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Suggest Treatment For Torn Frenulum With Bleeding

Posted on Wed, 28 Jan 2015

Question: "I tore my frenulum during intercourse last night. It has been bleeding quite badly for nearly 24 hours. Also, the blood is a strange thick, almost rubbery texture. How can i slow/stop the bleeding? should I go to the hospital?"

Answered by Dr. Muhammed Aslam (1 hour later)

Brief Answer:
apply ice pack and reach ER soon.

Detailed Answer:
Hello dear, welcome to HCM forum.
Thanks for posting to us.

Sorry to hear such a story.
The thick and rubbery nature of blood(suggests clotts) indicates significant bleeding and a blood vessel injury is likely.
This needs a physical examination to assess the depth and extend of injury. If the wound is superficial and no active bleeding, we can manage this with antibiotics and analgesics along with local wound care for a few days; otherwise this may need wound closure under local anaesthesia.

So kindly reach emergency room without delay.
Cold compression with ice packs will help in arresting bleeding.
We have to keep the area clean and avoid intercourse till full recovery.

Hope this answer will help.
Be free to ask if you need further clarification.
Wishing for a faster cure.
Thank you.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Muhammed Aslam (1 hour later)

I am currently living in South Korea. I just went into emerge, and they told me it would cost 1500 dollars to stay the night, which i can not afford. So i will have to treat the injury at home tonight.

Are there any particular symptoms that should alter me of danger?

Answered by Dr. Muhammed Aslam (24 minutes later)

Brief Answer:
Watch for bleeding or excessive swelling.

Detailed Answer:
Hi dear,

If there is no active bleeding, you need not worry much.
Just keep the area clean and dry as possible. Apply antibiotic creams like povidone iodine or mupirocin. Take analgesics like acetaminophen or ibuprofen 8th hourly after food. Watch for fresh bleeding or excessive swelling of the surrounding area(hematoma) and report accordingly.

Kindly note that you may need prophylactic antibiotics to prevent infection and promote smooth healing.

Hope now I have answered your query.

If you have no further questions, you can close the discussion and rate the answer.

Wishing for everything to be fine.

Thank you.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Muhammed Aslam (50 minutes later)

the bleeding has slowed. i am using ice and apply light pressure. but the bleeding has not stooped entirely. it appears as though i have ruptured a blood vessel.

aside from the continuing bleeding, are there any other symptoms that indicate danger?

i will keep watch fro swelling.

thanks for your assistance!

Answered by Dr. Muhammed Aslam (1 hour later)

Brief Answer:
if bleeding is decreasing, need not worry

Detailed Answer:
Hi dear,
If bleeding is on the way down, and not severe, just continue same measures.
Apart from bleeding and swelling, no no other warning signs.
Features of hypotension like dizziness and tachycardia are unlikely to occur unless a significant amount of blood has been lost.This need not be expected in my opinion.

Take care.
Thank you.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Muhammed Aslam (5 hours later)

Thank you so much for all of your assistance in this matter. The bleeding has finally stopped. it took almost two days, the the bleeding is stopped. i am wondering what to do now. should i go into the hospital and have it examined, which could induce more bleeding, or should i wait for the vein/blood vessel to heal for 48 hours and then go into the hospital?

If i wait for 48 hours, should i attempt to clean the area and risk activating the bleeding again?

Sorry, as for my last message, it has actually been just over 24 hours since the injury was sustained, not two days.

Answered by Dr. Muhammed Aslam (4 hours later)

Brief Answer:
kindly reach hospital for antibiotic treatment.

Detailed Answer:
Hi dear,
Sorry for delay in response.

Kindly reach hospital without delay as we need to start antibiotics for preventing secondary infection.As the bleeding has stopped, your doctor is unlikely to explore the wound and definitely he will take care of bleeding.

Also, note that cleaning the wound at least twice a day is also very important to prevent secondary infection. Handle with gently during cleaning to avoid bleeding.
Secondary infection can cause delayed and incomplete healing along with with an ugly scar.

Hope you got cleared.
Take care.
Thank you.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Muhammed Aslam (2 days later)

It has been two days since my frenulum tear stopped bleeding and it seems to be healing quickly. I am taking antibiotics and there are no signs of infection. However, it does feel like their is slight pressure on my bladder. I have a steady, though very mild urge to urinate, even shortly after urination. Can you explain this?

Answered by Dr. Muhammed Aslam (2 hours later)

Brief Answer:
UTI to be ruled out.

Detailed Answer:
Hi dear,
Thanks for follow up.

Such a symptom is usually caused by urinary tract infection.
Let me know which antibiotic you are taking, and whether this is associated with other features like increased frequency of urination/burning sensation on urination/nausea.

Meanwhile, drink plenty of oral fluids thank you.

Kindly follow up.
Thank you.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Muhammed Aslam (21 hours later)

I was prescribed Bactroban ointment (10 g tube), Gasmotin (5mg) and XXXXXXX (100mg).

The symptom is still quite mild. A slight urge to urinate frequently. My urine is not cloudy, nor does it have a foul odor. There are no visible signs of infection (no discoloration or swelling, no puss, or any other indicators).

I am hoping that the antibiotics i am taking now will do the job. However, I only have antibiotics for this evening and tomorrow morning.

Answered by Dr. Muhammed Aslam (4 hours later)

Brief Answer:
watch with same antibiotics.

Detailed Answer:
Hi dear,

Though not a first choice, banan(cefpodoxime) can be helpful to treat UTI.
So you may just continue the same antibiotics(continue for 3 more days). If the symptoms persist beyond two days, we will need urine examination and review of antibiotic, for which your doctor will guide you.
Meanwhile drink plenty of oral fluids.

Hope you got cleared.
Kinldly follow up if you need more help.

Thank you.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Muhammed Aslam (10 hours later)

As for an antibiotic to treat UTI, what is your number one choice?

Answered by Dr. Muhammed Aslam (4 hours later)

Brief Answer:
quinolones are better

Detailed Answer:
Hi dear,
Thanks for follow up.

UTI is most commonly caused by gram negative bacteria. So we prefer antibiotics like quinilones (norfloxacin/levofloxacin) or newer cephalosporines like cefixime.
Usually I start with norfloxacin.

But kindly remember to discuss with your doctor before starting, as these are prescription medicines.

Hope you got cleared.
If you have no further questions, you can close the discussion and rate the answer.
Take care.
Thank you.

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Above answer was peer-reviewed by : Dr. Shanthi.E