What is the treatment for a penis frenulum tear?

Treatment for Penis Frenulum Tear

The treatment for a penis frenulum tear requires prompt surgical repair with absorbable suture to prevent complications and improve long-term outcomes. 1

Assessment and Diagnosis

When evaluating a patient with a suspected frenulum tear, look for:

• Active bleeding
• Pain during erection or intercourse
• Visible tear in the frenular tissue
• History of painful intercourse (dyspareunia)

Treatment Algorithm

For Minor Frenulum Tears:

1. Clean the area with mild antiseptic solution
2. Apply direct pressure to control bleeding
3. Surgical repair with absorbable suture if bleeding persists or if the tear is complete 1
4. Consider the "pull and burn" method for recurrent tears or short frenulum causing dyspareunia 2

For Severe Tears or Bleeding:

1. Immediate surgical exploration and repair is indicated 1
2. Repair technique:
   • Expose the injured area
   • Identify the tear
   • Debride if necessary
   • Perform primary repair with absorbable suture 1, 3

Post-Repair Management

• Personal hygiene is essential
• Sexual abstinence for 4-6 weeks to allow complete healing
• Follow-up to ensure proper healing and function

Special Considerations

Short Frenulum Treatment

For patients with recurrent tears due to short frenulum, the "pull and burn" method has shown excellent results:

• Apply topical anesthesia (EMLA cream for 15-20 minutes)
• Cut the point of maximum tension using diathermy
• Create a controlled vertical tear by applying gentle retraction
• Seal minor bleeding with diathermy
• No sutures are typically needed 2

Potential Complications

• Infection
• Scarring
• Painful erections
• Recurrent tears
• Meatal stenosis (rare)

Important Caveats

• Avoid immediate operative intervention to repair or debride injured urethral tissue if there's suspicion of urethral involvement, as this could worsen outcomes 1
• For complex injuries involving the urethra, evaluation with urethroscopy or retrograde urethrogram may be necessary 1
• Patients with frenulum tears should be monitored for complications for at least 3 months 2

The "pull and burn" method is particularly effective for patients with recurrent frenulum tears due to a short frenulum, with studies showing excellent functional and cosmetic results in 98.4% of cases 2. This technique preserves the frenular artery and respects the anatomy of the glans penis.