Discharge from the genitals in men is 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, the prostate duct, the urethra and the bulbourethral gland open into the urethra.
In a healthy man, only urine and ejaculate flow through the urethra. This is a physiological discharge from the penis and should not cause discomfort. Unfortunately, this is not always the case.
For various reasons, men's health is shaky, and instead of normal discharge, abnormal discharge occurs, or urine and sperm change
Variants of physiological secretions
Criteria for normal discharge according to the functions of the organs of the genitourinary system:
- Urine - clear, from straw yellow to golden yellow in color, practically odorless, without flakes or other inclusions;
- The secret of the prostate has a viscous consistency and a whitish tinge, it smells like sperm;
- Ejaculate: Sperm from the ejaculation duct mixes with secretions from the Littre glands (urethra), Coopers (bulbourethral) and prostate secretions, taking on a grayish-white color and a slimy consistency;
- Fresh smegma from the preputial glands is like thick white fat; can turn yellowish or greenish over time.
The preputial lubricant - smegma - is constantly being released and accumulates under the inner layer of the foreskin and in the coronal groove of the penis. The lubricant consists of fat and bacterial residues, is distributed evenly and reduces the friction between the skin of the foreskin and the glans. The maximum activity of the preputial glands is inherent in puberty, with age, secretion decreases and completely stops with age.
If you neglect the rules of personal hygiene, smegma can build up under the folds of the foreskin. In this case, the greasy part of the lubricant is oxidized and the protein part decomposes (in fact, it rots), and the masses turn greenish and take on an unpleasant odor. The same process occurs in phimosis, when, due to the merging of the foreskin, it is impossible to completely free the head of the penis from the folds of the skin and remove the smegma. The build-up and breakdown of lubricant can lead to chronic balanitis and balanoposthitis (inflammation of the foreskin and glans penis), which increase the risk of developing tumors.
Urethrorrhea, slimy, colorless discharge from the bulbourethral and urethral glands. Discharge dates appear in men with arousal associated with libido. The discharge of clear mucus is said to moisten the urethra and improve semen passage. The amount of secretion ranges from scanty to abundant, these parameters are related to the individual characteristics of the organism and the frequency of sexual activity. After a long period of abstinence, the secretion volume increases.
Pollution is a spontaneous release of sperm that is unrelated to sexual intercourse. Usually seen in the morning when testosterone levels are rising. Depending on the age and intensity of sexual activity: it occurs in boys during puberty, in adult men - with irregular or infrequent sexual intercourse.
Prostatorrhea, discharge of a small amount of transparent mucus with grayish-white inclusions from the urethra. It occurs after tension in the abdominal muscles (for example constipation) or after urination. The secret is a mixture of semen and prostate discharge, an increase in 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 inflammation of the genitourinary organs, various injuries, medical manipulation or surgery.
Pathological discharge from the urethra is different 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, lazy, fishy);
- According to the frequency of occurrence (depending on the time of day, continuous or episodic discharge);
- In connection with urination, sexual arousal, the ingestion of alcohol, spicy and spicy foods.
The type of discharge depends on the pathogen, the status of the immune system, concomitant diseases and the severity and duration of the inflammation (acute or chronic).
If the amount, density or color of the discharge changes, if there is an unpleasant odor, it is recommended to consult a doctor and conduct tests. Self-diagnosis is not worthwhile, it is very difficult to correctly identify the disease by just one symptom.
Discharge from the penis related to sexually transmitted diseases
Mucus: transparent discharge, viscous and in small quantities, is found in the chronic form of chlamydia, mycoplasma or ureaplasma urethritis. Microscopy shows a moderate number of leukocytes in the secretion (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 glans as if they were "sticking" to the skin.
In the pathologies described above, the discharge comes 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 the white color seems to cover the head. This is found with chlamydia, candidiasis. In the first case, a film is formed, in the second - a loose cheesy bloom.
Characteristic of gonorrhea is a purulent discharge with an unpleasant odor. They are sticky, thick, yellow or greenish, with a putrid odor. Microscopic examination of the material reveals epithelial cells from the urethra, many leukocytes.
Concomitant symptoms of gonorrheic urethritis: persistent and heavy discharge; Pain, itching, and burning sensation are particularly severe when urinating.
Combined infections, in which several pathogens are combined at the same time, are often observed in sexually transmitted diseases. Gonorrhea and trichomoniasis are accompanied by chlamydia, mycoplasmosis and ureaplasmosis usually occur in pairs. The symptoms of such diseases differ from the classic manifestations; the urethral discharge can also take on a completely different character. Therefore, for the final diagnosis, modern analytical techniques with high reliability, and not the characteristics of the discharge, are used.
Non-specific (non-venereal) inflammation
The cause of unspecific inflammation is its own microflora, which is conditionally pathogenic and is only activated when there are problems with the body's own immune system. Streptococci and staphylococci, fungi of the genus Candida and E. coli are always present on the skin and mucous membrane surface, but begin to actively multiply and displace beneficial bacteria after hypothermia, prolonged stress, uncontrolled antibiotic treatment, after radiation and chemotherapy.
Non gonorrheic (nonspecific) urethritis. The inflammatory discharge is small in volume, visible in the urine as slimy-purulent strands or lumps that appear right at the onset of the disease. Symptoms 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, then the ureters and kidneys; Discharge with an admixture of scarlet blood appears.
Candidiasis (thrush), fungal infection of the urethra. Usually develops against a background of suppression of the immune system after antibiotic, chemotherapy or radiation therapy; sexual transmission of candidiasis in men is rare. Thrush is characterized by clotted discharge with a sour smell associated with itching and burning sensation during urination (urination) and ejaculation (ejaculation), and may be accompanied by dull pain in the groin, pubic bone, and lower back.
Gardnerellosis of the urethra. The fishy smell of the discharge is characteristic; they are sparse, yellowish-white or greenish. According to some classifications, Gardnerellosis is called an STD, but in men, sexual infection with Gardnerella is more of a curiosity. In fact, this disease is associated with a violation of normal microflora, that is, dysbiosis. In its treatment, immune correctors 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 (reddening) of the foreskin leaves, pain in the glans penis.
With prostatitis, at the end of urination, there is cloudy discharge, 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 poor erection, in severe cases, anuria (complete lack of urine flow) and impotence.
Discharge not associated with inflammation
Spermatorrhea - discharge in the form of passively flowing sperm that occurs outside of sexual intercourse or masturbation without feeling 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.
Haematorrhea, spotting. Often occurs when the urethral canal is injured during bougienage, after inserting a catheter, or when taking a swab from the mucous membrane. In these cases, the blood is fresh, without clots, the amount is small, the bleeding stops quickly. If small kidney stones or sand die off, blood is released during or immediately after urination, the haematorrhea is accompanied by very severe pain (renal colic). The outflow of blood in the hematous form of glomerulonephritis (inflammation of the kidney glomeruli) is associated with edema and persistent high blood pressure, the appearance of protein in the urine.
Discharge brown, with clots of blood or mucus, with an admixture of pus, occurs in malignant tumors that originate from the prostate, urethra or bladder. During wound healing on the mucous membranes, brownish mucus can form, which is secreted in polyposis of the urethra and / or bladder.
Prostatorrhea is the secretion from the prostate that flows out of the urethra. It occurs with chronic prostatitis, prostate adenoma, impaired innervation (neurogenic bladder).
Examination algorithm for pathological discharge from the penis
- Examination of the perineum, penis, foreskin and glans. The aim is to detect malformations of the genital organs, traces of their injury, signs of external inflammation, discharge, rash, etc. Traces of leakage can sometimes be seen on the laundry.
- Palpation of the inguinal lymph nodes, assessment of their condition: size, they are hotter or colder than the surrounding tissue, painful or not, soft or dense, mobile or clinging to the skin, whether there is any ulceration over them.
- Finger examination of the prostate; Massage the prostate through the rectum and extract secretions for microscopic examination. Before the massage, it is advisable to refrain from urinating for 1-2 hours. With a prostate adenoma, its lobes are about the same size, dense strands can be felt. Uneven growths and their consistency are typical of a malignant tumor; when palpating the prostate, blood with clots can be released from the urethra.
- Material - smears for microscopy and culture. Under the microscope, a colored smear shows blood cells, epithelium, sperm, fat inclusions, some pathogens (Escherichia coli, gonococci, Gardnerella, yeast). An increased number of leukocytes is characteristic of acute urethritis or an exacerbation of chronic inflammation, eosinophils - urethritis with allergies. Erythrocytes are found with severe inflammation, tumors, injuries to 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 topical application of antibiotics, antifungal agents and disinfectants. If antibiotic treatment was systemic, at least 3 weeks should pass after the course. Do not wash before smear, do not urinate for 2-3 hours.
- General clinical analysis of blood, blood on sugar - in the morning on an empty stomach. Extended urinalysis (morning portion, immediately after bed).
- Ultrasound of the prostate, bladder and kidneys; CT and urography.
If the manifestations of genital inflammation are severe, then the patient is immediately prescribed antibiotics with a wide spectrum of action before the test results are available. If the bleeding is profuse, hospitalization and active hemostasis measures are indicated. Confirmation of 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 used as a guide when making a diagnosis.
- The independent appointment of the court is unacceptable. Drugs, even if the manifestations for a particular disease seem obvious.