A frenulum is a small fold of connective tissue that helps to secure the motion of a bodily organ, such as the fold of skin under the tongue, under the upper lip or connecting the foreskin of the penis. The frenulum of the foreskin is also known as the banjo string, and tearing of this tissue can result in painful symptoms.

In this article discusses the causes, symptoms and management techniques that are involved with a torn frenulum.

Causes

A torn frenulum may result from any activity or procedure that involves the banjo string. It is common for damage to occur during sexual activities – with a partner or during masturbation – although some cases may present following a surgical procedure in the genital region.

According to one study, more than half of all cases involving a torn frenulum arise due to coital circumstances. In particular, having rough sex is the most common reason for the banjo string in the penis to become torn. Secondary mechanisms of injury include self-inflicted, iatrogenic and accidental injuries.

Symptoms

The primary symptom of a torn frenulum is pain, which is most severe when partaking in activities that put pressure on the area, such as sexual intercourse. There may be bleeding from the area immediately after the incident, resulting from the tear in the skin.

It is worth noting that the symptoms of a torn frenulum are not permanent and affected individuals do not usually notice lasting effects. With time, the frenulum will repair itself without treatment, although the replacement scar tissue may be less flexible than previously.

Most men that present with the condition are able to pinpoint the time when the injury occurred, which can help greatly in the diagnosis of the condition. For this reason, it is important that the patient consultation includes questions about activities in the lead up to symptom presentation, in addition to a physical examination to confirm the diagnosis.

Healing and Management

There is no treatment specifically indicated for a torn frenulum, as the tissue will usually heal itself spontaneously over time.

It is recommended for affected individuals to avoid sexual intercourse for a period of time following the incident to allow the tissue to heal. The length of this period will vary according to the severity of the tear and can last from a week to several months. In general, patients can be advised to continue partaking in sexual activities when they feel the healing is sufficient, although they should be aware that a subsequent tear while the tissue is still weak is more likely.

Recurrent Tearing

Some men find that the tear will not heal itself again naturally and it frequently becomes torn again in the same place. In this circumstance, a surgical procedure called a frenuloplasty may be indicated, which helps to increase the length of the frenulum and reduce the risk of tearing.

Men who have undergone this procedure should refrain from sexual activities for six weeks to allow the area to heal.

References

• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2066066/
• http://journals.rcni.com/doi/pdfplus/10.7748/ns2012.05.26.37.35.c9109
• http://www.nhs.uk/chq/Pages/876.aspx?CategoryID=61
• http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.1981.tb03126.x/pdf

Further Reading

• All Frenulum Content

Written by

Yolanda Smith

Yolanda graduated with a Bachelor of Pharmacy at the University of South Australia and has experience working in both Australia and Italy. She is passionate about how medicine, diet and lifestyle affect our health and enjoys helping people understand this. In her spare time she loves to explore the world and learn about new cultures and languages.