The discharge from the male genital organs is the discharge from the urethra (urethra) and the secretion of the prepuce gland, which is located on the head of the penis, under the skin of the foreskin.The ejaculatory duct, prostatic duct, urethra and bulbourethral gland 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 it should not cause any discomfort.Unfortunately, this is not always the case.
For various reasons, men's health becomes weak and instead of normal discharge, abnormal discharge appears or urine and sperm change.
Physiological secretory variants
Criteria for normal discharge corresponding to the function of organs of the urogenital system:
- The urine is clear, straw-colored to golden yellow, practically odorless, and contains no flakes or other inclusions;
- Prostatic secretions have a viscous consistency and a whitish color, and there is a specific smell of sperm;
- Ejaculation: sperm from the ejaculatory ducts mixed with secretions from Littre (urethra), Cooper (bulbourethral) glands and prostate secretions, acquires a gray-white color and mucus consistency;
- Fresh smegma from the preputial glands looks like a thick white lubricant;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 consists of fat and bacterial waste, is distributed evenly and reduces friction between the skin of the foreskin and the glans.The maximum activity of the preputial gland is characteristic of the period of puberty;with age, secretion decreases and in old age it stops completely.
If you neglect the rules of personal hygiene, then 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 (actually, this rots), and the mass becomes greenish, acquiring an unpleasant smell.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 folds of the skin and remove the smegma.Accumulation and breakdown of lubricant can cause chronic balanitis and balanoposthitis (inflammation of the foreskin and glans penis), increasing the risk of tumor development.
Urethrorrhea, mucus, colorless mucus from the bulbourethral and urethral glands.This release appears in men during pleasure associated with libido.Excretion of clear mucus is intended to lubricate the urethra and improve sperm passage.The amount of secretion is from little to much;This parameter is related to the individual characteristics of the body and the frequency of sexual activity.After prolonged abstinence, the amount of discharge increases.
A wet dream is a spontaneous release of sperm that is not associated with sexual intercourse.It is usually observed in the morning, when testosterone levels rise.Depending on the age and 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 transparent mucus with gray-white inclusions.Occurs after straining the abdominal muscles (for example, with constipation) or after urinating.The secretion consists of a mixture of seminal fluid and prostate discharge;increased volume and turbidity may be signs of prostatitis.
Pathological discharge
In men, the cause of discharge from the penis can be STDs, tumors, non-specific inflammation of the urogenital organs, various injuries, medical or surgical procedures.
Pathological discharge from the urethra differs from normal:
- By volume (too much or too little, maybe moderate);
- By color and transparency (from white to yellow-green, cloudy);
- By impurities (blood, pus, lumps of mucus);
- Consistency (very runny or too thick and sticky);
- With a smell (sour, rotten, fishy);
- According to the frequency of appearance (depending on the time of day, continuous or episodic release);
- Related to urination, sexual stimulation, drinking alcohol, hot and spicy food.
The nature of the discharge depends on the causative agent of the disease, the status 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 see a doctor and undergo a test.There is no point in self-diagnosis;it is very difficult to correctly recognize a disease based on only one symptom.
Penile discharge associated with STDs
Mucus: transparent discharge, viscous and small quantity, 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 field of view).
Mucopurulent: white, translucent discharge;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 pathology 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 it away".
It happens that a 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 and cheesy coating.
Purulent discharge with an unpleasant odor is characteristic of gonorrhea.It is sticky, thick, yellow or greenish in color, and has a foul smell.Under the microscope, epithelial cells from the urethra and many leukocytes are visible in the material.
Symptoms accompanying gonorrheal urethritis: constant and heavy discharge;pain, itching and burning very bad when urinating.
With sexually transmitted diseases, combined infections are often observed, combining several pathogens at once.Gonorrhea and trichomoniasis 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, 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 non-specific inflammation is its own microflora, which is classified as opportunistic and is activated only if there is a problem 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 replace beneficial bacteria after hypothermia, prolonged stress, uncontrolled treatment with antibiotics, after a course of radiation and chemotherapy.
Non-nononorrhoea (non-specific) urethritis.Inflammatory discharge is small in number, appears in the urine as mucopurulent strands or lumps, and appears at the beginning of the disease.Symptoms in the form of burning and itching during urination are less pronounced than with gonorrhea, but the desire is frequent and does not bring relief.With an ascending infection, the bladder becomes inflamed first, followed by the ureters and kidneys;discharge mixed with red blood appeared.
Candidiasis (thrush), a fungal infection of the urethra.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 curd-like discharge with a sour smell, which is combined with itching and burning during micturition (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 small, yellowish white or greenish.According to some classifications, gardnerella is classified as an STD, 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.When treating it, immunocorrectors and probiotics (lactic acid bacteria) must be 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 prepuce leaf, penile headache.
With prostatitis, cloudy discharge appears at the end of urination, abundant discharge - during the period of acute inflammation;little and white - when the disease becomes chronic.Prostatitis is usually complicated by difficulty urinating and erectile weakness, in severe cases even to anuria (complete absence of urine production) and impotence.
The discharge is not associated with inflammation
Spermatorrhea is the discharge in the form of passively flowing 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 in the genital area.Spermatorea is associated with a violation of the conservation and decreased tone of the vas deferens.
Hematorrhea, bloody discharge.Often appears with injuries to the urethra received during bougienage, after inserting a catheter, or when taking a smear from the mucous membrane.In this case, the blood is fresh, without clots, the amount is small, and the bleeding stops quickly.When small kidney stones or sand pass, blood is released during or immediately after urination, hematorea is accompanied by very severe pain (renal colic).Blood discharge in the hematuric form of glomerulonephritis (inflammation of the kidney glomeruli) combined with edema and persistent high blood pressure, and the appearance of protein in the urine.
Brown discharge, with clotted blood or mucus, mixed with pus, appears with malignant tumors originating from the prostate, urethra or bladder.Brownish mucus may form during wound healing of the mucous membrane, and is released during polyposis of 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 conservation (neurogenic bladder).
Algorithm of examination for the presence of pathological discharge from the penis
- Examination of the perineum, penis, foreskin and glands.The goal is to identify the deformation of the genital organs, the effects of injury, signs of external inflammation, discharge, rashes, etc.The discharge effect is sometimes noticeable on underwear.
- Palpation of the inguinal lymph node, assessment of its condition: size, whether it is hotter or colder than the surrounding tissue, painful or not, soft or hard, mobile or attached to the skin, whether there is an ulcer on it.
- Digital examination of the prostate;massage the prostate through the rectum and obtain secretions for microscopic examination.Before the massage, it is advised to hold urine for 1-2 hours.With prostate adenoma, the lobes are enlarged more or less equally, a dense cord can be felt.Irregular growth and consistency are typical for malignant tumors;during palpation of the prostate, blood with clots can be removed from the urethra.
- Materials: smears for microscopy and culture.When examined under a microscope, stained smears reveal blood cells, epithelium, sperm, fat 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 - allergic urethritis.Red blood cells are detected in severe inflammation, tumors, genitourinary organ injuries, and urolithiasis.A large number of epithelium is a sign of chronic urethritis, urethral leukoplakia.With spermatorrhea, sperm are found in the smear, with urethrorrhea - mucus, prostatorrhea - lipid grains.For information content and reliability of results, smears are taken no earlier than 3 days after local application of antibiotics, antifungals and disinfectants.If the treatment with antibiotics is 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 blood test, blood sugar test - in the morning, on an empty stomach.Detailed urine analysis (morning part, right 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 heavy bleeding, hospitalization and active measures to stop the bleeding are indicated.Suspicion of a malignant tumor can only be confirmed by biopsy results;The final diagnosis is made based on histological examination.
Important:
- Discharge from the penis is only a symptom that should not be used as a guide when making a diagnosis.
- Non-pharmaceutical prescriptions are not acceptable.drugs, although the manifestations seem clear for certain diseases.