The 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, the prostatic ducts, the urethral and bulbourethral glands 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 shouldn't cause any discomfort. Unfortunately, this isn't always the case.
For various reasons, men's health trembles, and instead of normal discharge, abnormal discharge appears or urine and sperm change
Variants of physiological secretions
Criteria for normal discharge corresponding to the functions of the organs of the urogenital system:
- Urine - clear, straw to golden yellow in color, practically odorless, free of flakes or other inclusions;
- The secret of the prostate has a viscous consistency and a whitish tinge, there is a specific smell of spermine;
- Ejaculate: the sperm of the ejaculatory duct mixes with the secretions of the Littre (urethra), Cooper (bulbourethral) and prostatic glands, acquiring a grayish-white color and mucous consistency;
- The fresh smegma of the preputial glands is like a thick white fat; it can 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 grease and bacterial residues, is evenly distributed and reduces the friction between the skin of the foreskin and the glans penis. The maximum activity of the preputial glands is inherent in the period of puberty; with age, 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 oxidizes 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 folds of the skin and remove the smegma. Buildup 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 bulbourethral and urethral glands. Discharge data appears in men with arousal associated with libido. Clear mucus excretion is intended to lubricate the urethra and improve semen passage. The amount of secretion varies from scarce 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. It depends on the age and intensity of sexual activity: it appears in boys during puberty, in adult men - with irregular or rare intercourse.
Prostatorrea, 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 consists of a mixture of sperm and prostatic secretion, an increase in volume and opacity 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 urogenital organs, various injuries, manipulations or medical 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);
- For impurities (blood, pus, lumps of mucus);
- Textures (very thin or too thick and sticky);
- From the smell (sour, putrid, fishy);
- From the frequency of the event (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 state of the immune system, concomitant disorders, as well as 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 take tests. Self-diagnosis is not worth it, it is very difficult to correctly recognize the disease from only one symptom.
Discharge from the penis associated with sexually transmitted diseases
Mucosa: A clear, viscous, small amount of secretion 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 visual field).
Mucopurulent: white, translucent secretion; observed in the phase of exacerbation with chlamydia, ureaplasmosis and mycoplasmosis. In chlamydial infections, they accumulate on the head of the penis, as if they "stick" 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 off".
It happens that the secret of the 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 melted cheese bloom.
Purulent discharge with an unpleasant odor is characteristic of gonorrhea. They are sticky, thick, yellow or greenish in color, with a putrid smell. Microscopic examination of the material shows epithelial cells of the urethra, many leukocytes.
Symptoms accompanying gonorrhea urethritis: persistent and profuse discharge; pain, itching, and burning are especially severe when urinating.
In sexually transmitted diseases, combined infections are often observed, which combine several pathogens at the same time. 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 with a high degree of reliability are used, and not the features of discharge.
Nonspecific (non-venereal) inflammation
The cause of non-specific 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-gonorrhea (non-specific) urethritis. The inflammatory discharge is small in volume, visible in the urine as mucopurulent cords or lumps, which appear at the very beginning of the disease. Symptoms in the form of burning and itching when urinating 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 appears with an admixture of scarlet blood.
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 radiation therapy; sexual transmission of candidiasis in men is rare. Thrush is characterized by curd discharge with an acrid odor, which combines with itching and burning during urination (urination) and ejaculation (ejaculation) and may be accompanied by dull pain in the groin, above the pubis and in the lower part of the back.
Gardnerellosis of the urethra. Characteristic is the fishy smell of the drain; they are scarce, yellowish white or greenish. According to some classifications, gardnerellosis is referred to as an STD, but sexual infection with gardnerella in men is more likely a curiosity. Indeed, 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 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, abundant discharge - in the acute period of inflammation; scarce 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.
Leaks not associated with inflammation
spermatorrea - discharge in the form of passively flowing sperm, occurring 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. Spermatorhea is associated with a violation of innervation and a decrease in the tone of the vas deferens.
Hematorrea, spotting. It often appears with lesions of the urethral canal received during bougienage, after insertion of a catheter or when taking a smear from the mucosa. 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, bleeding is accompanied by very severe pain (renal colic). Blood discharge in the hematuria form of glomerulonephritis (inflammation of the renal glomeruli) is combined with edema and constantly high blood pressure, the appearance of protein in the urine.
Brown discharge, with blood clots or mucus, with an admixture of pus appear in malignant tumors originating from the prostate, urethra or bladder. Brownish mucus can form during wound healing on mucous membranes and is secreted with polyposis of the urethra and / or bladder.
Prostatorea is the secretion of the prostate gland that flows from the urethra. It occurs in chronic prostatitis, prostate adenoma, impaired innervation (neurogenic bladder).
Algorithm of examination in the presence of pathological secretion 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, rashes, etc. Sometimes there are traces of discharge on the laundry.
- Palpation of the inguinal lymph nodes, assessment of their condition: size, they are warmer or colder than surrounding tissues, painful or not, soft or dense, mobile or adherent to the skin, if there are ulcerations above them.
- Prostate finger examinationmassage of the prostate through the rectum and obtaining secretions for microscopic examination. Before the massage, it is recommended to refrain from urinating for 1-2 hours. In case of prostate adenoma, its lobes increase approximately the same, dense threads are felt. For a malignant tumor, irregular 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 increase in the 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, lesions of the genitourinary organs, urolithiasis. A large amount of epithelium is a sign of chronic urethritis, urethral leukoplakia. With spermatorhea, spermatozoa are found in a smear, with urethorrhea - mucus, prostatorrhea - lipid grains. For informational content and reliability of the results, the smear is carried out no earlier than 3 days after the 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, 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 part, immediately after sleep).
- Ultrasound of the prostate, bladder and kidneys; CT and urography.
If the manifestations of genital inflammation are strong, then before obtaining the test results, the patient is immediately prescribed antibiotics of a broad spectrum of action. With profuse bleeding, hospitalization and active actions to stop bleeding are indicated. Confirmation of a suspicion of 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 guided when making a diagnosis.
- Independent appointment of the farm is unacceptable. drugs, even if the manifestations seem obvious for a particular disease.