Discharge from the genitals in men is the discharge from the urethra (urethra) and the secret of the preputial 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. This is 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 appears or urine and semen change
Variants of physiological secretions
Criteria for normal discharge corresponding to the functions of the organs of the urogenital system:
- Urine - clear, from straw to golden-yellow color, practically odorless, containing no flakes or other inclusions;
- The secret of the prostate has a viscous consistency and a whitish tint, there is a specific smell of spermine;
- Ejaculate: sperm from the ejaculatory duct mixes with secretions from Littre's (urethral), Cooper's (bulbourethral) glands and prostatic secretion, acquiring a grayish-white color and mucous consistency;
- Fresh smegma from the preputial glands is like a thick white grease; may turn yellowish or greenish over time.
The preputial lubricant - smegma - is constantly released, 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 inherent in the period of puberty; with age, secretion decreases and stops completely by old age.
If you neglect the rules of personal hygiene, then smegma can accumulate under the folds of the foreskin. In this case, the fatty part of the lubricant is oxidized, and the protein part decomposes (in fact, it is rotting), 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 accumulation and breakdown of lubricant can lead to chronic balanitis and balanoposthitis (inflammation of the foreskin and glans penis), increasing the risk of developing tumors.
Urethrorrhea, mucous, 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 ranges from meager 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.
Pollution is a spontaneous release of sperm, not associated with intercourse. Usually seen in the morning when testosterone levels rise. Depends on the age and intensity of sexual activity: it appears in boys during puberty, in adult men - with irregular or rare intercourse.
Prostatorrhea, discharge from the urethra of a small amount of transparent mucus with grayish-white inclusions. It occurs after tension of the abdominal muscles (for example, with constipation) or after urination. The secret consists of a mixture of semen and prostate discharge, an increase in volume and opacity can 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 manipulations or operations.
Pathological discharge from the urethra differs from normal:
- By volume (too abundant or scarce, possibly moderate);
- In color and transparency (from white to yellow-green, cloudy);
- By impurities (blood, pus, lumps of mucus);
- Consistencies (very thin or too thick and sticky);
- By smell (sour, putrid, fishy);
- By the frequency of occurrence (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 status of the immune system, on concomitant ailments, as well as on 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 do tests. Self-diagnosis is not worth it, it is very difficult to correctly recognize the disease by just one symptom.
Discharge from the penis associated with STDs
Mucous: transparent discharge, viscous and small in quantity, found in the chronic form of chlamydia, 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 discharge, translucent; observed in the exacerbation phase with chlamydia, ureaplasmosis and mycoplasmosis. In chlamydial infections, they accumulate on the head of the penis, as if "sticking" to the skin.
With the above-described pathologies, the discharge will come from the urethra itself, since microorganisms irritate the mucous membrane of the urethra, and the body tries to "wash it off".
It happens that the secret of white color seems to cover the head. This is noted with chlamydia, candidiasis. 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 greenish in color, with a putrid odor. Microscopic examination of the material shows epithelial cells from the urethra, many leukocytes.
Symptoms accompanying gonorrheal urethritis: persistent and profuse discharge; pain, itching, and burning are especially severe when urinating.
In 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 symptomatology of such diseases differs from the classical manifestations; urethral discharge can also acquire a completely different character. Therefore, for the final diagnosis, modern analytical techniques are used with a high degree of reliability, 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 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 actively multiply and displace beneficial bacteria after hypothermia, prolonged stress, uncontrolled antibiotic treatment, after courses of radiation and chemotherapy.
Non-gonorrheal (nonspecific) urethritis. Inflammatory discharge is small in volume, visible in the urine as mucopurulent cords or lumps, appear 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 frequent and does not bring relief. With an ascending infection, the bladder first becomes inflamed, followed by the ureters and kidneys; discharge with an admixture of 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; the 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 miction (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 fishy smell of the discharge is characteristic; they are scanty, yellowish white or greenish. According to some classifications, gardnerellosis is referred to as an STD, but in men, sexual infection with gardnerella is more likely a curiosity. In fact, this disease is associated with a violation of the normal microflora, that is, with dysbiosis. In its treatment, immunocorrectors and probiotics (lactic acid bacteria) are necessarily used.
Balanoposthitis, inflammation of the foreskin. Abundant purulent discharge is locally observed, an admixture of mucus is possible. Always accompanied by edema and hyperemia (redness) of the prepuce leaves, soreness of the head of the penis.
With prostatitis, a cloudy discharge appears at the end of urination, abundant discharge - in the acute period of inflammation; scanty and white - with the transition of the disease into a chronic form. Prostatitis is usually complicated by difficulty urinating and weak erection, in severe cases - up to anuria (complete absence of urine flow) and impotence.
Discharge not associated with inflammation
Spermatorrhea - discharge in the form of passively flowing sperm, occur 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.
Hematorrhea, spotting. Often appears with injuries 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 pass away, blood is released during or immediately after urination, hematorrhea is accompanied by very severe pain (renal colic). Discharge of blood in the hematuric form of glomerulonephritis (inflammation of the renal glomeruli) is combined with edema and consistently high blood pressure, the appearance of protein in the urine.
Discharge brown, with clots of blood or mucus, with an admixture of pus appear with malignant tumors emanating from the prostate, urethra or bladder. Brownish mucus can form during the healing of wounds on the mucous membranes, and is secreted with polyposis of the urethra and / or bladder.
Prostatorrhea is the secretion of the prostate gland flowing from the urethra. It occurs in chronic prostatitis, prostate adenoma, impaired innervation (neurogenic bladder).
Algorithm of examination 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, discharge, rash, etc. Traces of discharge are sometimes noticeable on linen.
- Palpation of the inguinal lymph nodes, assessment of their condition: size, they are hotter or colder than the surrounding tissues, painful or not, soft or dense, mobile or adhered to the skin, whether there are ulcerations above them.
- Finger examination of the prostate; massage of 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 case of prostate adenoma, its lobes are increased 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 can be released from the urethra.
- Material - smears 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, injuries of the genitourinary organs, urolithiasis. A large amount of epithelium is a sign of chronic urethritis, urethral leukoplakia. With spermatorrhea, sperm cells are found in a smear, with urethorrhea - mucus, prostatorrhea - lipid grains. For informational content and reliability of the results, the smear is taken no earlier than 3 days after the topical application of antibiotics, antifungal and disinfectants. If 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 for sugar - in the morning, on an empty stomach. Expanded urinalysis (morning portion, immediately after sleep).
- Ultrasound of the prostate, bladder and kidneys; CT and urography.
If the manifestations of genital inflammation are strong, then 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 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 one symptom that cannot be guided by when making a diagnosis.
- The independent appointment of the farm is unacceptable. drugs, even if the manifestations seem obvious for a particular disease.