Minor Tears at the Penile Frenulum Can Cause Pain and Bleeding During Sex.

What should you do if your penis frenulum is torn?

The penile frenulum, often referred to as the "banjo string," plays a crucial role in male anatomy by connecting the foreskin to the head of the penis. When this small piece of skin is too short, it can lead to a condition known as frenulum breve, causing discomfort during erection and sexual activities.

Adults feel pain during sex due to several reasons.  Some men have recurrent pain during sex. This may be due to a short or tight frenulum or a tear to the frenulum.   However, pain can occur due to other reasons as well. 

What is Frenulum Breve?

 Frenulum breve occurs when the penile frenulum is too tight. This small band of skin can cause pain, tears, bleeding, and scarring during sexual activities, making it a concern for many adolescents and men. In some cases, frenulum breve is associated with a skin condition called Balanitis Xerotica Obliterans (BXO), which can result in more severe scarring.

 Understanding the Stages of the penile frenulum

1. Tight/Short Frenulum without Tear or Scar:

   - Mild cases with no visible issues.

   - Lubricants during sex can help prevent problems.

2. Torn Frenulum with Healing:

   - Tear and healing occur, but no lasting scar.

   - Considerable discomfort during this stage.

3. Visible Frenulum Scarring with or without BXO:

   - Scar tissue becomes visible.

   - Associated with a skin condition (BXO) in some cases.

4. Complete Scarring of BXO Beyond the Frenulum:

   - Severe scarring extends beyond the frenulum.

   - Can result in significant complications.

Treatment Options

1. Observation:

   - For mild cases, no specific treatment.

   - Using a lubricant during sex can help avoid problems.

2. Steroids Cream:

   - In the early stages of scarring, applying a steroid cream can be effective.

3. Penile Frenuloplasty or frenulectomy:

   - A procedure to release the tight frenulum.

   - Dissolvable stitches used for healing.

   - Loose bandage applied for a day or two.

4. Circumcision:

   - Removal of the foreskin, suitable for more severe cases.

Frenuloplasty or frenulectomy of the penis or release or division of frenulum breve can be cured the pain during sex. Frenulectomy, is simply a foreskin-releasing procedure. An incision is made on the frenulum or excised the ridge underneath the surface, thus allowing full retraction. This will allow you to retain your foreskin but at the same time be able to keep the area underneath clean. 

Frenulectomy and circumcision can be done at the same time. Sometimes, adults preferred frenulum removal during the circumcision. 

Frenulectomy is the first-line treatment in these cases in which pain or tear to the frenulum is the main complaint. 

The benefit is that he retains his foreskin. Frenuloplasty helps to get rid of most of the bending of the penis.

What Happens During Frenuloplasty or Frenulectomy

- Done under local or general anaesthesia.

- The frenulum is cut and stitched in a way that lengthens it.

- Wound is sealed with glue

- Dissolvable stitches are used, and a bandage is applied temporarily.

Risks and After-Effects:

- Expect swelling and bruising, which can last a few weeks.

- Minimal bleeding, usually manageable with pressure.

- Infection is a rare complication treated with antibiotics.

- Changes in sensation over the penis head may occur.

- Some tenderness at the scar site.

- 5-10% chance of foreskin tightness recurrence.

Taking Care After the Procedure:

- Swelling and bruising may persist for a few days.

- Stitches dissolve in 3-4 weeks.

- Painkillers can help with discomfort.

- Keep the area dry. Avoid baths for 10 days.

- No swimming or intense exercise for two weeks.

- Maintain wound hygiene after urination.

- Apply Vaseline to the penis tip.

- Wear tight underwear for a couple of days.

- Start withdrawing the foreskin daily after 4 days.

- Sexual abstinence for 4-6 weeks.

Dr. Khan and Our Consultant Urologists, who are fully trained and most experienced in frenuloplasty or frenulectomy (removal of frenulum), will give you professional advice on whether this frenulum removal suits you.