The discharge from the genitals in men is discharge from the urethra (urethra) and the secret of the preputial glands, located on the head of the penis, under the skin of the foreskin. The ejaculatory duct, prostatic ducts, urethral and bulburethral glands open into the urethra.
In a healthy man, only urine and ejaculate pass through the urethra. This is a physiological discharge from the penis and should not cause any discomfort. Unfortunately, this is not always the case.
Due to various reasons, men's health is shaky and instead of normal discharge, abnormal discharge appears or urine and semen change
Variants of physiological secretions
Normal discharge criteria corresponding to the functions of the organs of the urogenital system:
- Urine - clear, straw colored to golden yellow, practically odorless, free from 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: the semen from the ejaculatory duct mixes with the secretions of the Littré (urethral), Cooper (bulbourethral) glands and the prostatic secretions, acquiring a grayish white color and a mucous consistency;
- The fresh smegma of the preputial glands is like a thick white fat; 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 sulcus of the penis. The lubricant is composed of fat and bacterial residue, 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 secretion 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 is oxidized, and the protein part breaks down (in fact, it rots) 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 skin folds and remove smegma. The build-up and breakdown of the lubricant can lead to chronic balanitis and balanoposthitis (inflammation of the foreskin and glans penis), increasing the risk of developing tumors.
Urethrorrhea, mucous and colorless discharge from the bulbo-urethral and urethral glands. Discharge data appears in men with arousal associated with libido. The purpose of excreting clear mucus is to lubricate the urethra and improve the passage of semen. The amount of secretion varies 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 the spontaneous release of sperm, not associated with sexual intercourse. Usually seen in the morning when testosterone levels are increasing. Depends 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 grayish-white inclusions. It occurs after tension in the abdominal muscles (for example, with constipation) or after urination. The secret is a mixture of semen and prostatic 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:
- In volume (too abundant or rare, possibly moderate);
- In color and transparency (from white to yellow-green, cloudy);
- By impurities (blood, pus, pieces of mucus);
- Consistencies (very thin or too thick and sticky);
- By the 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 consumption 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 conditions, as well as the severity and duration of the inflammation (acute or chronic).
If the amount, density or color of the discharge changes, an unpleasant odor appears, it is recommended to consult a doctor and take 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
Mucosa: transparent, viscous discharge in small quantities, found in the chronic form of urethritis due to chlamydia, mycoplasma or ureaplasma. 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 phase of exacerbation with chlamydia, ureaplasmosis and mycoplasmosis. In chlamydia infections, they build up on the head of the penis, as if they "stuck" 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" it.
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 flower of cheese.
A 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 gonorrheic 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 these diseases differs from the classic manifestations; urethral discharge can also take on 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.
Non-specific (non-venereal) inflammation
The cause of non-specific inflammation is its own microflora, which is conditionally pathogenic and is activated only with problems with the body's immune defense. Streptococci and staphylococci, fungi of the genus Candida and E. coli are still present on the surface of the skin and mucous membranes, but they begin to actively multiply and displace beneficial bacteria after hypothermia, prolonged stress, treatmentuncontrolled antibiotic, after cures of radiotherapy and chemotherapy.
Non-gonorrheic urethritis (nonspecific). The inflammatory discharge is small in volume, visible in the urine as mucopurulent cords or lumps, appearing at the very onset 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; a discharge with a mixture of scarlet blood appears.
Candidiasis (thrush), fungal infection of the urethra. Usually develops against the background of suppressed immune system after a course of antibiotics, chemotherapy or radiation therapy; sexual transmission of candidiasis in men is rare. Thrush is characterized by a curdled discharge with a sour smell, which is associated with itching and burning during urination (urination) and ejaculation (ejaculation), and may be accompanied by dull aches in the groin, au-above the pubis and in the lower back.
Gardnerellosis of the urethra. The fishy smell of the landfill is characteristic; they are rare, yellowish-white or greenish. According to some classifications, gardnerellosis is referred to as STD, but in men, sexual infection with gardnerella is more likely a curiosity. In fact, this disease is associated with a violation of normal microflora, that is, dysbiosis. In its treatment, immunocorrectors and probiotics (lactic acid bacteria) are necessarily used.
Balanoposthitis, inflammation of the foreskin. Abundant purulent discharge is observed locally, an admixture of mucus is possible. Always accompanied by edema and hyperemia (redness) of the leaves of the foreskin, pain in the head of the penis.
With prostatitis, cloudy discharge appears at the end of urination, profuse discharge - in the acute period of inflammation; lean and white - with the transition of the disease to a chronic form. Prostatitis is usually complicated by difficulty urinating and a weak erection, in severe cases - up to anuria (complete lack of urine flow) and impotence.
Discharge not associated with inflammation
Spermatorrhea - discharge as passively-flowing semen, occurring outside of intercourse or masturbation, without a feeling of orgasm. The reasons are certain diseases of the nervous system, injuries to the spine, 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 lesions of the urethral canal received during bougienage, after insertion of a catheter or when taking a smear of 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, blood is released during or immediately after urination, hematorrhea is accompanied by very severe pain (renal colic). The outflow of blood in the hematuric form of glomerulonephritis (inflammation of the renal glomeruli) is accompanied by edema and constantly high blood pressure, the appearance of protein in the urine.
Brown discharge, with clots of blood or mucus, with an admixture of pus, appears in malignant tumors emanating from the prostate, urethra, or bladder. Brownish mucus can form as wounds on the mucous membranes heal, and is secreted with polyposis of the urethra and / or bladder.
Prostatorrhea is the prostate gland secretion that drains from the urethra. It occurs in chronic prostatitis, prostate adenomas, innervation disorders (neurogenic vesicle).
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 genitals, traces of their injury, signs of external inflammation, discharge, rashes, etc. Traces of leakage are sometimes noticeable on the laundry.
- Palpation of the inguinal lymph nodes, assessment of their condition: in size, they are hotter or colder than the surrounding tissues, painful or not, soft or dense, mobile or adherent to the skin, whether there are ulcers at-above them.
- Examination of the prostate fingers; massage the prostate through the rectum and obtain secretions for microscopic examination. Before the massage, it is advisable to refrain from urinating for 1 to 2 hours. With adenoma of the prostate, its lobes are increased almost equally, dense strands are felt. For a malignant tumor, uneven growths and their consistency are typical; when palpating 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, certain pathogens (Escherichia coli, gonococci, gardnerella, yeast). An increased number of leukocytes is characteristic of acute urethritis or exacerbation of chronic inflammation, eosinophils - for allergic urethritis. Erythrocytes are found in severe inflammation, tumors, damage to 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, along with urethhorrhea - mucus, prostatorrhea - fat grains. For informative content and reliability of the results, the smear is carried out 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 yourself, try not to urinate for 2-3 hours.
- General clinical analysis of blood, blood for sugar - in the morning, on an empty stomach. Enlarged urinalysis (morning portion, immediately after sleep).
- Ultrasound of the prostate, bladder and kidneys; CT and urography.
If the manifestations of genital inflammation are strong, before obtaining the test results, the patient is immediately prescribed antibiotics with a broad spectrum of action. In case of heavy bleeding, hospitalization and active actions to stop the bleeding are indicated. Confirmation of a suspected malignant tumor can only be the result of a biopsy, the final diagnosis is made on the basis of histological examination.
Important:
- Discharge from the penis is just one symptom that cannot be guided by a diagnosis.
- The independent appointment of the farm is unacceptable. drugs, even if the manifestations seem obvious for a particular disease.