The discharge from the genital organs in men is the discharge from the urethra (urethra) and the secretion of the glands of the foreskin, 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 discharges from the penis and should not cause 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 spermatozoa change.
Variants of physiological secretions
Criteria for normal discharge that correspond 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 scales or other inclusions;
- Prostate secretion has a viscous consistency and a whitish hue, and there is also a specific smell of sperm;
- Ejaculate: semen from the ejaculatory duct mixes with the secretion of the Littre (urethral), Cooper's (bulbourethral) glands and prostate secretion, it takes on a grayish-white color and a mucous consistency;
- Fresh smegma from the preputial glands looks like a thick white lubricant;it may turn 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 fat 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 for the period of puberty;with age, the secretion decreases and by 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 part breaks down (in fact, this is rotting), and the masses become greenish, acquiring an unpleasant smell.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 head of the penis), increasing the risk of tumor development.
Urethrorrhea, slimy, colorless discharge from the bulbourethral and urethral glands.These discharges occur in men during libido-related arousal.The secretion of clear mucus aims to lubricate the urethra and improve the passage of sperm.The amount of secretion ranges from scanty to abundant;these parameters are related to individual body characteristics and frequency of sexual activity.After prolonged abstinence, the secretion volume 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 the age and intensity of sexual activity: it occurs in boys at puberty, in adult men - with irregular or rare sexual relations.
Prostatorrhea, discharge from the urethra of a small amount of transparent mucus with grayish-white inclusions.It appears after straining the abdominal muscles (for example, with constipation) or after urination.The secretion consists of a mixture of seminal fluid and prostate discharge;increased volume and cloudiness can be signs of prostatitis.
Pathological discharge
In men, the causes of discharge from the penis 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:
- By volume (too abundant or scarce, perhaps moderate);
- By color and transparency (from white to yellow-green, cloudy);
- Impurities (blood, pus, lumps of mucus);
- Consistency (very runny or too thick and sticky);
- By smell (sour, rotten, fishy);
- According to the frequency of occurrence (depending on the time of day, constant or episodic discharge);
- In connection with urination, sexual excitement, consumption of alcohol, hot and spicy food.
The nature of the discharge depends on the causative agent of the disease, the status of the immune system, accompanying complaints, as well as the severity and duration of the inflammation (acute or chronic).
If there is a change in the quantity, density or color of the discharge, or if an unpleasant smell appears, it is advisable to consult a doctor and have tests done.There is no point in self-diagnosing;it is very difficult to correctly recognize a disease based on just one symptom.
Penile discharge associated with sexually transmitted diseases
Mucus: transparent discharge, viscous and in small quantities, 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 visual field).
Mucopurulent: white discharge, transparent;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 discharge will come from the urethra itself, because 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.
Gonorrhea is characterized by purulent discharge with an unpleasant smell.They are sticky, thick, yellow or greenish in color and have a putrid smell.Under the microscope, epithelial cells from the urethra and many leukocytes are visible in the material.
Symptoms accompanying gonorrhoeal urethritis: constant and copious discharge;pain, itching and burning are especially strong when urinating.
In sexually transmitted diseases, combined infections are often observed, which combine 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 the classic manifestations;urethral discharge can also take on a completely different character.Therefore, modern analytical techniques with a high degree of reliability are used for the final diagnosis, and not the characteristics of secretions.
Non-specific (non-venereal) inflammation
The cause of non-specific inflammation is the body's own microflora, which is classified as opportunistic and is activated only in case of problems with the body's immune defenses.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 actively and crowd out useful bacteria after hypothermia, long-term stress, uncontrolled antibiotic treatment, after courses of radiation and chemotherapy.
Non-gonorrheal (non-specific) urethritis.Inflammatory discharge is of small volume, visible in the urine as muco-purulent threads 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 in gonorrhea, but the urge is frequent and does not bring relief.With an ascending infection, the bladder first becomes inflamed, followed by the ureters and kidneys;a discharge mixed with crimson blood appears.
Candidiasis (thrush), 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 sour-smelling chest discharge, 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, with dysbacteriosis.Immunocorrectors and probiotics (lactic acid bacteria) must be used in the treatment.
Balanoposthitis, inflammation of the foreskin.Abundant purulent discharge can be observed locally, and there may also be an admixture of mucus.They are always accompanied by swelling and hyperemia (redness) of the foreskin, pain in the head of the penis.
In 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 difficult urination and weak erection, in severe cases even to anuria (complete absence of urine output) and impotence.
The discharge is not associated with inflammation
Spermatorrhea is a discharge in the form of passive 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.Spermatorrhea is associated with disturbed innervation and reduced tone of the vas deferens.
Haematorrhea, bloody discharge.It often occurs with injuries of the urethral canal obtained during drilling, after inserting a catheter or when taking a swab from the mucous membrane.In these cases, the blood is fresh, without clots, a small amount, 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 kidney glomeruli) is combined with edema and persistently elevated blood pressure, as well as the appearance of protein in the urine.
Brown discharge, with clots of blood or mucus, mixed with pus, occurs in malignant tumors arising from the prostate, urethra or bladder.Brownish mucus can occur during the healing of wounds on the mucous membranes, and is released during polyposis of the urethra and/or bladder.
Prostatorrhea is prostate secretion that flows from the urethra.It occurs in chronic prostatitis, prostate adenoma, disturbed innervation (neurogenic bladder).
Examination algorithm for the presence of pathological discharge from the penis
- Examination of the perineum, penis, foreskin and glans.The goal is to identify deformations of the genital organs, traces of injuries, signs of external inflammation, discharge, rash, etc.Traces of discharge are sometimes visible on underwear.
- Palpation of 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 attached to the skin, whether there are ulcerations on them.
- Digital examination of the prostate;massage the prostate through the rectum and collect secretions for microscopic examination.Before the massage, it is recommended to refrain from urinating for 1-2 hours.With adenoma of the prostate, its lobes are enlarged approximately equally, dense cords are palpable.Uneven growths and their consistency are typical of a malignant tumor;during palpation of the prostate, there may be release of blood with clots from the urethra.
- Material: smears for microscopy and culture.When examined under a microscope, the stained smear reveals blood cells, epithelium, sperm, fat 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 - for urethritis due to allergies.Red blood cells are detected in severe inflammations, tumors, injuries of genitourinary organs and urolithiasis.A large amount of epithelium is a sign of chronic urethritis, urethral leukoplakia.In spermatorrhea, spermatozoa are found in smear, in urethrorhoea - mucus, prosatorrhoea - lipid granules.For the sake of informative content and reliability of the results, the swab is taken no later than 3 days after the local application of antibiotics, antifungals and disinfectants.If antibiotic treatment was systemic, at least 3 weeks should pass after the course.Do not wash yourself before taking the swab;try not to urinate for 2-3 hours.
- General clinical blood test, blood sugar analysis - in the morning, on an empty stomach.Detailed analysis of urine (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 the test results, the patient is immediately prescribed broad-spectrum antibiotics.In case of profuse 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:
- Penile discharge is only one of the symptoms that cannot be used as a guide in establishing a diagnosis.
- Independent dispensing of prescription drugs is unacceptable.medicines, even if they appear obvious for a specific disease.