Penile frenulum tear
Introduction
A frenulum tear is a laceration of the mucocutaneous band on the ventral aspect of the glans penis. It commonly occurs with sexual activity (especially in uncircumcised men), masturbation, blunt trauma or, less commonly, assault. Tears are often painful and bleed readily due to the frenulum’s rich vascular and sensory supply.
Most are superficial and heal without surgery, but emergency management must prioritise haemorrhage control, effective analgesia, basic wound care and-for relevant cases-forensic and sexual‑health considerations.
Anatomy and mechanism
The frenulum is a small, highly vascular and densely innervated mucosal fold connecting the glans to the prepuce. Sudden traction (for example forced foreskin retraction) or a short frenulum (frenulum breve) increases the risk of tearing. Consider associated injuries to the prepuce, glans or urethra and be alert for signs of urethral involvement such as blood at the meatus or urinary symptoms.
Clinical presentation
Typical features include sudden sharp pain during intercourse or trauma and immediate bleeding from the ventral glans. On inspection there may be a visible laceration, often small, that usually responds to direct pressure.
Screen for ongoing bleeding, expanding haematoma, urinary symptoms (dysuria, haematuria, retention) and signs of wider genital or perineal injury. In cases related to sexual assault consider the patient’s psychological state and the need for forensic pathways.
Assessment in the emergency...
Ready to master this topic for the FRCEM?