The secretion from the genital organs in men is a secretion from the urethra (urethra) and the secretion of the preputial glands, which are located on the head of the penis, under the skin of the foreskin.The ejaculatory duct, prostatic ducts, urethral and bulbourethral glands open into the urethra.
In a healthy person, only urine and ejaculate flow through the urethra.These are physiological secretions from the penis and should not cause discomfort.Unfortunately, this is not always the case.
For various reasons, men's health is weakened, and instead of normal discharge, abnormal discharge or change in urine and semen occurs
Variants of physiological secretions
Criteria for normal discharge corresponding to the functions of the organs of the genitourinary system:
- Urine is clear, straw-yellow in color, practically odorless and does not contain scales or other impurities;
- Prostatic secretion has a viscous consistency and a whitish hue, has a specific smell of semen;
- Ejaculate: spermatozoa from the ejaculatory duct are mixed with secretions from the Littre (urethral), Cooper (bulbourethral) glands and prostatic secretion, acquiring a gray-white color and mucous consistency;
- Fresh smegma from the preputial glands appears as a thick white lubricant;it may turn yellowish or greenish over time.
Preputial lubricant - smegma - is constantly secreted, accumulating under the inner layer of the foreskin and in the coronal groove of the penis.The lubricant consists of fats and bacterial residues, distributes 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, the secretion decreases and by old age 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 breaks down (in fact, this is rotting), and the masses become greenish, acquiring an unpleasant smell.The same process occurs in 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 lead to chronic balanitis and balanoposthitis (inflammation of the foreskin and glans penis), increasing the risk of developing tumors.
Urethrorrhea, a slimy, colorless discharge from the bulbourethral and urethral glands.These discharges occur in men during libido-related arousal.The secretion of clear mucus is intended to lubricate the urethra and improve the passage of sperm.The amount of secretion varies from scanty to copious;these parameters are related to the individual characteristics of the body and the frequency of sexual activity.After prolonged abstinence, the volume of excretion increases.
A wet dream is a spontaneous release of semen that is not related to sexual contact.It is usually seen in the morning when testosterone levels rise.It depends on the age and the intensity of sexual activity: it appears in boys at puberty, in adult men - with irregular or rare sexual contacts.
Prostatorrhea, discharge from the urethra of a small amount of transparent mucus with gray-white inclusions.It occurs after straining the abdominal muscles (for example, with constipation) or after urination.The secretion consists of a mixture of seminal fluid and secretion from the prostate;increased volume and cloudiness may 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, 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 yellow-green, cloudy);
- Through impurities (blood, pus, lumps of mucus);
- Consistency (very runny or too thick and sticky);
- By smell (sour, putrid, fishy);
- According to the frequency of occurrence (depending on the time of day, constant or episodic discharge);
- In connection with urination, sexual excitement, drinking alcohol, hot and spicy foods.
The nature of the discharge depends on the causative agent of the disease, the state of the immune system, concomitant diseases, as well as the severity and duration of the inflammation (acute or chronic).
If there is a change in the amount, density or color of the discharge or if an unpleasant smell appears, it is recommended to consult a doctor and have tests done.There is no point in self-diagnosis;it is very difficult to correctly diagnose the disease based on only one symptom.
Penile discharge associated with sexually transmitted diseases
Mucosa: transparent discharge, viscous and small in quantity, occurs in chronic form of chlamydial, mycoplasma or ureaplasma urethritis.Microscopy reveals a moderate number of leukocytes in the discharge (the norm is up to 4 cells per field of view).
Mucopurulent: white discharge, translucent;observed in the acute phase of chlamydia, ureaplasmosis and mycoplasmosis.With chlamydial infection, they accumulate on the head of the penis, as if "sticking" to the skin.
In the pathologies described above, the discharge will come from the urethra itself, since the microorganisms irritate the mucous membrane of the urethra and the body tries to "wash" them away.
It happens that a white discharge covers the glans.This is seen in chlamydia and candidiasis.In the first case, a film is formed, in the second - a loose, cheesy coating.
Purulent discharge with an unpleasant odor is characteristic of gonorrhea.They are sticky, thick, yellow or greenish in color and have a putrid smell.Under microscopy, epithelial cells from the urethra and numerous leukocytes are visible in the material.
Symptoms accompanying gonorrheal urethritis: constant and profuse discharge;the pain, itching, and burning are especially severe when urinating.
In sexually transmitted diseases, combined infections combining several pathogens at once are often observed.Gonorrhea and trichomoniasis are accompanied by chlamydia;mycoplasmosis and ureaplasmosis usually occur in pairs.The symptoms of such diseases differ from the classic manifestations;discharge from the urethra can also take on a completely different character.Therefore, modern analytical techniques with a high degree of reliability are used for a final diagnosis, and not the characteristics of the secretions.
Non-specific (non-venereal) inflammation
The cause of the non-specific inflammation is the own microflora, which is classified as opportunistic 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 the beneficial bacteria after hypothermia, prolonged stress, uncontrolled treatment with antibiotics, after courses of radiation and chemotherapy.
Non-gonorrheal (non-specific) urethritis.The inflammatory secretion is small in volume, visible in the urine as mucopurulent threads or lumps, and appears at the very beginning of the disease.Symptoms in the form of burning and itching during urination are less pronounced than in gonorrhea, but the desire is frequent and does not bring relief.In ascending infection, the bladder first becomes inflamed, followed by the ureters and kidneys;a discharge mixed with scarlet blood appears.
Candidiasis (thrush), a 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.Thrush is characterized by a mushy discharge with a sour smell, which is combined with itching and burning during micturition (urinating) and ejaculation (ejaculation) and can 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 scanty, yellowish-white or greenish.According to some classifications, gardnerella is classified as an STD, but in men, contracting gardnerella 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) must be used in its treatment.
Balanoposthitis, inflammation of the foreskin.Abundant purulent discharge is observed locally, there may be an admixture of mucus.They are always accompanied by swelling and hyperemia (redness) of the foreskin, soreness of the head of the penis.
In prostatitis, cloudy secretion appears at the end of urination, copious secretion - during the acute period of inflammation;scanty and white - when the disease becomes chronic.Prostatitis is usually complicated by difficult urination and weak erection, in severe cases even to anuria (complete lack of urine output) and impotence.
A secretion that is not associated with inflammation
Spermatorrhea is a discharge in the form of passively flowing semen that occurs outside of sexual intercourse or masturbation, without the sensation of orgasm.The causes are some diseases of the nervous system, spinal injuries, chronic stress and any prolonged inflammation of the genital area.Spermatorrhea is associated with impaired innervation and reduced tone of the vas deferens.
Haematorrhea, bloody discharge.It often occurs with injuries to the urethral canal, received during bulging, after insertion of a catheter, or when taking a mucosal smear.In these cases, the blood is fresh, without clots, the amount is small, and the bleeding stops quickly.When small kidney stones or sand are passed, blood is released during or immediately after urination, the bleeding is accompanied by very severe pain (renal colic).The discharge of blood 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 secretions with clots of blood or mucus mixed with pus appear in malignant tumors originating in the prostate, urethra or bladder.During the healing of wounds on the mucous membranes, a brownish mucus may form, which is released in polyposis of the urethra and/or bladder.
Prostatorrhea is a discharge from the prostate gland leaking from the urethra.It occurs in chronic prostatitis, prostate adenoma, disturbed innervation (neurogenic bladder).
Research algorithm for the presence of pathological secretion from the penis
- Inspection of the perineum, penis, foreskin and glans.The purpose is to identify deformations of the genital organs, traces of injury, signs of external inflammation, discharge, rash, etc.Traces of secretion are sometimes noticed 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, movable or adherent to the skin, whether there are ulcers on them.
- Digital prostate examination;massage the prostate through the rectum and collect secretions for microscopic examination.Before the massage, it is recommended to refrain from urinating for 1-2 hours.In prostate adenoma, its lobes are enlarged approximately equally, dense connections 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).The increased number of leukocytes is characteristic of acute urethritis or exacerbation of chronic inflammation, eosinophils - for urethritis due to allergies.Red blood cells are found in severe inflammation, tumors, injuries of the genitourinary organs and urolithiasis.The large amount of epithelium is a sign of chronic urethritis, urethral leukoplakia.In spermatorrhea, spermatozoa are found in the smear, in urethrorrhea - mucus, prostatorrhea - lipid grains.For informativeness and reliability of the results, a smear is taken no earlier than 3 days after local application of antibiotics, antifungals and disinfectants.If antibiotic treatment is 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 blood test, blood sugar - in the morning, on an empty stomach.Detailed urine analysis (morning portion, immediately after sleep).
- Ultrasound of the prostate, bladder and kidneys;CT scan and urography.
If the manifestations of inflammation of the genitals are severe, then before receiving the test results, the patient is immediately prescribed 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 be confirmed only by the result of a biopsy;the final diagnosis is made on the basis of histological examination.
Important:
- Penile discharge is only one symptom that cannot be used as a guide in making a diagnosis.
- Independent prescription of drugs is unacceptable.drugs, even if the manifestations seem obvious to a certain disease.