Discharge from the genital organs in men is discharge from the urethra (urethra) and secretion of the foreskin glands, which are 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 secretions 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 secretions or changes in urine and sperm appear
Variants of physiological secretions
Criteria for normal discharge corresponding to the functions of the organs of the urogenital system:
- The urine is clear, straw-colored to golden yellow, practically odorless and does not contain scales or other inclusions;
- The secretion from the prostate has a viscous consistency and a whitish tint, and a specific odor of semen is felt;
- Ejaculate: the sperm of the ejaculatory duct mixes with the secretions of the Littre (urethral), Cooper (bulbourethral) glands and with the prostatic secretions, acquiring a greyish-white color and a mucous consistency;
- Fresh smegma from the preputial glands appears as a thick white lubricant;it 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 sulcus 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 puberty period;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, and the protein part disintegrates (in fact, rots), 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 eliminate smegma.The accumulation and degradation of lubricant can lead to chronic balanitis and balanoposthitis (inflammation of the foreskin and glans), increasing the risk of developing tumors.
Urethrorrhea, mucous and colorless discharge from the bulbourethral and urethral glands.These secretions appear in men during arousal associated with libido.The excretion of clear mucus is intended to lubricate the urethra and improve the passage of sperm.The amount of secretion varies 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 secretions increases.
A wet dream is a spontaneous release of semen not associated with sexual intercourse.Usually observed in the morning, when testosterone levels increase.It depends on age and the 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 clear mucus with greyish-white inclusions.It occurs after straining your abdominal muscles (for example, if you are constipated) or after urinating.The secretion is made up of a mixture of seminal fluid and prostatic secretion;enlargement and cloudiness may be signs of prostatitis.
Pathological discharge
In men, the causes of discharge from the penis can be sexually transmitted diseases, 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 scarce, perhaps moderate);
- By color and transparency (from white to yellow-green, cloudy);
- From impurities (blood, pus, lumps of mucus);
- Consistency (very liquid or too thick and sticky);
- From the smell (sour, putrid, fishy);
- According to the frequency of appearance (depending on the time of day, constant or episodic secretion);
- In connection with urination, sexual arousal, alcohol consumption, hot and spicy foods.
The nature of the secretion depends on the causative agent of the disease, the state of the immune system, concomitant disorders, as well as the severity and duration of inflammation (acute or chronic).
If you notice a change in the quantity, density or color of the secretions, or if an unpleasant odor appears, it is recommended to consult a doctor and carry out tests.Self-diagnosis makes no sense;it is very difficult to correctly recognize the disease based on just one symptom.
Penis discharge associated with sexually transmitted diseases
Mucous: transparent, viscous and small quantity secretion, occurs in the chronic form of urethritis due to chlamydia, mycoplasma or ureaplasma.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 secretion;observed in the acute phase of chlamydia, ureaplasmosis and mycoplasmosis.With chlamydia infection, they accumulate on the head of the penis, as if “sticking” to the skin.
With the pathologies described above, the secretion will come from the urethra itself, as microorganisms irritate the mucosa of the urethra and the body tries to “wash them out”.
It happens that a white discharge 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 the microscope, epithelial cells of the urethra and many leukocytes are visible in the material.
Symptoms accompanying gonorrheal urethritis: constant, heavy discharge;pain, itching and burning are especially severe during urination.
With 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 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 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, 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 begin to multiply and actively displace beneficial bacteria after hypothermia, prolonged stress, uncontrolled treatment with antibiotics, after courses of radiation and chemotherapy.
Non-gonorrhea urethritis (nonspecific).Inflammatory secretions are small in volume, visible in the urine as mucopurulent threads or lumps, and appear early in 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;a discharge mixed with scarlet blood appears.
Candidiasis (thrush), fungal infection of the urethra.It usually develops against a background of immune system suppression after a course of antibiotics, chemotherapy, or radiation therapy;Sexual transmission of candidiasis in men is rare.Thrush is characterized by curd-like discharge with a sour odor, which is combined with itching and burning during urination (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 scarce, yellowish-white or greenish.According to some classifications, Gardnerella is classified as a sexually transmitted disease, but in men, Gardnerella infection through sexual contact is more of a curiosity.In fact, this disease is associated with a disruption of the normal microflora, that is, dysbacteriosis.In 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 foreskin, pain in the head of the penis.
With prostatitis, a cloudy discharge appears at the end of urination, abundant 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 more serious cases also by anuria (complete absence of urine production) and impotence.
Secretion not associated with inflammation
Spermatorrhea is a secretion in the form of passively flowing semen that occurs outside of sexual intercourse or masturbation, without the sensation 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, blood loss.It often appears with injuries to the urethral canal sustained during bougienage, after insertion of a catheter or when taking a smear from the mucosa.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, hematorrhea is accompanied by very severe pain (renal colic).Bloody discharge in the hematuria form of glomerulonephritis (inflammation of the renal glomeruli) is combined with edema and persistently high 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 originating from the prostate, urethra, or bladder.During the healing of wounds, brownish mucus may form on the mucous membranes, which is released during polyposis of the urethra and/or bladder.
Prostatorrhea is the secretion of the prostate gland that comes out of the urethra.Occurs in chronic prostatitis, prostatic 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 lesions, signs of external inflammation, discharge, rash, etc.Traces of secretion are sometimes visible on underwear.
- Palpation of the inguinal lymph nodes, evaluation of their state: size, whether they are warmer or colder than the surrounding tissues, painful or not, soft or hard, mobile or adherent to the skin, whether there are ulcerations above them.
- Digital prostate exam;massage the prostate through the rectum and obtain the secretions for microscopic examination.Before the massage it is recommended to refrain from urinating for 1-2 hours.With prostatic adenoma, its lobes are enlarged approximately equally, dense cords are palpable.Irregular growths and their consistency are typical of a malignant tumor;During palpation of the prostate, it is possible that blood with clots comes out of 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 increase in the number of leukocytes is characteristic of acute urethritis or exacerbation of chronic inflammation, eosinophils - urethritis due to allergies.Red blood cells are detected in severe inflammation, tumors, lesions of 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 granules.For information content and reliability of the results, a smear is taken no earlier than 3 days after local use of antibiotics, antifungals and disinfectants.If treatment with antibiotics was systemic, 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, before receiving the 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.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 only one symptom that cannot be used as a guide to diagnosis.
- Independent prescribing of drugs is unacceptable.medications, even if the manifestations seem obvious for a particular disease.