In men, the discharge from the genital organs is the secretion from the urethra (urethra) and the glands of the prepuce, which are located on the head of the penis, under the skin of the foreskin.The ejaculatory duct, prostatic ducts, urethra, and bulbourethral glands open into the urethra.
In a healthy person, only urine and ejaculate flow through the urethra.These are physiological secretions from the penis and should not cause discomfort.Unfortunately, this is not always the case.
For various reasons, men's health deteriorates and abnormal secretions appear instead of normal secretions, or changes in urine and sperm
Variations of physiological secretions
Criteria for normal discharge according to the functions of the organs of the urogenital system:
- The urine is clear, straw-golden in color, practically odorless, does not contain flakes or other inclusions;
- The secretion of the prostate has a viscous consistency and a whitish tint, and has the peculiar smell of spermatozoa;
- Ejaculate: the sperms from the ejaculatory duct are mixed with the secretions of the Littre (urethral), Cooper (bulbourethral) glands and the secretion of the prostate, obtaining a grayish-white color and a slimy texture;
- Fresh smegma from the precutaneous glands appears as a thick white lubricant;it may turn yellowish or greenish over time.
The preputial lubricant - smegma - is continuously secreted and accumulates under the inner layer of the foreskin and in the coronal groove of the penis.The lubricant consists of fats and bacterial residues, distributes evenly and reduces friction between the skin of the foreskin and the glans.The maximum activity of the precutaneous glands is typical for the period of puberty;with advancing age, the secretion decreases, and in old age it stops completely.
If you ignore the rules of personal hygiene, smegma can accumulate under the folds of the foreskin.In this case, the fatty part of the lubricant oxidizes, and the protein disintegrates (in fact, this is putrefaction), and the masses are greenish, with an unpleasant odor.The same process occurs in phimosis, when due to the fusion of the foreskin, it is impossible to completely free the head of the penis from the skin folds and remove the smegma.Accumulation and breakdown of lubricant can lead to chronic balanitis and balanoposthitis (inflammation of the foreskin and glans penis), increasing the risk of developing tumors.
Urethrorhoea, a slimy, colorless discharge from the bulbourethral and urethral glands.These secretions appear during libido-related excitement in men.The purpose of secreting clear mucus is to lubricate the urethra and improve the passage of sperm.The amount of discharge ranges from scanty to copious;these parameters are related to the individual characteristics of the body and the frequency of sexual activity.After prolonged abstinence, the amount of mucus increases.
A wet dream is a spontaneous release of sperm that is not related to sexual intercourse.It is usually observed in the morning when testosterone levels rise.It depends on age and the intensity of sexual activity: it appears in boys during puberty, in adult men - in case of irregular or infrequent sexual contact.
Prostatorrhea, a small amount of transparent mucus from the urethra, with grayish-white inclusions.It occurs after straining the abdominal muscles (e.g. during constipation) or after urination.The discharge consists of a mixture of seminal fluid and prostatic secretion;increased volume and cloudiness may be a sign of prostatitis.
Pathological discharge
In men, discharge from the penis can be caused by STDs, tumors, non-specific inflammation of the urogenital organs, various injuries, medical procedures or surgeries.
Abnormal discharge from the urethra differs from normal:
- By volume (too much or too little, maybe moderate);
- By color and transparency (from white to yellowish-green, cloudy);
- By impurities (blood, pus, mucous glands);
- Consistency (very runny or too thick and sticky);
- By smell (sour, putrid, fishy);
- According to the frequency of appearance (constant or episodic discharge depending on the time of day);
- Related to urination, sexual excitement, alcohol consumption, hot and spicy foods.
The nature of the discharge depends on the causative agent of the disease, the state of the immune system, accompanying diseases, and the severity and duration of the inflammation (acute or chronic).
If the amount, density, color of the discharge changes, or if an unpleasant odor appears, you should consult a doctor and have tests performed.There is no point in self-diagnosis;it is very difficult to correctly recognize the disease based on only one symptom.
Penile discharge associated with STDs
Mucous membrane: transparent discharge, viscous and in small quantities, occurs in the form of chronic chlamydia, mycoplasma or ureaplasma urethritis.Microscopic examination reveals a moderate number of leukocytes in the sputum (the norm is no more than 4 cells in the visual field).
Mucous purulent: white discharge, translucent;it is observed in the acute phase of chlamydia, ureaplasmosis and mycoplasmosis.During chlamydia infection, they accumulate on the head of the penis, as if "sticking" to the skin.
In the case of the pathologies described above, the discharge comes from the urethra itself, as microorganisms irritate the mucous membrane of the urethra, and the body tries to "wash them away".
It happens that white discharge covers the head.This is observed in 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 smell.Under a microscope, epithelial cells of the urethra and numerous leukocytes can be seen in the material.
Symptoms accompanying gonorrhoeal urethritis: constant and strong discharge;the pain, itching and burning sensation are especially strong during urination.
In the case of sexually transmitted diseases, combined infections are often observed, which combine several pathogens at the same time.Gonorrhea and trichomoniasis are accompanied by chlamydia;mycoplasmosis and ureaplasmosis usually occur in pairs.The symptoms of such diseases differ from the classical manifestations;the discharge of the urethra can also take on a completely different character.Therefore, modern high-reliability analytical techniques are used for the final diagnosis, rather than the characteristics of the secretion.
Non-specific (non-sexual) inflammation
The cause of non-specific inflammation is one's own microflora, which is considered an opportunist and is only activated when there are problems with the body's immune defenses.Streptococcus and staphylococcus, fungi belonging to the Candida and E. coli genera are always present on the surface of the skin and mucous membranes, but they begin to multiply actively and displace useful bacteria after hypothermia, prolonged stress, uncontrolled antibiotic treatment, radiation and chemotherapy.
Nongonorrheal (non-specific) urethritis.Inflammatory exudate can be seen in the urine in the form of small-volume muco-purulent threads or nodules and appears at the very beginning of the disease.The burning and itching symptoms during urination are less pronounced than in gonorrhea, but the urge is frequent and does not bring relief.In the case of an ascending infection, the bladder first becomes inflamed, then the ureters and kidneys;discharge mixed with red blood appears.
Candidiasis (thrush), a fungal infection of the urethra.It usually develops against the background of suppression of the immune system after antibiotics, chemotherapy or radiation therapy;Sexual transmission of candidiasis in men is rare.Thrush is characterized by a curd-like discharge with a sour smell, accompanied by itching and burning during urination (urinating) 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 small, 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 interesting.In fact, this disease is related to the disruption of the normal microflora, i.e. dysbacteriosis.In its treatment, immune correctors and probiotics (lactic acid bacteria) are necessarily used.
Balanoposthitis, inflammation of the foreskin.Abundant purulent discharge is observed locally, and pus may also occur.They are always accompanied by swelling and hyperemia (redness) of the leaves of the prepuce, and pain in the head of the penis.
In case of prostatitis, cloudy discharge appears at the end of urination, abundant discharge - during the acute period of inflammation;few and white - when the disease becomes chronic.Prostatitis is usually complicated by difficulty urinating and a weak erection, in severe cases even anuria (complete lack of urination) and impotence.
The discharge is not associated with inflammation
Semen is a discharge in the form of passively flowing spermatozoa that occurs outside of sexual intercourse or masturbation, without the sensation of orgasm.The causes are certain nervous system diseases, spinal injuries, chronic stress and any long-lasting inflammation of the genitals.Sperms are associated with impaired innervation and reduced tone of the vas deferens.
Haematorrhoea, bloody discharge.It often appears when the urethral canal is injured, obtained during bougienage, after inserting a catheter or when taking a smear from the mucous membrane.In these cases, the blood is fresh, clot-free, the amount is small, and the bleeding stops quickly.If small kidney stones or sand are passed, blood is released during or immediately after urination, the bleeding is accompanied by very strong pain (renal colic).The blood flow of the hematuric form of glomerulonephritis (inflammation of the glomeruli of the kidney) is combined with edema and persistently elevated blood pressure, as well as the appearance of protein in the urine.
Brown discharge, mixed with blood clots or mucus, pus, appears in the case of malignant tumors originating from the prostate, urethra or bladder.Brownish mucus may form during the healing of mucosal wounds and is released during polyposis of the urethra and/or bladder.
Prostatorrhea is the discharge of the prostate gland from the urethra.It occurs in chronic prostatitis, prostate adenoma, damaged innervation (neurogenic bladder).
Examination algorithm for the presence of abnormal discharge from the penis
- Examination of the perineum, penis, foreskin and glans.The goal is to detect deformations of the genitals, signs of injury, signs of external inflammation, discharge, rash, etc.identification.Traces of discharge can sometimes be noticed on underwear.
- Palpation of the inguinal lymph nodes, assessment of their condition: size, whether they are warmer or colder than the surrounding tissues, painful or not, soft or hard, mobile or sticking to the skin, whether they have ulcers.
- Digital examination of the prostate;massage the prostate through the rectum and obtain secretions for microscopic examination.It is advisable to refrain from urinating for 1-2 hours before the massage.In the case of prostate adenoma, the lobes are approximately equally enlarged, dense cords can be felt.Uneven growths and their consistency are characteristic of a malignant tumor;blood clots may be released from the urethra during palpation of the prostate.
- Material: smears for microscopy and culture.When examined under a microscope, blood cells, epithelium, sperm, fat inclusions and some pathogens (Escherichia coli, gonococci, gardnerella, yeast) can be seen in the stained smear.An increased number of leukocytes is characteristic of acute urethritis or exacerbation of chronic inflammation, eosinophils - urethritis due to allergies.Red blood cells are detected in cases of severe inflammation, tumors, urinary tract injuries and urolithiasis.A large amount of epithelium is a sign of chronic urethritis, leukoplakia of the urethra.In the case of spermatorrhea, sperm are found in the smear, in the case of urethrorhoea - mucus, prostatorrhea - lipid particles.For the sake of the information content and the reliability of the results, smears should be taken no earlier than 3 days after the local application of antibiotics, antifungal agents and disinfectants.If the antibiotic treatment was systemic, then at least 3 weeks should pass after the course.Before taking an ointment, 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 dose, immediately after sleep).
- Ultrasound of the prostate, bladder and kidneys;CT and urography.
If the manifestations of genital inflammation are severe, the patient is immediately prescribed broad-spectrum antibiotics before the test results arrive.In case of heavy bleeding, hospitalization and active measures to stop the bleeding are necessary.The suspicion of a malignant tumor can only be confirmed by the results of the biopsy;the final diagnosis is based on the histological examination.
Important:
- Penile discharge is only a symptom and should not be used as a guide in making a diagnosis.
- Independent prescription of drugs is unacceptable.drugs, even if the manifestations seem obvious for a particular disease.