In men, genital discharge is the discharge from the urethra (urethra) and the secretion of the precursor glands located at the head of the genital organ, under the foreskin.The ejaculatory duct, ducts of the prostate gland, urethra and bulbourethral glands open into the urethra.
In a healthy man, only urine and ejaculation flow through the urethra.These are physiological discharges from the penis and should not cause any concern.Unfortunately, this is not always the case.
For various reasons, men's health deteriorates and abnormal secretions occur instead of normal secretions, or urine and sperm change.
Variants of physiological secretions
Criteria for normal discharge according to the functions of the organs of the genitourinary system:
- Urine is clear, straw to golden yellow in color, practically odorless and free of flakes or other inclusions;
- Prostate secretion has a viscous consistency and whitish color and has a specific sperm smell;
- Ejaculation: sperm from the ejaculatory duct mixes with secretions of the Littre (urethral), Cooper (bulbourethral) glands and prostate secretions, acquires a gray-white color and mucous consistency;
- Fresh smegma from the preputial glands appears as a thick white smear;it may turn yellowish or greenish over time.
Preputial lubricant - smegma - is constantly secreted, accumulates under the inner layer of the foreskin and in the coronal groove of the penis.The lubricant contains oils and bacterial residues, distributes evenly and reduces friction between the foreskin and the scalp.The maximum activity of the preputial glands is characteristic for puberty;secretion decreases with age and stops completely in old age.
If you neglect the rules of personal hygiene, smegma can accumulate under the folds of the foreskin.In this case, the fat part of the lubricant oxidizes and the protein part breaks down (in fact, it rots), and the masses become greenish and have an unpleasant smell.The same process occurs with phimosis, when it is impossible to completely free the head of the penis from the skin folds and remove smegma due to the fusion of the foreskin.Accumulation and breakdown of lubricant can lead to chronic balanitis and balanoposthitis (inflammation of the foreskin and glans penis), which increases the risk of tumor development.
Urethrorrhea, mucous, colorless discharge from the bulbourethral and urethral glands.These secretions appear during libido-related excitement in men.The discharge of clear mucus aims to lubricate the urethra and improve the passage of sperm.The amount of secretion varies from little 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 unrelated to 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 - with irregular or rare sexual intercourse.
Prostatorrhea, discharge of a small amount of transparent mucus with gray-white inclusions from the urethra.It occurs after straining 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
The causes of discharge from the genital organs in men can be sexually transmitted diseases, tumors, non-specific inflammation of the urogenital organs, various injuries, medical procedures or operations.
Pathological discharge from the urethra differs from normal:
- Volume (too much or little, maybe medium);
- According to color and transparency (white to yellow-green, cloudy);
- With impurities (blood, pus, pieces of mucus);
- consistency (too liquid or too thick and sticky);
- By smell (sour, rotten, fishy);
- According to the frequency of appearance (depending on the time of day, constant or episodic discharge);
- In connection with urinary incontinence, sexual arousal, alcohol consumption, hot and spicy food.
The nature of discharge depends on the causative agent of the disease, the state of the immune system, concomitant diseases, 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 smell appears, it is recommended to consult a doctor and conduct tests.There is no point in self-diagnosis;It is very difficult to correctly recognize a disease based on only one symptom.
STD-related penile ejaculation
Mucous: clear, viscous and small amount of discharge occurs in the chronic form of chlamydia, mycoplasma or ureaplasma urethritis.Microscopy reveals a moderate amount of leukocytes in discharge (the norm is up to 4 cells in the visual field).
Mucopurulent: white discharge, transparent;It is observed in the acute phase of chlamydia, ureaplasmosis and mycoplasmosis.With chlamydia infection, it collects at the head of the penis, as if it "sticks" to the skin.
With the pathologies described above, the discharge will come from the urethra itself, because microorganisms irritate the mucous membrane of the urethra, and the body tries to "wash" them.
It happens that the 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 smell.Under the microscope, epithelial cells of 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 that combine several pathogens at once are often observed.Gonorrhea and trichomoniasis are accompanied by chlamydia;mycoplasmosis and ureaplasmosis usually occur in pairs.Symptoms of such diseases differ from classical manifestations;urethral discharge can also take a completely different character.Therefore, modern analytical methods with a high degree of reliability are used for the final diagnosis, not the characteristics of the secretions.
Non-specific (non-venomous) inflammation
The cause of non-specific inflammation is the body's own microflora, which is classified as opportunistic and is activated only when there are problems with the body's immune defense.Streptococci and staphylococci, Candida and E. coli fungi are always present on the surface of the skin and mucous membranes, but after hypothermia, long-term stress, uncontrolled treatment with antibiotics, radiation and chemotherapy courses, they begin to multiply actively and crowd out beneficial bacteria.
Non-gonorrheal (non-specific) urethritis.Inflammatory discharge is small in volume, appears in the form of mucopurulent fibers or lumps in the urine and appears at the very beginning of the disease.Symptoms in the form of burning and itching during urination are less pronounced than in gonorrhea, but the urge is frequent and does not bring relief.With rising infection, the bladder is first inflamed, and then the ureters and kidneys;a discharge mixed with red blood is seen.
Candidiasis, a fungal infection of the urethra.It 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 sour-smelling curd-like discharge accompanied by itching and burning during micturition (urinating) and voiding (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 few, yellowish-white or greenish.According to some classifications, gardnerella is classified as an STD, but the infection of gardnerella through sexual intercourse in men is of more interest.In fact, this disease is associated with disruption of normal microflora, that is, dysbacteriosis.During treatment, immunocorrectors and probiotics (lactic acid bacteria) are definitely used.
Balanoposthitis, inflammation of the foreskin.Abundant purulent discharge is observed locally and may be mixed with mucus.They are always accompanied by swelling and hyperemia (redness) of the blister leaves, pain in the head of the penis.
With prostatitis, a cloudy discharge appears at the end of urination, a lot of discharge - during the acute period of inflammation;less and white - when the disease becomes chronic.Prostatitis is usually complicated by difficulty urinating and erectile dysfunction, and in severe cases even anuria (absence of urination) and impotence.
Ejaculation not associated with inflammation
Spermatorrhea is a passive flow of semen that occurs outside of sexual intercourse or masturbation, without the feeling of orgasm.The causes are some diseases of the nervous system, spinal injuries, chronic stress and any long-term inflammation of the genitals.Spermatozoa are associated with impaired innervation and decreased tone of the vas deferens.
Haematorrhea, bloody discharge.Often seen during bougienage, after inserting a catheter or after taking a smear from the mucous membrane, the urethral canal is damaged.In these cases, the blood is fresh, clot-free, the amount is small, and the bleeding stops quickly.When small kidney stones or sand are passed, blood is released during or immediately after urination, hematorrhea is accompanied by severe pain (renal colic).In the hematuric form of glomerulonephritis, blood discharge (inflammation of the kidney glomeruli) is combined with edema and persistently elevated blood pressure and the appearance of protein in the urine.
Brown discharge, clotted blood or mucous, mixed with pus, appears with malignant tumors from the prostate, urethra or bladder.Brown mucus may form on the mucous membranes during wound healing and is released during urethral and/or bladder polyposis.
Prostatorrhea is the discharge of the prostate gland from the urethra.It occurs in chronic prostatitis, prostate adenoma, innervation disorder (neurogenic bladder).
Examination algorithm for the presence of pathological discharge from the penis
- Examination of the perineum, genitals, foreskin and glans.The aim is to remove genital deformities, injury marks, external signs of inflammation, discharges, rashes, etc. The traces of discharge are sometimes noticeable in underwear.
- Palpation of inguinal lymph nodes, assessment of their condition: size, whether they are warmer or colder than the surrounding tissues, painful or not painful, soft or hard, mobile or attached to the skin, whether there are ulcers on them.
- digital examination of the prostate;massage the prostate through the rectum and obtain secretions for microscopic examination.It is recommended to refrain from urinating for 1-2 hours before the massage.With prostate adenoma, its lobes grow almost evenly, dense cords are palpable.Uneven growths and their consistency are characteristic for a malignant tumor;During palpation of the prostate, clotted blood may come out of the urethra.
- Material: smear for microscopy and culture.When examined under a microscope, blood cells, epithelium, sperm, fatty inclusions and some pathogens (Escherichia coli, gonococci, gardnerella, yeast) are detected in the stained smear.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, injuries of the genitourinary organs, urolithiasis.A large amount of epithelium is a sign of chronic urethritis, urethral leukoplakia.There are lipid grains in semen smear with spermatozoa, mucus with urethrorrhea, prostatorrhea.For data content and reliability of results, the smear is taken no later than 3 days after the local use of antibiotics, antifungals and disinfectants.If the treatment with antibiotics was systemic, at least 3 weeks should pass after the course.Do not wash before taking a smear;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 part, immediately after sleep).
- Ultrasound of the prostate gland, bladder and kidneys;CT and urography.
If the manifestations of genital inflammation are severe, the patient is immediately prescribed broad-spectrum antibiotics before receiving the test results.In case of severe 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 based on histological examination.
Important:
- Penile discharge is only one symptom that cannot be used as a guide in making a diagnosis.
- Independent prescription of drugs is unacceptable.drugs, even if the manifestations seem obvious for a certain disease.