friction and produce heat on the penile skin making it more susceptible to wear and tear. The same goes for vigorous masturbation because when the patient rubs the same area repeatedly, the risk of itching, irritation, and frenulum tear increases.

• Cycling - Males who do cycling for prolonged periods are more likely to have frenulum tears because the saddle shape of the bicycle affects the penile blood flow. Horse riding and cycling uphill can damage the penile arteries and cause frenulum tear.

• Sports - People involved in sports like rugby might increase the risk of bodily injury. The risk of frenulum tear increases when people get involved in activities like sprinting and jumping. Such people must wear a cup around their genitals for support and protection. Purchasing a compression shorts with protective bio-flex cup can be beneficial.

• Labor - Physical activities or doing hard labor near the construction site can cause accidents, falls, and damage to the groin.

• Wearing Tight Undergarments - Tight pants and underwear can put pressure and friction on the groin, so the person must always wear loose cotton undergarments.

• Using a Razor - Using a razor to trim the penile hair can damage the penile skin, and the frenulum might become torn.

What Should a Patient Do if It Starts Bleeding After the Frenulum Tear?

Numerous blood vessels are present beneath the penile skin, and as the area is sensitive, it is more likely to cause pain. Light bleeding might occur after the frenulum tear but can be controlled by the following measures:

• Wash your hands with soap and water before touching the bleeding site.

• Place a clean cloth over the area to stop bleeding.

• Use clean water and a chemical-free soap to rinse the skin around the torn frenulum, but do not let the soap enter the torn skin.

• Pat the area dry with the help of a towel or a cloth, but make sure that the towel is clean.

• Apply a medicated ointment to the torn frenulum.

• Cover the torn frenulum with a bandage and secure it with gauze and medical tape.

• Make sure to replace the dressing once or twice during the day.

• If the bandage soaks the blood within an hour, the patient must seek emergency medical care and attention.

• The patient might not see heavy bleeding, but getting the correct medical care is important.

Will a Frenulum Tear Cause a Lot of Pain?

The penis consists of nerve fibers and receptors, so it is an incredibly sensitive area. Therefore, a patient might experience a lot of pain after a frenulum tear. The intensity of the pain depends upon the length and severity of the frenulum tear. It is difficult to describe the pain in words. Sometimes, the patient experiences a sharp and throbbing pain near the penis head. However, the pain might fade within a few hours after treating the wound. Wound healing is a slow process, so a dull achy pain might persist for a few weeks. The patient must consult the doctor if the symptoms last longer than a week.

Will the Torn Tissues Heal by Themselves?

Frenulum tear is not a life-threatening condition, and it normally heals by itself. However, the healing is faster if the patient takes the following measure:

1. Treat the wound immediately and do not wait for it to progress further.

2. Always keep the wound covered with a fresh bandage to prevent contamination, which will delay the healing process.

3. Make sure to rinse and pat the area regularly while bathing.

4. Do not get engaged in vigorous sexual activities that increase the risk of frenulum tear.

5. After the wound healing is complete and the patient is ready for sexual activity, he can use a natural water-based lubricant to ensure the frenulum does not tear again.

6. Wear loose, comfortable cotton undergarments until the wound healing is complete.

When Should the Patient Consult the Doctor?

Immediate medical care and attention are required if the frenulum has torn to a large length and is severe. The doctor will debride and bandage the area and provide tips on wound management. However, the patient should immediately approach the emergency room if the bleeding is severe and does not stop even after a few hours. Sometimes, the doctor might suture or stitch the wound. The doctor might prescribe an antibiotic if the torn skin does not heal and there are symptoms of infection. The patient must consult the doctor under the following circumstances:

1. A frenulum tear that does not heal even with light sexual activity and exercise and keeps on opening each time.

2. Swelling and redness around the tear if the infections start spreading.

3. Pain, tenderness, and warmth around the torn frenulum skin.

4. Pus or discharge coming out from the torn frenulum skin.

5. Loss of sensation in the penile area.

6. Low-grade fever.

7. Burning sensation while urinating.

8. A strong urge to pass urine.

9. Urinary frequency.

10. Hematuria (blood in the urine).

11. The urine appears cloudy.

12. Abdominal cramps.

Will a Patient Need Surgery for a Frenulum Tear?

Surgical intervention is only required when the tear does not heal over time or the skin tears frequently. The surgical procedure done to repair or lengthen the frenulum is known as frenuloplasty. It is an outpatient procedure done under local or general anesthesia. The steps of the procedure are listed below:

• First, the doctor will administer anesthesia to make the patient unconscious during the surgery.

• Next, he makes a small incision near the penis head.

• The doctor will stretch the frenulum tissue in a diamond shape and lose the area to make it less vulnerable to tearing.

• Finally, the doctor will stitch or suture the tissues to become wide and flexible to facilitate healing.

How Should the Patient Take Care of Himself After the Surgery?

The patient must take care of himself in the following ways after the surgery:

• The patient must take over-the-counter drugs if he feels uncomfortable after the surgery.

• Pat, the area, dry every time after passing urine to prevent urine accumulation near the wound.

• Remove the bandage from time to time, especially after urinating.

• Apply a silicone-based lubricant over the penile skin so that it does not stick to the clothes.

• Uncircumcised males must retract their foreskin daily to allow the area to heal properly.

• Avoid immersing the area in water for two days after the surgery.

• The wound will heal fully after two months, so the patient must refrain from masturbation or other sexual activities.

How to Prevent Frenulum Tears?

The frenulum is a part of the penis and is susceptible to tear because it is a delicate and sensitive area. White scar tissue forms after the frenulum tear, making the area less flexible. The patient must take the following precautions to prevent frenulum tear:

1. Keep the area clean and bandaged, and give some time for the tissues to heal themselves.

2. Avoid engaging in masturbation and sexual intercourse for a few weeks, depending on the severity of the condition. The patient must use a lubricant before getting involved in sexual activities.

3. Do not use barrier methods like condoms until the tissues have healed completely because they increase friction and cause further damage.

4. Do not get engaged in sports and strenuous activities for a few weeks after the frenulum tear.

Conclusion:

Frenulum tear is commonly seen in sexually active males having multiple sex partners and having rough sex. When a person engages in sexual activities without using a lubricant, the risk of frenulum tear increases. Though it is not life-threatening, the patient must take care of his genitals after the injury. There are several causes of frenulum tear, the most common being masturbation and vigorous sex. However, the patient need not worry as a torn frenulum can be surgically repaired and does not pose major harm. Sometimes, the patient might even need surgery; instead, he has to take some necessary precautions and over-the-counter drugs to enhance the healing of the affected site. Consult the doctor to know more about the treatment of frenulum tear.