The secretions of the male reproductive organs are secretions from the urethra (urethra) and from the foreskin glands, which are located on the head of the penis, under the foreskin.The ejaculatory ducts, prostatic ducts, urethral glands, and bulbourethral glands open into the urethra.
In healthy men, only urine and semen flow through the urethra.These are physiological discharges from the penis and do not cause any discomfort.Unfortunately, this is not always the case.
Due to various reasons, men's health declines, and the secretions are no longer normal, but abnormal secretions or changes in urine and sperm occur.
Variants of physiological secretions
Standards for normal secretions corresponding to organ functions of the genitourinary system:
- Urine is clear, straw to golden in color, almost odorless, and contains no flakes or other inclusions;
- Prostatic secretions are viscous and white in color, with a unique odor of sperm;
- Ejaculation: Sperm from the ejaculatory ducts are mixed with secretions from the urethral glands, bulbourethral glands and prostate secretions. They are gray-white in color and have high mucus consistency;
- Fresh smegma from the foreskin glands looks like a thick, white lubricant; over time, it may turn yellow or green.
The foreskin lubricant - smegma - is constantly secreted and accumulates in the lining of the foreskin and the coronal groove of the penis.The lubricant consists of fat and bacterial residue and is evenly distributed to reduce friction between the foreskin and glans skin.Maximum activity of the foreskin glands is characteristic of puberty; with increasing age, secretion decreases and ceases completely in old age.
If you neglect personal hygiene, smegma can accumulate under the folds of the foreskin.In this case, the fat part of the lubricant oxidizes, the protein part breaks down (in fact, this is putrefaction), the clumps turn green, creating an unpleasant smell.The same process occurs with phimosis, where due to the fusion of the foreskin it is impossible to completely release the glans penis from the skin folds and remove 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 tumors.
Urethral leakage, a mucous, colorless discharge from the bulb and urethral glands.Men experience these discharges during arousal associated with sexual desire.The purpose of clear mucus discharge is to lubricate the urethra and improve the passage of sperm.The amount of secretion varies from small to large; these parameters are related to the individual characteristics of the body and the frequency of sexual activity.After prolonged abstinence, the amount of discharge increases.
Nocturnal emissions are the spontaneous release of sperm not associated with sexual intercourse.It is usually observed in the morning when testosterone levels rise.Depends on age and intensity of sexual activity: it appears in boys during puberty, in adult men - irregular or infrequent sexual intercourse.
Prostatic leakage, discharge of a small amount of clear mucus from the urethra containing gray-white inclusions.Occurs when the abdominal muscles are tight (such as constipation) or after urination.The discharge consists of a mixture of semen and prostate secretions; increased volume and cloudiness may be signs of prostatitis.
pathological secretions
In men, the causes of penile discharge can be sexually transmitted diseases, tumors, non-specific inflammation of the genitourinary organs, various injuries, medical procedures or surgeries.
Pathological discharge from the urethra is different from normal:
- By quantity (too much or too little, maybe just the right amount);
- By color and transparency (from white to yellow-green, cloudy);
- Impurities (blood, pus, mucus clumps);
- Consistency (very runny or too thick and sticky);
- By smell (sour, rancid, fishy);
- According to frequency of occurrence (depending on time of day, continuous or intermittent discharge);
- Related to urination, sexual arousal, alcohol consumption, and spicy food.
The nature of the secretion depends on the causative agent of the disease, the state of the immune system, concomitant diseases, and the severity and duration of inflammation (acute or chronic).
If the amount, density or color of the discharge changes, or if it develops an unpleasant odor, it is recommended to consult a doctor and get it checked out.There is no point in self-diagnosis; it is difficult to correctly identify a disease based on just one symptom.
Penile discharge associated with STDs
Mucous: transparent secretion, thick, small amount, occurs in chronic chlamydia, mycoplasma or urealyticum urethritis.Microscopic examination reveals a moderate number of leukocytes in the secretion (normally up to 4 cells in the field of view).
Mucopurulent: white discharge, translucent; observed in the acute phase of chlamydiasis, ureaplasmosis, and mycoplasmosis.After a chlamydia infection, they can accumulate on the glans penis, as if "sticking" to the skin.
With the above pathologies, the discharge will come from the urethra itself, since microorganisms irritate the urethral mucosa and the body will try to "flush" them away.
It happens that the head seems to be covered with white discharge.This is observed in chlamydia and candidiasis.In the first case, a film is formed, in the second, a loose coating of cheese.
Purulent discharge with an unpleasant odor is characteristic of gonorrhea.They are sticky, yellow or green in color, and have a rancid smell.Under a microscope, epithelial cells from the urethra and many white blood cells can be seen in the material.
Symptoms of gonorrheal urethritis: persistent, heavy discharge; pain, itching, and burning especially when urinating.
With sexually transmitted diseases, co-infections in which multiple pathogens combine simultaneously are often observed.Gonorrhea and trichomoniasis are both associated with chlamydia; mycoplasmosis and ureaplasmosis usually occur in pairs.Symptoms of these disorders differ from the typical presentation; urethral discharge may also present completely different characteristics.Therefore, for the final diagnosis, modern analytical techniques with high reliability are used instead of the characteristics of the secretions.
Nonspecific (non-STD) inflammation
The cause of non-specific inflammation is its own microbiome, which is classified as opportunistic inflammation and is only activated when there is a problem with the body's immune defenses.Streptococci and Staphylococci, fungi of the genus Candida and Escherichia coli are always present on skin and mucosal surfaces, but after hypothermia, prolonged stress, uncontrolled antibiotic treatment, radiation and chemotherapy, they begin to actively multiply and replace beneficial bacteria.
Nongonococcal (nonspecific) urethritis.The inflammatory secretions are small in quantity and can be seen in the urine in the form of mucopurulent filaments or masses, appearing in the early stages of the disease.The symptoms of burning and itching when urinating are less pronounced than with gonorrhea, but the urgency to urinate is frequent and does not relieve the symptoms.With ascending infection, first the bladder, then the ureters and kidneys become inflamed; a discharge mixed with scarlet blood appears.
Candidiasis (thrush), urinary tract fungal infection.Usually occurs in the context of a suppressed immune system after a course of antibiotics, chemotherapy, or radiotherapy; sexual transmission of candidiasis in men is rare.Thrush is characterized by a sour-smelling, curd-like discharge that is accompanied by itching and burning during urination and ejaculation, and may be accompanied by dull pain in the groin, above the pubic bone, and in the lower back.
Urethral Gardnerellosis.The discharges have a fishy smell; they are sparse, yellow-white or green.According to some classifications, Gardnerella is classified as a sexually transmitted disease, but in men, contracting Gardnerella through sexual contact is more curious.In fact, this disease is associated with a disruption of the normal microbiota (i.e., dysbiosis).Immune corrective agents and probiotics (lactobacilli) must be used during treatment.
Balanoposthitis, inflammation of the foreskin.A large amount of purulent secretions may be seen locally, and may be mixed with mucus.They are always accompanied by swelling and congestion (redness) of the foreskin lobe and soreness of the glans penis.
With prostatitis, turbid secretions appear at the end of urination, abundant - in the acute phase of inflammation; sparse and white - when the disease becomes chronic.Prostatitis is often complicated by difficulty urinating and weak erections. In severe cases, anuria (a complete lack of urine output) and impotence can occur.
Secretions not related to inflammation
Nocturnal emissions are the discharge of passively flowing sperm in the form of sperm that occurs outside of sexual intercourse or masturbation, without the sensation of orgasm.Causes are some neurological disorders, spinal injuries, chronic stress, and long-term inflammation of the genital area.Spermia is associated with impaired innervation and reduced vas deferens tone.
Hemorrhage, bloody discharge.Injury to the urethra often occurs during bougie placement, after catheter insertion, or during mucosal smearing.In this case, the blood is fresh, clot-free, and in small amounts, and the bleeding stops quickly.Bleeding with very severe pain (renal colic) occurs when small kidney stones or sand are passed, during or immediately after urination.Glomerulonephritis (inflammation of the glomeruli) is a discharge of blood in the form of hematuria, with edema, a persistent increase in blood pressure, and the presence of protein in the urine.
Malignant tumors of the prostate, urethra, or bladder may cause brown discharge with blood clots or mucus mixed with pus.Brown mucus can form during mucosal wound healing and be released during urethral and/or bladder polyposis.
Prostatic leakage is the discharge of secretions from the prostate from the urethra.Occurs in chronic prostatitis, prostate adenoma, damaged innervation (neurogenic bladder).
Examination process for the presence of pathological discharge from the penis
- Examine the perineum, penis, foreskin, and glans.The purpose is to identify deformations of the reproductive organs, traces of injury, external signs of inflammation, discharge, rashes, etc.Sometimes visible traces of discharge can be seen on the underwear.
- Palpate the inguinal lymph nodes and assess their condition: size, whether they are hotter or cooler than surrounding tissue, whether they are painful, soft or hard, move or adhere to the skin, and whether they are ulcerated.
- Digital prostate exam; massage the prostate through the rectum and obtain secretions for microscopic examination.Do not urinate 1-2 hours before massage.In prostatic adenomas, the gland lobes are approximately equally enlarged and can be palpated as dense bands.Uneven growth and its consistency are typical features of malignancy; when the prostate is palpated, blood with clots may be released from the urethra.
- Materials: Smears for microscopy and culture.When examined under a microscope, the stained smear may reveal blood cells, epithelium, sperm, fatty inclusions, and some pathogens (E. coli, gonococci, Gardnerella, yeast).Increased white blood cell counts are characteristic of acute urethritis or exacerbation of chronic inflammation, and eosinophils are characteristic of urethritis caused by allergies.Red blood cells can be detected in severe inflammation, tumors, genitourinary organ damage, and urolithiasis.A large amount of epithelium is a sign of chronic urethritis and urethral leukoplakia.Nocturnal emissions, sperm found in smear, urethral leakage - mucus, prostate leakage - lipid particles.To ensure the informative content and reliability of the results, smears should be collected no earlier than 3 days after topical antibiotics, antifungals, and antiseptics.If antibiotic therapy is systemic, at least 3 weeks should elapse after the end of the course.Do not wash before applying; try not to urinate within 2-3 hours.
- General clinical blood tests and blood glucose checks - on an empty stomach in the morning.Detailed urinalysis (morning portion, immediately after sleep).
- Ultrasound examination of the prostate, bladder, and kidneys; CT and urography.
If the manifestations of genital inflammation are severe, then the patient is immediately prescribed broad-spectrum antibiotics before the test results are received.If the bleeding is severe, you should be hospitalized and take active measures to stop bleeding.Suspicion of malignancy can only be confirmed by biopsy results; the final diagnosis is made based on histological examination.
important:
- Penile discharge is only a symptom and should not be used as a guide to diagnosis.
- Independent prescriptions of medicines are not acceptable.Medications, even if the symptoms seem obvious for a particular disease.