Discharge from the genitals in men is discharge from the urethra (urethra) and secretion from the foreskin glands, located on the head of the penis, under the skin of the foreskin.The ejaculatory duct, prostate ducts, urethral and bulbourethral glands open into the urethra.
In a healthy man, only urine and ejaculate flow through the urethra.These are physiological losses from the penis and 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
Normal flow criteria corresponding to the functions of the organs of the urogenital system:
- Urine is clear, straw-colored to golden yellow, virtually odorless, and contains no flakes or other inclusions;
- Prostatic secretion has a viscous consistency and a whitish tint, and there is a specific smell of semen;
- Ejaculate: sperm from the ejaculatory duct mix with the secretions of Littre's (urethral), Cooper's (bulburethral) 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 turn yellowish or greenish over time.
The preputial lubricant - smegma - is constantly secreted and accumulates under the inner layer of the foreskin and in the coronal sulcus of the penis.The lubricant is composed of fats and bacterial residues, is distributed evenly 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, the secretion decreases, and with old age it stops completely.
If you neglect the rules of personal hygiene, smegma can accumulate under the folds of the foreskin.In this case, the fatty part of the lubricant oxidizes, the protein part disintegrates (in fact, it is rotten) and the masses become greenish, acquiring an unpleasant odor.The same process occurs with 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.The buildup and breakdown of lubricant can lead to chronic balanitis and balanoposthitis (inflammation of the foreskin and glans), increasing the risk of tumor development.
Uretrorrhea, mucous and colorless discharge from the bulbourethral and urethral glands.These discharges appear in men during excitations linked to the libido.The purpose of excretion of clear mucus is to lubricate the urethra and improve the passage of sperm.The amount of secretion varies from scanty to abundant;these parameters are related to individual characteristics of the body and the frequency of sexual activity.After prolonged abstinence, the volume of losses increases.
A wet dream is a spontaneous release of sperm not associated with sexual intercourse.Typically seen in the morning, when testosterone levels increase.It 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 tension in the abdominal muscles (for example, with constipation) or after urinating.The secretion consists of a mixture of seminal fluid and prostatic 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:
- In volume (too abundant or not very abundant, perhaps moderate);
- By color and transparency (from white to yellow-green, cloudy);
- By impurities (blood, pus, pieces of mucus);
- Consistency (very liquid or too thick and sticky);
- By the smell (sour, putrid, fishy);
- Depending on the frequency of occurrence (depending on the time of day, constant or episodic discharge);
- In relation to urination, sexual arousal, 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, concomitant conditions, as well as the severity and duration of inflammation (acute or chronic).
If there is a change in the quantity, density or color of discharge, or an unpleasant odor appears, it is recommended to consult a doctor and take tests.Self-diagnosis is useless;it is very difficult to correctly recognize the disease from a single symptom.
Penile discharge associated with STDs
Mucous: a transparent, viscous discharge in small quantities occurs in the chronic form of chlamydial, 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, translucent discharge;observed in the acute phase of chlamydia, ureaplasmosis and mycoplasmosis.In case of Chlamydia 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 out”.
Sometimes a white secretion appears 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 the microscope, urethral epithelial cells and numerous leukocytes are visible in the material.
Symptoms accompanying gonorrheal urethritis: constant, profuse discharge;the pain, itching and burning are particularly intense 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 these diseases differ from the classic manifestations;urethral discharge can also take on a completely different character.Therefore, for the final diagnosis, modern analytical techniques with a high degree of reliability are used, and not the characteristics of secretions.
Non-specific (non-venereal) inflammation
The cause of nonspecific inflammation is its own microflora, classified as opportunistic and activated only in cases 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 multiply and actively displace beneficial bacteria after hypothermia, prolonged stress, uncontrolled treatment with antibiotics, after courses of radiation therapy and chemotherapy.
Non-gonorrheal (non-specific) urethritis.Inflammatory discharge is small in volume, visible in the urine in the form of 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 common and does not bring relief.In cases of ascending infection, the bladder becomes inflamed first, followed by the ureters and kidneys;a 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 curdled discharge with a sour odor, which is combined with itching and burning during urination (urination) and ejaculation (ejaculation), and can 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 rare, yellowish white or greenish.According to some classifications, gardnerella is classified as an STD, but in men, gardnerella infection through sexual contact is more of a curiosity.In fact, this disease is associated with a disruption of normal microflora, that is, with dysbacteriosis.During its treatment, 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 foreskin, pain in the head of the penis.
With prostatitis, cloudy discharge appears at the end of urination, profuse discharge - during the acute period of inflammation;rare and white - when the disease becomes chronic.Prostatitis is generally complicated by difficulty urinating and erectile weakness, even leading in severe cases to anuria (total absence of urine production) and impotence.
Discharge not associated with inflammation
Spermatorrhea is a discharge in the form of passively circulating sperm that occurs outside of sexual intercourse or masturbation, without the sensation of orgasm.The reasons for this are certain diseases of the nervous system, spinal injuries, chronic stress and any long-term inflammation of the genital area.Spermatozoa are associated with impaired innervation and decreased tone of the vas deferens.
Hematorrhea, bloody discharge.Often appears with injuries to the urethral canal sustained during bougienage, after insertion of a catheter or when taking a smear from the mucous membrane.In these cases, the blood is fresh, without clots, the quantity is small and the bleeding stops quickly.When small kidney stones or sand pass, blood is released during or immediately after urination, hemarrhoea is accompanied by very intense pain (renal colic).Blood discharge in the hematuric form of glomerulonephritis (inflammation of the kidney glomeruli) is associated with edema and constantly high blood pressure, as well as 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 may form during healing of wounds on the mucous membranes, and is released during polyposis of the urethra and/or bladder.
Prostatorrhea is secretion from the prostate that leaks 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 purpose is to identify deformities of the genitals, traces of injuries, signs of external inflammation, discharge, rashes, etc.Traces of discharge are sometimes noticeable 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 adhering to the skin, whether there are ulcerations on them.
- Digital prostate exam;massage the prostate through the rectum and obtain the secretions for microscopic examination.Before the massage, it is advisable to refrain from urinating for 1-2 hours.With prostate adenoma, its lobes are approximately equally enlarged, dense cords are palpable.Uneven growths and their consistency are typical of a malignant tumor;when palpating the prostate, blood containing clots may be released from the urethra.
- Material: smear for microscopy and culture.When examined under a microscope, the colored 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 an exacerbation of chronic inflammation, eosinophils - of urethritis due to allergies.Red blood cells are detected in severe inflammations, tumors, damage to the genitourinary organs and urolithiasis.A large amount of epithelium is a sign of chronic urethritis, urethral leukoplakia.With spermatorrhea, spermatozoa are found in the smear, with urethrorrhea - mucus, prostatorrhea - lipid grains.For the informative 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 the antibiotic treatment was systemic, at least 3 weeks should elapse after treatment.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, before receiving the test results, the patient is immediately prescribed broad-spectrum antibiotics.In case of heavy bleeding, hospitalization and active measures to stop bleeding are indicated.Suspicion of a malignant tumor can only be confirmed by the result of a biopsy;the final diagnosis is made on the basis of a histological examination.
Important :
- Discharge from the penis is only a symptom that cannot be used as a guide to making a diagnosis.
- Independent prescribing of pharmaceuticals is unacceptable.medications, even if the manifestations seem obvious for a particular disease.