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 empty into the urethra.
In a healthy man, only urine and ejaculate flow through the urethra.They are physiological discharges from the penis and should not cause any discomfort.Unfortunately, this is not always the case.
For various reasons, men's health weakens 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 urogenital system:
- The urine is clear, straw yellow to golden in color, virtually odorless, and contains no flakes or other inclusions;
- Prostate secretion has a viscous consistency and a whitish tint, and there is a specific sperm odor;
- Ejaculate: the sperm from the ejaculatory duct mix with the secretions of the Littre (urethral), 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 and accumulates under the inner layer of the foreskin and in the coronal sulcus of the penis.The lubricant is composed of fats and bacterial residues, is distributed evenly 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 with old age it stops completely.
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 disintegrates (in fact, it rots), 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 skin folds and remove the smegma.The accumulation and breakdown of lubricant can cause chronic balanitis and balanoposthitis (inflammation of the foreskin and glans of the penis), increasing the risk of tumor development.
Urethrorrhea, colorless mucous discharge from the bulbourethral and urethral glands.These discharges appear in men during excitement 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 scant to abundant;These parameters are related to 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.It is usually seen in the morning, when testosterone levels increase.It depends on the age and intensity of sexual activity: it appears in children during puberty, in adult men, with irregular or infrequent sexual relations.
Prostatorrhea, discharge from the urethra of a small amount of transparent mucus with grayish-white inclusions.It occurs after straining the abdominal muscles (for example, with constipation) or after urinating.The secretion consists of a mixture of seminal fluid and prostate secretion;Increased volume and cloudiness can be signs of prostatitis.
pathological discharge
In men, the causes of penile discharge can be sexually transmitted diseases, tumors, nonspecific inflammation of the urogenital organs, various injuries, medical procedures or operations.
Pathological discharge from the urethra differs from normal:
- By volume (too abundant or scarce, perhaps moderate);
- By color and transparency (from white to greenish-yellow, cloudy);
- Due to impurities (blood, pus, lumps of mucus);
- Consistency (too runny or too thick and sticky);
- By smell (sour, putrid, fishy);
- Depending on the frequency of appearance (depending on the time of day, constant or episodic secretion);
- In relation to urination, sexual arousal, alcohol consumption, spicy and spicy foods.
The nature of the secretion depends on the causative agent of the disease, the state of the immune system, concomitant ailments, as well as the severity and duration of inflammation (acute or chronic).
If there is a change in the amount, 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 a single symptom.
Penile discharge associated with STDs
Mucous: transparent, viscous and small quantity secretion, occurs in the chronic form of urethritis due to 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 "stick" to the skin.
In the pathologies described above, the secretion will come from the urethra itself, since the microorganisms irritate the mucosa of the urethra and the body tries to “wash” them.
It happens 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, corny 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 seen in the material.
Symptoms accompanying gonorrheal urethritis: abundant and constant discharge;The pain, itching and burning are especially intense 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, modern analytical techniques with a high degree of reliability are used for the final diagnosis, and not the characteristics of the secretions.
Nonspecific (non-venereal) inflammation
The cause of nonspecific inflammation is its own microflora, which is classified as opportunistic and is activated only in case of problems 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 multiply and actively displace beneficial bacteria after hypothermia, prolonged stress, uncontrolled treatment with antibiotics, after courses of radiation and chemotherapy.
Non-gonorrheic (nonspecific) urethritis.The inflammatory secretion is small in volume, visible in the urine as mucopurulent strands or lumps, and appears at the 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 relieve.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 in the context of suppression of the immune system after treatment with antibiotics, chemotherapy or radiotherapy;Sexual transmission of candidiasis in men is rare.Thrush is characterized by curd-like discharge with a sour odor, which is combined with itching and burning during urination (micturition) 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 discharge has a fishy odor;They are scarce, yellowish white or greenish in color.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 the normal microflora, that is, with dysbacteriosis.Immunocorrectors and probiotics (lactic acid bacteria) are necessarily used in its treatment.
Balanoposthitis, inflammation of the foreskin.Locally, abundant purulent discharge is observed and there may be an admixture of mucus.They are always accompanied by swelling 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 - during the acute period of inflammation;Sparse and white: when the disease becomes chronic.Prostatitis is usually complicated by difficulty urinating and weakness of the erection, in severe cases even with 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 altered innervation and decreased tone of the vas deferens.
Hematorrhea, bloody discharge.It often appears with injuries to the urethral canal received during bougienage, after inserting a catheter or when taking a smear from the mucous membrane.In these cases, the blood is fresh, without clots, the amount is small, and the bleeding stops quickly.When small kidney stones or sand pass, blood is released during or immediately after urination, hematorrhoea is accompanied by very severe pain (renal colic).Blood secretion in the hematuric form of glomerulonephritis (inflammation of the kidney 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 emanating from the prostate, urethra or bladder.During wound healing, brownish mucus may form on the mucous membranes and is released during polyposis of the urethra and/or bladder.
Prostatorrhea is the secretion of the prostate gland that flows from the urethra.It occurs in chronic prostatitis, prostate adenoma, altered innervation (neurogenic bladder).
Examination algorithm for the presence of pathological discharge from the penis.
- Inspection of the perineum, penis, foreskin and glans.The goal is to identify deformations of the genital organs, traces of injury, signs of external inflammation, discharge, rash, etc.Sometimes traces of discharge are noticeable on underwear.
- 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, if they have ulcerations on them.
- Digital prostate examination;massage the prostate through the rectum and obtain secretions for microscopic examination.Before the massage it is advisable to refrain from urinating for 1-2 hours.With prostate adenoma, its lobes enlarge approximately equally, and dense cords are palpated.Uneven 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: smear 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, sperm are found in the smear, with urethrorrhea - mucus, prostatorrhea - lipid grains.For the informative content and reliability of the results, a smear is performed no earlier than 3 days after topical use of antibiotics, antifungals and disinfectants.If the antibiotic treatment was systemic, 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 blood test, blood sugar test: in the morning, on an empty stomach.Detailed urine analysis (morning portion, immediately after sleeping).
- Ultrasound of the prostate, bladder and kidneys;CT and urography.
If the manifestations of genital inflammation are severe, before receiving the test results, the patient is immediately prescribed broad-spectrum antibiotics.In case of heavy bleeding, hospitalization and active measures to stop the bleeding are indicated.The suspicion of a malignant tumor can only be confirmed by the result of a biopsy;The final diagnosis is made on the basis of histological examination.
Important:
- Discharge from the penis is only a symptom that cannot be used as a guide when making a diagnosis.
- Independent prescription of pharmaceutical products is unacceptable.medications, even if the manifestations seem obvious for a particular disease.