The secretion of the genital organs in men is the secretion of the urethra (urethra) and the secretion of the foreskin glands, which are located on the head of the penis, under the skin of the foreskin.The ejaculatory duct, prostate ducts, urethral and bulbourethral 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 discomfort.Unfortunately, this is not always the case.
For various reasons, a man's health becomes weakened 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 genitourinary system:
- The urine is clear, straw yellow to golden in color, practically odorless and does not contain flakes or other inclusions;
- Prostate secretion has a viscous consistency and a whitish hue, and there is a specific smell of sperm;
- Ejaculate: sperm from the ejaculatory duct mix with secretions from the Littre (urethral) and Cooper (bulbourethral) glands and prostatic secretions, acquiring a grayish-white color and mucous consistency;
- Fresh smegma from the preputial glands looks like a thick, white lubricant;it may turn yellowish or greenish over time.
The preputial lubricant - smegma - is constantly secreted, accumulating under the inner layer of the foreskin and in the coronal groove of the penis.The lubricant is composed of fats and bacterial residues, is evenly distributed and reduces friction between the skin of the foreskin and the glans.The maximum activity of the preputial glands is characteristic of the period of puberty;with age, secretion decreases and in old age it stops completely.
If you neglect personal hygiene rules, smegma can accumulate under the folds of the foreskin.In this case, the fatty part of the lubricant oxidizes and the protein part disintegrates (in fact, it is rotting), 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 the skin folds and remove the smegma.The accumulation and degradation of lubricant can cause chronic balanitis and balanoposthitis (inflammation of the foreskin and glans penis), increasing the risk of tumor development.
Urethrorrhea, mucous and colorless secretion from the bulbourethral and urethral glands.These secretions appear in men during arousal associated with libido.The excretion of clear mucus aims to lubricate the urethra and improve the passage of sperm.The amount of secretion varies from scarce to abundant;these parameters are related to the individual characteristics of the body and the frequency of sexual activity.After prolonged abstinence, the volume of secretion increases.
A wet dream is a spontaneous release of sperm not associated with sexual intercourse.Usually observed in the morning when testosterone levels increase.It 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 clear mucus with grayish-white inclusions.It occurs after distension of the abdominal muscles (for example, with constipation) or after urinating.The secretion consists of a mixture of seminal fluid and prostatic secretion;Increased volume and cloudiness may be signs of prostatitis.
Pathological discharge
In men, the causes of penile discharge can be STDs, tumors, nonspecific inflammation of the urogenital organs, various injuries, medical procedures or operations.
Pathological discharge from the urethra differs from normal:
- By volume (very abundant or scarce, perhaps moderate);
- By color and transparency (from white to yellow-green, cloudy);
- By impurities (blood, pus, mucus lumps);
- Consistency (very liquid or very thick and sticky);
- By smell (sour, putrid, fishy);
- According to the frequency of appearance (depending on the time of day, constant or episodic discharge);
- In connection with urination, sexual arousal, consumption of alcohol, hot and spicy foods.
The nature of the secretion depends on the causative agent of the disease, the state of the immune system, concomitant diseases, as well as the severity and duration of inflammation (acute or chronic).
If there is a change in the quantity, density or color of the discharge, or if an unpleasant odor appears, it is recommended to consult a doctor and undergo tests.There is no point in self-diagnosis;It is very difficult to correctly recognize the disease based on just one symptom.
Penile discharge associated with STDs
Mucous: transparent, viscous discharge in small quantities, occurs in the chronic form of urethritis caused by chlamydia, mycoplasma or ureaplasma.Microscopy reveals a moderate number of leukocytes in the secretion (the norm is up to 4 cells in the field of view).
Mucopurulent: white, translucent discharge;observed in the acute phase of chlamydia, ureaplasmosis and mycoplasmosis.In chlamydia infection, they accumulate on the head of the penis, as if they were “sticking” to the skin.
In the pathologies described above, the discharge will come from the urethra itself, as microorganisms irritate the urethra mucosa and the body tries to “wash them away”.
It turns out 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, curdled layer.
Purulent discharge with an unpleasant odor is characteristic of gonorrhea.They are sticky, thick, yellow or greenish in color and have a putrid odor.Under microscopy, urethral epithelial cells and many leukocytes are visible in the material.
Symptoms accompanying gonorrheal urethritis: constant and abundant 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 symptoms of these 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.
Nonspecific (nonvenereal) inflammation
The cause of non-specific inflammation is the microflora itself, which is classified as opportunistic and is only activated in the event of problems in 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 treatment with antibiotics, after courses of radiation and chemotherapy.
Non-gonorrheal (nonspecific) urethritis.The inflammatory secretion is small in volume, visible in the urine as mucopurulent threads or lumps and appears at the beginning of the disease.Symptoms in the form of burning and itching when urinating are less pronounced than in gonorrhea, but the urge is frequent and does not bring relief.With ascending infection, the bladder becomes inflamed first, followed by the ureters and kidneys;discharge mixed with scarlet 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.Candidiasis is characterized by a curd-like discharge with a sour odor, which is combined 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 back.
Gardnerellosis of the urethra.The secretion has a fishy odor;they are scarce, yellowish-white or greenish.According to some classifications, Gardnerella is classified as an STD, but in men, Gardnerella infection through sexual contact is more of a curiosity.In fact, this disease is associated with a disruption of normal microflora, that is, with dysbiosis.In the treatment, immunocorrectors and probiotics (lactic acid bacteria) are mandatory.
Balanoposthitis, inflammation of the foreskin.Locally, abundant purulent secretion is observed, and there may be an admixture of mucus.They are always accompanied by swelling and hyperemia (redness) of the foreskin sheets, 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 weak erection, in severe cases even anuria (complete absence of urine production) and impotence.
Discharge not associated with inflammation
Spermatorrhea is a secretion in the form of passively flowing sperm that occurs 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.Spermatorea is associated with impaired innervation and decreased tone of the vas deferens.
Hematorrhea, bloody discharge.It often appears with injuries to the urethral canal received during bougienage, after insertion of a catheter or when taking a smear from the mucous membrane.In these cases, the blood is fresh, without clots, the quantity is small and the bleeding stops quickly.When small kidney stones or sand pass, blood is released during or immediately after urination, hematorrhea is accompanied by very severe pain (renal colic).Bloody 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 blood clots or mucus mixed with pus, appears with malignant tumors originating from the prostate, urethra or bladder.Brownish mucus can form during wound healing on mucous membranes and is released during polyposis of the urethra and/or bladder.
Prostatorrhea is prostate secretion flowing from the urethra.It occurs in chronic prostatitis, prostate adenoma, impaired innervation (neurogenic bladder).
Examination algorithm for the presence of pathological discharge from the penis
- Inspection of the perineum, penis, foreskin and glans.The aim is to identify deformations of the genital organs, traces of injuries, signs of external inflammation, discharge, rash, etc.
- 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 adherent to the skin, whether there are ulcerations on them.
- Digital prostate exam;massage the prostate through the rectum and obtain secretions for microscopic examination.Before the massage, it is advisable not to urinate for 1 to 2 hours.In prostate adenoma, its lobes are approximately equally enlarged and dense cords are palpable.Irregular growths and their consistency are typical of a malignant tumor;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, the stained 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, lesions of the genitourinary organs and urolithiasis.A large amount of epithelium is a sign of chronic urethritis, urethral leukoplakia.With spermatorrhea, spermatozoa are found in the smear, with urethrorrhea - mucus, with prostatorrhea - lipid grains.For informative content and reliability of results, the smear is taken no later than 3 days after local use of antibiotics, antifungals and disinfectants.If antibiotic treatment is systemic, at least 3 weeks should pass after the course.Before taking the smear, do not wash;try not to urinate for 2 to 3 hours.
- General clinical blood test, blood sugar test - in the morning, on an empty stomach.Detailed urine analysis (morning portion, immediately after bed).
- Ultrasound of the prostate, bladder and kidneys;Computed tomography and urography.
If the manifestations of genital inflammation are severe, then before receiving the test results, the patient will immediately be given 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 results of a biopsy;the final diagnosis is made based on histological examination.
Important:
- Penile discharge is just a symptom that cannot be used as a guide in diagnosis.
- Independent prescribing of pharmaceutical products is unacceptable.medications, even if the manifestations seem obvious for a specific disease.