Discharge from the genital organs in men is discharge from the urethra (urethra) and the secretion of the prepuce glands, which are located on the head of the penis, under the skin of the foreskin.The ejaculatory duct, ducts of the prostate, urethral and bulbourethral glands open into the urethra.
In a healthy man, only urine and ejaculate flow through the urethra.These are physiological discharges from the penis and they should not cause any discomfort.Unfortunately, this is not always the case.
For various reasons, men's health is weakened and instead of normal discharge, abnormal discharge appears or urine and sperm change
Variants of physiological secretions
Criteria for normal discharge corresponding to the functions of the organs of the urogenital system:
- Urine is clear, straw to golden yellow in color, practically odorless, and does not contain flakes or other inclusions;
- Prostate secretion has a viscous consistency and a whitish tint, and there is a specific smell of sperm;
- Ejaculate: sperm from the ejaculatory duct mixes with secretions from the Littre (urethral), Cooper (bulbourethral) glands and prostatic secretions, acquiring a grayish-white color and mucous consistency;
- Fresh smegma from the preputial glands looks like a thick white lubricant;may become yellowish or greenish over time.
Preputial lubricant - smegma - is constantly secreted, accumulating under the inner layer of the foreskin and in the coronal groove of the penis.The lubricant consists of fats and bacterial residues, is evenly distributed and reduces friction between the skin of the foreskin and the glans.The maximum activity of the preputial glands is characteristic of the period of puberty; with age, secretion decreases and by old age it stops completely.
If you neglect the rules of personal hygiene, then smegma can accumulate under the folds of the foreskin.In this case, the fatty part of the lubricant oxidizes, and the protein part disintegrates (in fact, this is rotting), and the masses become greenish, acquiring an unpleasant odor.The same process occurs with phimosis, when, due to fusion of the foreskin, it is impossible to completely free the head of the penis from the skin folds and remove the smegma.The accumulation and breakdown of lubricant can lead to chronic balanitis and balanoposthitis (inflammation of the foreskin and glans penis), increasing the risk of tumor development.
Urethrorrhea, mucous, colorless discharge from the bulbourethral and urethral glands.These discharges appear in men during excitement associated with libido.The excretion of clear mucus is intended to lubricate the urethra and improve the passage of sperm.The amount of secretion ranges from scanty to abundant; these parameters are related to the individual characteristics of the body and the frequency of sexual activity.After prolonged abstinence, the volume of discharge increases.
A wet dream is a spontaneous release of sperm not associated with sexual intercourse.Usually observed in the morning, when testosterone levels rise.Depends on age and intensity of sexual activity: it appears in boys during puberty, in adult men - with irregular or rare sexual intercourse.
Prostatorrhea, discharge from the urethra of a small amount of transparent mucus with grayish-white inclusions.Occurs after straining the abdominal muscles (for example, with constipation) or after urinating.The secretion consists of a mixture of seminal fluid and prostate discharge; increased volume and cloudiness may be signs of prostatitis.
Pathological discharge
In men, the causes of discharge from the penis can be STDs, tumors, nonspecific inflammation of the urogenital organs, various injuries, medical procedures or operations.
Pathological discharge from the urethra differs from normal:
- By volume (too abundant or scanty, perhaps moderate);
- By color and transparency (from white to yellow-green, cloudy);
- By impurities (blood, pus, lumps of mucus);
- Consistency (very liquid or too thick and sticky);
- By smell (sourish, putrid, fishy);
- According to the frequency of appearance (depending on the time of day, constant or episodic discharge);
- In connection with urination, sexual arousal, drinking alcohol, hot and spicy foods.
The nature of the discharge depends on the causative agent of the disease, the status of the immune system, concomitant ailments, as well as the severity and duration of inflammation (acute or chronic).
If there is a change in the amount, density or color of the discharge, or if an unpleasant odor appears, it is recommended to consult a doctor and have tests done.There is no point in self-diagnosis; it is very difficult to correctly recognize the disease based on just one symptom.
Penile discharge associated with STDs
Mucous: transparent discharge, viscous and small in quantity, occurs in the chronic form of chlamydia, mycoplasma or ureaplasma urethritis.Microscopy reveals a moderate number of leukocytes in the discharge (the norm is up to 4 cells in the field of view).
Mucopurulent: white discharge, translucent;observed in the acute phase of chlamydia, ureaplasmosis and mycoplasmosis.With chlamydial infection, they accumulate on the head of the penis, as if “sticking” to the skin.
With the pathologies described above, the discharge will come from the urethra itself, since microorganisms irritate the mucous membrane of the urethra, and the body tries to “wash them away”.
It happens that a white secretion seems to cover the head.This is observed with chlamydia and candidiasis.In the first case, a film is formed, in the second - a loose, cheesy coating.
Purulent discharge with an unpleasant odor is characteristic of gonorrhea.They are sticky, thick, yellow or greenish in color, and have a putrid odor.Under microscopy, epithelial cells from the urethra and many leukocytes are visible in the material.
Symptoms accompanying gonorrheal urethritis: constant and heavy discharge;pain, itching and burning are especially severe when urinating.
With sexually transmitted diseases, combined infections are often observed, combining several pathogens at once.Gonorrhea and trichomoniasis are accompanied by chlamydia; mycoplasmosis and ureaplasmosis are usually found in pairs.The symptoms of such diseases differ from classical manifestations; urethral discharge can also take on a completely different character.Therefore, for final diagnosis, modern analytical techniques with a high degree of reliability are used, and not the characteristics of the secretions.
Nonspecific (non-venereal) inflammation
The cause of nonspecific inflammation is its own microflora, which is classified as opportunistic and is activated only in case of problems with the body’s immune defense.Streptococci and staphylococci, fungi of the genus Candida and E. coli are always present on the surface of the skin and mucous membranes, but they begin to actively multiply and displace beneficial bacteria after hypothermia, prolonged stress, uncontrolled treatment with antibiotics, after courses of radiation and chemotherapy.
Nongonorrheal (nonspecific) urethritis.Inflammatory discharge is small in volume, visible in the urine as mucopurulent strands or lumps, and appears at the very beginning of the disease.Symptoms in the form of burning and itching during urination are less pronounced than with gonorrhea, but the urge is frequent and does not bring relief.With ascending infection, the bladder becomes inflamed first, followed by the ureters and kidneys;discharge mixed with scarlet blood appears.
Candidiasis (thrush), fungal infection of the urethra.Usually develops against the background of suppression of the immune system after a course of antibiotics, chemotherapy or radiotherapy;sexual transmission of candidiasis in men is rare.Thrush is characterized by a curd-like discharge with a sour odor, which is combined with itching and burning during miction (urination) and ejaculation (ejaculation), and may be accompanied by dull pain in the groin, above the pubis and in the lower back.
Gardnerellosis of the urethra.The discharge has a fishy odor;they are scanty, yellowish-white or greenish.According to some classifications, gardnerella is classified as an STD, but in men, infection with gardnerella through sexual contact is more of a curiosity.In fact, this disease is associated with a disruption of the normal microflora, that is, with dysbacteriosis.When treating it, immunocorrectors and probiotics (lactic acid bacteria) are necessarily used.
Balanoposthitis, inflammation of the foreskin.Locally, abundant purulent discharge is observed, and there may be an admixture of mucus.They are always accompanied by swelling and hyperemia (redness) of the leaves of the prepuce, soreness of the head of the penis.
With prostatitis, cloudy discharge appears at the end of urination, copious discharge - during the acute period of inflammation;scanty and white - when the disease becomes chronic.Prostatitis is usually complicated by difficulty urinating and weakness of erection, in severe cases even to anuria (complete absence of urine output) and impotence.
Discharge not associated with inflammation
Spermatorrhea is a discharge in the form of passively flowing sperm that occurs outside of sexual intercourse or masturbation, without the feeling of orgasm.The reasons are some diseases of the nervous system, spinal injuries, chronic stress and any long-term inflammation of the genital area.Spermatorea is associated with impaired innervation and decreased tone of the vas deferens.
Hematorrhea, bloody discharge.Often appears with injuries to the urethral canal received during bougienage, after inserting a catheter, or when taking a smear from the mucous membrane.In these cases, the blood is fresh, without clots, the amount is small, and the bleeding stops quickly.When small kidney stones or sand pass, blood is released during or immediately after urination, hematorrhea is accompanied by very severe pain (renal colic).Blood discharge in the hematuric form of glomerulonephritis (inflammation of the renal glomeruli) is combined with edema and persistently elevated blood pressure, and the appearance of protein in the urine.
Brown discharge, with clots of blood or mucus, mixed with pus, appears with malignant tumors emanating from the prostate, urethra or bladder.Brownish mucus can form during the healing of wounds on the mucous membranes, and is released during polyposis of the urethra and/or bladder.
Prostatorrhea is the secretion of the prostate gland flowing from the urethra.Occurs in chronic prostatitis, prostate adenoma, impaired innervation (neurogenic bladder).
Examination algorithm for the presence of pathological discharge from the penis
- Inspection of the perineum, penis, foreskin and glans.The goal is to identify deformations of the genital organs, traces of injury, signs of external inflammation, discharge, rash, etc. Traces of discharge are sometimes noticeable on underwear.
- Palpation of the inguinal lymph nodes, assessment of their condition: size, whether they are hotter or colder than the surrounding tissues, painful or not, soft or hard, mobile or adherent to the skin, whether there are ulcerations over them.
- Digital examination of the prostate;massage the prostate through the rectum and obtain secretions for microscopic examination.Before the massage, it is advisable to refrain from urinating for 1-2 hours.With prostate adenoma, its lobes are enlarged approximately equally, dense cords are palpable.Uneven growths and their consistency are typical for a malignant tumor; during palpation of the prostate, blood with clots may be released from the urethra.
- Material: smears for microscopy and culture.When examined under a microscope, the stained smear reveals blood cells, epithelium, sperm, fatty inclusions, and some pathogens (Escherichia coli, gonococci, gardnerella, yeast).An increased number of leukocytes is characteristic of acute urethritis or exacerbation of chronic inflammation, eosinophils - of urethritis due to allergies.Red blood cells are detected in severe inflammation, tumors, injuries of the genitourinary organs, and urolithiasis.A large amount of epithelium is a sign of chronic urethritis, urethral leukoplakia.With spermatorrhea, sperm are found in the smear, with urethrorrhea - mucus, prostatorrhea - lipid grains.For information content and reliability of the results, a smear is taken no earlier than 3 days after the local use of antibiotics, antifungals and disinfectants.If treatment with antibiotics was systemic, then at least 3 weeks should pass after the course.Before taking a smear, do not wash; try not to urinate for 2-3 hours.
- General clinical blood test, blood sugar test - in the morning, on an empty stomach.Detailed urine analysis (morning portion, immediately after sleep).
- Ultrasound of the prostate, bladder and kidneys;CT and urography.
If the manifestations of genital inflammation are severe, then before receiving test results, the patient is immediately prescribed broad-spectrum antibiotics.In case of heavy bleeding, hospitalization and active measures to stop the bleeding are indicated.The suspicion of a malignant tumor can only be confirmed by the result of a biopsy; the final diagnosis is made on the basis of histological examination.
Important:
- Discharge from the penis is just one symptom that cannot be used as a guide when making a diagnosis.
- Independent prescription of pharmaceuticals is unacceptable.drugs, even if the manifestations seem obvious for a particular disease.