Discharge from the genitals in men is discharge from the urethra (urethra) and the secretion of the preputial gland, located at the head of the penis, under the skin of the foreskin. The ejaculatory duct, prostate duct, urethra and bulbourethral glands open into the urethra.
In healthy men, only urine and ejaculate flow through the urethra. This is a physiological discharge from the penis and should not cause any discomfort. Unfortunately, this is not always the case.
For a variety of reasons, men’s health shivers instead of normal vaginal discharge, abnormal vaginal discharge appears or urine and semen change.
Physiological secretion variants
Criteria for normal discharge corresponding to the function of the organs of the urogenital system:
- Urine - clear, from straw to golden yellow, almost odorless, containing no flakes or other inclusions;
- The secretion of the prostate has a viscous consistency and whitish color, there is a specific odor of spermine;
- Ejaculation: sperm from the ejaculatory tract mixed with secretions from the Littre glands (urethra), Cooper (bulbourethral) and prostate secretions, acquiring a grayish white color and mucus consistency;
- Fresh smegma from the preputial gland is like a thick white grease; may turn yellowish or greenish from time to time.
The preputial lubricant - smegma - is constantly removed, accumulating under the inner lining of the foreskin and in the corona groove of the penis. The lubricant consists of fat and bacterial residues, is evenly distributed and reduces friction between the skin of the foreskin and glans. Maximum activity of the preputial gland is present during puberty; with age, secretions decrease and stop completely in old age.
If you ignore the rules of personal hygiene, then smegma can accumulate under the folds of the foreskin. In this case, the fat part of the lubricant is oxidized, and the protein part decomposes (in fact, it rots), and the mass turns green, acquires 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. The 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 developing tumors.
Urethrorrhea, a colorless, colorless mucus from the bulbourethral glands and urethra. Release data appear in men with libido -associated stimuli. The excretion of clear mucus is intended to lubricate the urethra and improve the passage of semen. The amount of secretion ranges from little to much, these parameters are associated with individual characteristics of the organism and the frequency of sexual activity. After prolonged abstinence, the amount of secretion increases.
Contamination is the spontaneous release of sperm, not associated with sexual intercourse. It is usually seen in the morning when testosterone levels rise. Depending on age and intensity of sexual activity: it appears in boys during puberty, in adult men - with irregular or infrequent intercourse.
Prostatorrhea, the discharge from the urethra of a small amount of transparent mucus with grayish white inclusions. It occurs after abdominal muscle tension (for example, with constipation) or after urination. The secret consists of a mixture of semen and prostate discharge, increased volume and opacity can be signs of prostatitis.
Pathological discharge
In men, the cause of discharge from the penis can be an STD, tumor, nonspecific inflammation of the urogenital organs, various injuries, medical manipulation or surgery.
Pathological discharge from the urethra differs from normal:
- By volume (too much or limited, maybe moderate);
- In color and transparency (from white to yellow-green, cloudy);
- By impurities (blood, pus, lumps of mucus);
- Consistency (too thin or too thick and sticky);
- With odor (sour, foul, fishy);
- According to the frequency of occurrence (depending on the time of day, continuous or episodic discharge);
- In connection with urination, sexual arousal, with the intake of alcohol, spicy and spicy foods.
The nature of the release depends on the causative agent of the disease, the status of the immune system, on the corresponding disease, as well as on 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 perform a test. Self -diagnosis is not worth it, it is very difficult to diagnose the disease correctly with just one symptom.
Discharge from the penis associated with an STD
Mucosa: transparent, viscous discharge and small in quantity, found in chronic forms of chlamydia, mycoplasma or ureaplasma urethritis. Microscopy revealed a moderate number of leukocytes in the secretion (the norm is up to 4 cells per field of view).
Mucopurulent: white, translucent discharge; observed in the exacerbation phase with chlamydia, ureaplasmosis and mycoplasmosis. In chlamydial infections, they accumulate at the head of the penis, as if "sticking" to the skin.
With the pathology 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 out".
It happens that the secret of white color seems to cover the head. This is observed with chlamydia, candidiasis. In the first case, a film is formed, in the second - a loose cheesy bloom.
Purulent discharge with an unpleasant odor is characteristic of gonorrhea. They are sticky, thick, yellow or greenish in color, with a foul odor. Microscopic examination of the material showed epithelial cells from the urethra, many leukocytes.
Symptoms that accompany gonorrheal urethritis: persistent and numerous discharge; pain, itching, and burning are especially severe when urinating.
In venereal disease, 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 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 are used with a high degree of reliability, rather than discharge characteristics.
Nonspecific (non -venereal) inflammation.
The cause of nonspecific inflammation is its own microflora, which is conditionally pathogenic 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 antibiotic treatment, after a course of radiation. and chemotherapy.
Non -gonorrheal urethritis (not specific). The inflammatory discharge is small in volume, visible in the urine as mucopurulent cords or lumps, appearing 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 ascending infection, the bladder first becomes inflamed, followed by the ureters and kidneys; discharge with a mixture of red blood appears.
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 a curdled discharge with a sour odor, which is combined with itching and burning during miction (urination) and ejaculation (ejaculation), and may be accompanied by dull pain in the groin, above the pubis and in the lower back.
Gardnerellosis urethra. The fishy smell of the discharge is characteristic; they are slight, yellowish white or greenish. According to some classifications, gardnerellosis is referred to as an STD, but in men, sexual infection with gardnerella is more likely to arouse curiosity. In fact, the disease is associated with a violation of the normal microflora, that is, with dysbiosis. In its treatment, immunocorrectors and probiotics (lactic acid bacteria) must be used.
Balanoposthitis, inflammation of the foreskin. Numerous purulent discharge is observed locally, a mixture of mucus is possible. Always accompanied by edema and hyperemia (redness) of the prepuce leaves, penile headache.
With prostatitis, a cloudy discharge appears at the end of urination, a copious discharge - in the period of acute inflammation; little and white - with the transition of the disease into a chronic form. Prostatitis is usually complicated by difficulty urinating and poor erections, in severe cases - up to anuria (complete absence of urine flow) and impotence.
Discharge is not associated with inflammation
Spermatorrhea - a 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 in the genital area. Spermatorrhea is associated with violations of conservation and decreased tone of the vas deferens.
Hematorrhea, spots. Often appears with injury of the urethral canal received during bougienage, after inserting a catheter or when taking a smear from the mucous membrane. In this case, fresh blood, without clots, the amount is small, the bleeding stops quickly. When small stones or sand are gone, blood is expelled during or immediately after urination, hematorrhea is accompanied by very severe pain (renal colic). Blood discharge in the form of hematuric glomerulonephritis (inflammation of the glomeruli of the kidneys) is combined with edema and consistently high blood pressure, the appearance of proteins in the urine.
The discharge is brown in color, with clotted blood or mucus, with a mixture of pus appearing in malignant tumors originating from the prostate, urethra or bladder. Brownish mucus can form during wound healing on the mucous membranes, and is secreted with polyposis of the urethra and / or bladder.
Prostatorrhea is a secretion of the prostate gland that flows from the urethra. It occurs in chronic prostatitis, prostate adenoma, impaired conservation (neurogenic bladder).
Examination algorithm in the presence of pathological discharge from the penis
- Examination of the perineum, penis, foreskin and glands. The goal is to identify the genital defect, the effects of its injury, signs of external inflammation, discharge, rash, etc. The effect of the discharge is sometimes noticeable on the linen.
- Palpation of the inguinal lymph nodes, assessment of their condition: size, they are warmer or colder than the surrounding tissue, painful or not, soft or dense, mobile or attached to the skin, whether there is an ulcer on it.
- Examination of the prostate finger; massage the prostate through the rectum and obtain secretions for microscopic examination. Before massaging, it is advisable to hold urine for 1-2 hours. In the case of prostate adenoma, the lobes increase more or less the same, dense strands are felt. For malignant tumors, uneven growth and consistency are typical; during palpation of the prostate, blood with clots can be removed from the urethra.
- Materials - smears for microscopes and cultures. When examined under a microscope, colored smears show blood cells, epithelium, sperm, fat 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, injuries of the genitourinary organs, urolithiasis. A large amount of epithelium is a sign of chronic urethritis, urethral leukoplakia. With spermatorrhea, sperm cells are found in the smear, with urethorrhea - mucus, prostatorrhea - lipid granules. For information content and reliability of results, smears were taken no earlier than 3 days after topical application of antibiotics, antifungals and disinfectants. If antibiotic treatment is systemic, then at least 3 weeks should elapse after the course. Before taking the 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. Extended 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 test results are obtained, the patient is immediately given a broad -spectrum antibiotic of action. With heavy bleeding, hospitalization and active action to stop the bleeding are indicated. Confirmation of the suspicion of a 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 a symptom that should not be guided when making a diagnosis.
- Farm -independent appointments are not acceptable. drugs, although the manifestations are obvious for certain diseases.