Discharges from the genital organs in men are discharge from the urethra (urethra) and the secretion of the prepuce glands, which are located on the head of the penis, under the skin of the foreskin.The ejaculatory ducts, prostate ducts, urethral and bulburethral 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 concern.Unfortunately, this is not always the case.
For various reasons, men's health weakens and instead of normal discharge, abnormal discharge or changes in urine and sperm appear.
Variants of physiological secretions
Criteria for normal discharge corresponding to the functions of the organs of the urogenital system:
- Urine is clear, straw-colored to golden yellow, practically odorless and does not contain flakes or other inclusions;
- Prostate secretion has a viscous consistency and a white tint, and has a specific smell of semen;
- Ejaculation: semen from the ejaculatory duct mixes with secretions from the Littre (urethral), Cooper (bulbourethral) glands and prostate secretions, taking on a gray-white color and mucous consistency;
- Fresh smegma from the preputial glands looks like a thick white lubricant;it may turn yellow or green 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 fats and bacterial residues, distributes evenly 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 with 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 fatty part of the lubricant is oxidized, and the protein part breaks down (in fact, it is rotting), and the mass becomes green, taking on an unpleasant smell.The same process occurs with phimosis, when, due to the melting 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 glans of the penis), increasing the risk of tumor development.
Urethral, mucous, colorless discharge from bulburethral and urethral glands.These discharges appear in men during sexual excitement.The excretion of clear mucus is intended to lubricate the urethra and improve sperm passage.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 discharge volume increases.
A wet dream is a spontaneous release of sperm that is not associated with sexual intercourse.It is usually seen in the morning, when testosterone levels rise.It depends on the age and the 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 white-gray inclusions.It occurs after straining the abdominal muscles (for example, with constipation) or after urination.The secretion consists of a mixture of seminal fluid and prostatic 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 inflammations of the genital organs, various injuries, medical procedures or operations.
Pathological discharge from the urethra differs from normal:
- By volume (very abundant or scarce, possibly moderate);
- According to color and transparency (from white to yellow-green, cloudy);
- From impurities (blood, pus, lumps of mucus);
- Consistency (too runny or too thick and sticky);
- From the smell (sour, rotten, of fish);
- According to the frequency of occurrence (depending on the time of day, constant or episodic discharge);
- Regarding urination, sexual arousal, drinking alcohol, hot and spicy foods.
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 the 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 have tests done.There is no point in self-diagnosis;it is very difficult to correctly recognize the disease based on only one symptom.
Penile discharge associated with sexually transmitted diseases
Mucous: transparent discharge, viscous and small in quantity, appears in the chronic form of chlamydia, mycoplasma or ureaplasmic urethritis.Microscopy reveals a moderate number of leukocytes in the discharge (the rate is up to 4 cells in the field of view).
Mucopurulent: white, transparent discharge;observed in the acute phase of chlamydia, ureaplasmosis and mycoplasmosis.With chlamydial 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, as microorganisms irritate the mucous membrane of the urethra and the body tries to "wash them away".
It happens that a white discharge 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 layer.
Purulent discharge with an unpleasant odor is characteristic of gonorrhea.They are sticky, thick, yellow or green in color and have a rotten smell.Under the microscope, epithelial cells from the urethra and many leukocytes are visible in the material.
Symptoms accompanying gonorrheal urethritis: continuous and heavy flow;pain, itching and burning are especially strong during urination.
With sexually transmitted diseases, combined infections are often observed, combining several pathogens at the same time.Gonorrhea and trichomoniasis are associated with chlamydia;mycoplasmosis and ureaplasmosis usually occur 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 the secretions.
Non-specific (non-venereal) inflammation.
The cause of nonspecific inflammation is its microflora, which is classified as opportunistic 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 multiply actively and displace beneficial bacteria after hypothermia, prolonged stress, uncontrolled treatment with antibiotics, after courses of radiation and chemotherapy.
Nongonorrheal (nonspecific) urethritis.Inflammatory discharges are small in volume, visible in the urine as mucopurulent threads or lumps and appear at the 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 increasing infection, the bladder is inflamed first, followed by the ureters and kidneys;discharge mixed with red blood appears.
Candidiasis (thrush), 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 curd-like discharge with a sour smell, which is combined with itching and burning during micturition (urinating) 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 smell;they are few, yellow-white or green.According to some classifications, gardnerella is classified as an STD, but in men, infection with gardnerella through sexual contact is more of a curiosity.In fact, this disease is associated with a breakdown of the normal microflora, that is, with dysbacteriosis.During its treatment, immunocorrectors and probiotics (lactic acid bacteria) are necessarily 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 foreskin, pain in the head of the penis.
With prostatitis, cloudy discharge appears at the end of urination, abundant discharge - during the acute period of inflammation;scanty and white - when the disease becomes chronic.Prostatitis is usually complicated by difficulty urinating and erectile weakness, in severe cases up to anuria (complete lack of urine output) and impotence.
The discharge is not accompanied by inflammation
Spermatorhea is a 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 of the genital area.Spermatorea is associated with impaired innervation and decreased tone of the vas deferens.
Hematorrhea, flow of blood.It often occurs with injuries to the urethral canal obtained during bougienation, after the insertion of a catheter or when a smear is taken from the mucosa.In these cases, 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 urination or immediately after urination, hematorrhea is accompanied by very strong pain (renal colic).Blood discharge in the hematuric form of glomerulonephritis (inflammation of the renal glomeruli) is combined with edema and persistently elevated blood pressure and the appearance of protein in the urine.
Brown discharge, with clots of blood or mucus, mixed with pus, occurs with malignant tumors arising from the prostate, urethra or bladder.Brown mucus may form during mucosal wound healing and is released during urethral and/or bladder polyposis.
Prostatorrhea is the secretion of the prostate gland that flows from the urethra.Occurs in chronic prostatitis, prostate adenoma, damaged innervation (neurogenic bladder).
Examination algorithm for the presence of pathological discharge from the penis
- Inspection of the perineum, penis, foreskin and glans.The goal is to identify genital deformities, traces of injuries, signs of external inflammation, secretions, rashes, etc.Traces of secretions are sometimes visible in the underwear.
- Palpation of the inguinal lymph nodes, assessment of their condition: size, whether they are hotter or colder than the surrounding tissues, painful or not, soft or hard, mobile or sticking to the skin, if there are ulcers on them.
- Digital prostate examination;massage the prostate through the rectum and collect secretions for microscopic examination.Before the massage, it is advisable to refrain from urinating for 1-2 hours.With prostate adenoma, 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, clotted blood can be released from the urethra.
- Material: stains for microscopy and culture.When examined under a microscope, the smear reveals blood cells, epithelium, sperm, fatty 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 - of urethritis due to allergies.Red blood cells are detected in severe inflammation, tumors, injuries of genitourinary organs and urolithiasis.A large amount of epithelium is a sign of chronic urethritis, urethral leukoplakia.With spermatorrhoea, spermatozoa are found in the spot, with urethral - mucus, prostatorrhoea - lipid grains.For the content of information and the reliability of the results, a smear is taken no earlier than 3 days after the local use of antibiotics, antifungals and disinfectants.If the antibiotic treatment was systemic, then at least 3 weeks should pass after the course.Before you get a stain, don't wash it;try not to urinate for 2-3 hours.
- General clinical blood test, blood sugar test - 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 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 established on the basis of histological examination.
Important:
- Penile discharge is only a symptom that cannot be used as a guide when making a diagnosis.
- Independent prescription of pharmaceutical drugs is unacceptable.drugs, even if the manifestations seem obvious for a certain disease.