The discharge from the genitals in men is the discharge from the urethra (urethra) and the secret from the preputial glands, which are located on the head of the penis, under the skin of the foreskin. The ejaculatory duct, the prostatic ducts, the urethral and bulbourethral glands open into the urethra.
In a healthy man, only urine and ejaculation flow through the urethra. This is a physiological discharge from the penis and should not cause any discomfort. Unfortunately, this is not always the case.
For various reasons, men's health is shaking, and instead of normal discharge, abnormal discharge or changes appear in urine and semen.
Variants of physiological secretions.
Criteria for normal discharge corresponding to the functions of the organs of the urogenital system:
- Urine: transparent, straw-colored to golden yellow, practically odorless, without scales or other inclusions;
- The secret of the prostate has a viscous consistency and a whitish tint, there is a specific smell of spermine;
- Ejaculation: the sperm from the ejaculatory duct mix with the secretions of the Littre (urethral), Cooper (bulbourethral) and prostate glands, acquiring a grayish-white color and mucous consistency;
- Fresh smegma from the preputial glands is like thick white fat; it may turn yellowish or greenish over time.
The foreskin lubricant, smegma, is constantly released and accumulates under the inner layer of the foreskin and in the coronal groove of the penis. The lubricant is made up of fatty 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 inherent in the period of puberty; With age, the discharge decreases and stops completely with old age.
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 decomposes (in fact, it is rotting) and the masses turn 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 accumulation and breakdown of lubricant can lead to chronic balanitis and balanoposthitis (inflammation of the foreskin and glans of the penis), increasing the risk of developing tumors.
Urethrhea, mucous and colorless discharge from the bulbourethral and urethral glands. Discharge data appear in men with arousal associated with libido. The excretion of clear mucus is intended to lubricate the urethra and improve the passage of semen. The amount of secretion varies from little to abundant, these parameters are associated with the individual characteristics of the organism and the frequency of sexual activity. After prolonged abstinence, the volume of secretions increases.
Contamination is a spontaneous release of sperm, not associated with intercourse. It is usually seen in the morning when testosterone levels rise. It depends on the age and intensity of sexual activity: it appears in boys during 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 occurs after the tension of the abdominal muscles (for example, with constipation) or after urination. The secret is a mixture of semen and prostate secretion, an increase in volume and opacity can 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, manipulations or medical operations.
Pathological discharge from the urethra differs from normal:
- By volume (too abundant or too little, possibly moderate);
- In color and transparency (from white to greenish yellow, cloudy);
- By impurities (blood, pus, mucus clumps);
- Consistencies (too thin or too thick and sticky);
- By smell (sour, putrid, fishy);
- By the frequency of appearance (depending on the time of day, constant or episodic discharge);
- In connection with urination, sexual arousal, with the intake of alcohol, spicy and spicy foods.
The nature of the discharge depends on the causative agent of the disease, the state of the immune system, concomitant ailments, as well as the severity and duration of inflammation (acute or chronic).
If the amount, density or color of the discharge changes, if an unpleasant odor appears, it is recommended to consult a doctor and carry out tests. Self-diagnosis is not worth it, it is very difficult to correctly recognize the disease from a single symptom.
Discharge from the penis associated with sexually transmitted diseases
Mucous - A small, slimy, clear discharge found in the chronic form of chlamydial, mycoplasma, or ureaplasma urethritis. Microscopy reveals a moderate number of leukocytes in the secretions (the norm is up to 4 cells per field of view).
Mucopurulent: white, translucent discharge; observed in the exacerbation phase with chlamydia, ureaplasmosis and mycoplasmosis. In chlamydial infections, they collect on the head of the penis, as if they "stick" to the skin.
With the pathologies described above, the discharge will come from the urethra itself, since the microorganisms irritate the mucous membrane of the urethra and the body tries to "wash" it.
It happens that the secret of the white color seems to cover the head. This is noted with chlamydia, yeast infection. In the first case, a film is formed, in the second - a loose cheesy bloom.
Purulent discharge with an unpleasant odor is characteristic of gonorrhea. They are sticky, thick, yellow or green in color, with a putrid odor. Microscopic examination of the material shows epithelial cells of the urethra, many white blood cells.
Symptoms that accompany gonorrheal urethritis: persistent and profuse discharge; pain, itching, and burning are especially severe when urinating.
In sexually transmitted diseases, combined infections are often seen, combining several pathogens at the same time. Gonorrhea and trichomoniasis are associated with chlamydia, mycoplasmosis and ureaplasmosis are usually found in pairs. The symptomatology of such diseases differs 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 the discharge.
Nonspecific (non-venereal) inflammation
The cause of nonspecific inflammation is its own microflora, which is conditionally pathogenic 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 actively multiply and displace beneficial bacteria after hypothermia, prolonged stress, treatment with Uncontrolled antibiotics, after radiation courses. and chemotherapy.
Non-gonorrheal (nonspecific) urethritis. The inflammatory discharge is small in volume, visible in the urine as strings or mucopurulent bumps that appear early in the disease. Symptoms in the form of burning and itching when urinating are less pronounced than with gonorrhea, but the urge is frequent and does not provide relief. With an ascending infection, the bladder becomes inflamed first, followed by the ureters and kidneys; A discharge appears with a mixture of scarlet blood.
Candidiasis (thrush), a fungal infection of the urethra. It usually develops in the context of suppression of the immune system after a course of antibiotics, chemotherapy, or radiation therapy; Sexual transmission of yeast infection in men is rare. Candidiasis is characterized by a curdled discharge with a sour smell, which is combined with itching and burning during urination (urination) and ejaculation (ejaculation), and may be accompanied by a dull pain in the groin, above the pubis and in the lumbar area.
Gardnerellosis of the urethra. The fishy odor of the discharge is characteristic; they are rare, yellowish-white or greenish in color. According to some classifications, gardnerellosis is known as an STD, but in men, the sexually transmitted infection with gardnerella is more likely to be a curiosity. In fact, this disease is associated with a violation of the normal microflora, that is, with dysbiosis. Immunocorrectors and probiotics (lactic acid bacteria) are necessarily used in its treatment.
Balanoposthitis, inflammation of the foreskin. An abundant purulent discharge is observed locally, an admixture of mucus is possible. Always accompanied by edema and hyperemia (redness) of the foreskin leaves, pain in the head of the penis.
With prostatitis, a cloudy discharge appears at the end of urination, abundant discharge, in the acute period of inflammation; sparse and white, with the disease transitioning to a chronic form. Prostatitis is usually complicated by difficulty urinating and a weak erection, in severe cases, up to anuria (total absence of urine flow) and impotence.
Discharge not associated with inflammation.
Spermatorrhea - Passively flowing sperm discharge, occurring 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 prolonged inflammation of the genital area. Spermatorrhea is associated with a violation of innervation and a decrease in the tone of the vas deferens.
Hematorrhoea, spotted. It often appears with lesions of the urethral canal received 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 amount is small, the bleeding stops quickly. When small kidney stones or sand disappear, the blood is released during or immediately after urination, hematorrhea is accompanied by very severe pain (renal colic). The discharge of blood in the hematuric form of glomerulonephritis (inflammation of the renal glomeruli) is combined with edema and constant high blood pressure, the appearance of protein in the urine.
Brown discharge, with blood clots or mucus, with a mixture of pus appear in malignant tumors that emanate from the prostate, urethra or bladder. Brownish mucus can form during wound healing on mucous membranes and is secreted with polyposis from the urethra and / or bladder.
Prostatorrhea is the secretion of the prostate gland that flows from the urethra. Occurs in chronic prostatitis, prostate adenoma, impaired innervation (neurogenic bladder).
Examination algorithm in the presence of pathological discharge from the penis.
- Examination of the perineum, penis, foreskin and glans. The goal is to identify deformities of the genital organs, traces of their injury, signs of external inflammation, secretions, rashes, etc. Sometimes traces of discharge are noticeable on clothing.
- Palpation of the inguinal lymph nodes, assessment of their condition: size, they are warmer or colder than the surrounding tissues, painful or not, soft or dense, mobile or attached to the skin, whether there are ulcerations above them.
- Prostate finger exam; massaging the prostate through the rectum and obtaining secretions for microscopic examination. Before the massage, it is advisable to refrain from urinating for 1-2 hours. In the case of prostate adenoma, its lobes increase approximately equally, dense strands are felt. For a malignant tumor, uneven growths and their consistency are typical; During palpation of the prostate, blood with clots may be released from the urethra.
- Material: smear for microscopy and culture. When examined under a microscope, a stained smear shows blood cells, epithelium, sperm, fatty inclusions, 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 with allergies. Erythrocytes are found in severe inflammation, tumors, lesions of the genitourinary organs, urolithiasis. A large amount of epithelium is a sign of chronic urethritis, urethral leukoplakia. With spermatorrhea, sperm are found in a smear, with urethorrhea - mucus, prostatorrhea - lipid grains. For informational content and reliability of results, the smear is taken no earlier than 3 days after topical application of antibiotics, antifungals, and disinfectants. If the antibiotic treatment was systemic, then 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 analysis of blood, blood to determine the level of sugar: in the morning, on an empty stomach. Extended urinalysis (morning portion, immediately after sleeping).
- Prostate, bladder and kidney ultrasound; CT and urography.
If the manifestations of genital inflammation are strong, before the test results are obtained, the patient is immediately prescribed antibiotics of a wide spectrum of action. With profuse bleeding, hospitalization and active actions to stop the bleeding are indicated. Confirmation of a suspicion of a malignant tumor can only be the result of a biopsy, the final diagnosis is made on the basis of a histological examination.
Important:
- Discharge from the penis is just a symptom that cannot be guided when making a diagnosis.
- The independent appointment of the estate is unacceptable. medications, even if the manifestations seem obvious for a particular disease.