Discharge from the natural openings of the human body can tell a lot about the state of a person’s health. The nature of the discharge from the ear indicates whether the ear is healthy or not, the discharge from the nose can provide exhaustive information about the pathology of this organ, and the discharge from the penis indicates the state of the organs of the male sexual system. Very often, unusual discharge from the penis becomes the first, and sometimes the only, symptom of a severe disease. Therefore, a man should pay attention not only to the size of the male organ but also to the nature of the secretions.
The discharge from the penis is a collective concept, combining the discharge from the urethra, secretions from the sebaceous glands (located on the head of the penis), and discharge from the pathological skin formations. There are several types of normal (physiological) secretions and a great number of pathological discharge from the male organ.
Physiological Discharge from the Penis
Normal discharge that corresponds to the functions of the organs of the urogenital system include:
- Urine – transparent, almost odorless, free of flakes, or other inclusions.
- The secret of the prostate has a viscous consistency and whitish hue. There is a specific smell of spermine.
- Ejaculate – semen from the ejaculatory duct mixed with secretions from the glands of Littre (urethral), Cooper (bulbourethral), and prostatic secret, acquiring a grayish-white color and mucous consistency.
- Fresh smegma from preputial glands is like a thick white lubricant. Over time, it can become yellowish or greenish.
Libidinal (physiological) urethrorrhea, which is a transparent secretion that flows from the urethra when a man is sexually aroused, is a normal type of a discharge. The source of secretions, in this case, is the urethral glands. The amount of secretions can range from small to significant depending on the physiological characteristics of the man and the duration of the period of sexual abstinence. It should be noted that the discharge secreted by the urethra includes a certain number of spermatozoa, which, when ingested in the female’s sexual organs, can lead to the conception and pregnancy.
Another type of normal discharge from the penis is smegma. Smegma is the secretion of glands located in the skin of the prepuce and the glans penis. The amount of smegma is usually small. With daily hygienic procedures, it is easily washed off and does not cause any problems. If you violate the rules of personal hygiene, the smegma accumulates on the penis head and between the sheets of the foreskin and creates the prerequisites for the development of the inflammatory process.
To avoid the accumulation of smegma and subsequent inflammation, it is necessary to regularly wash the penis (1–2 times a day with warm water using non-aromatized varieties of soap). When washing, it is necessary to move the foreskin and wash the head of the penis carefully removing all the secretions.
Normal secretions from the penis also include sperm, a mixture of the sex glands secretion and spermatozoa, which is released during ejaculation at the time of sexual intercourse or masturbation. Usually, the sperm secretion is accompanied by sexual discharge (orgasm). This group of normal discharges from the penis includes nocturnal emission – involuntary ejaculation (usually at night), which occurs in boys during puberty and in men after prolonged sexual abstinence. The average frequency of nocturnal emission fluctuates in a wide range – from 1–3 per week to 1–2 within 2–3 months.
Pathological Discharge from the Penis
Pathological discharge from the penis in men can be caused by STDs, tumors, nonspecific inflammation of the urogenital organs, various trauma, medical manipulations, or surgery.
Pathological discharge from the urethra is different from normal by the following parameters:
- Amount (too abundant or meager, perhaps – moderate).
- Color and transparency (from white to yellow-green).
- Impurities (blood, pus, or lumps of mucus).
- Consistency (very liquid, too thick, and sticky).
- Smell (sour, putrid, or fishy).
- The periodicity of appearance (depending on the time of day, constant or episodic discharge).
- Urination, sexual arousal, alcohol intake, spicy food, etc.
The causes of the appearance of pathological discharge from the penis can be a variety of diseases, including inflammatory processes caused by their own conditionally pathogenic flora or sexually transmitted infections, oncological diseases, the consequences of injuries, and surgeries. The nature of the discharge is affected by the nature of the pathogen, the severity of the inflammation, the state of the patient’s immune system, duration of the disease, and the presence of concomitant illnesses. Note that the same disease can be accompanied by secretions of a different nature. At the same time, different diseases can lead to the appearance of completely similar types of discharge from the penis. That is why it is sometimes impossible to diagnose a disease by the look of the discharge alone.
The diagnosis of different types of discharge from the penis can include the following:
- The examination of the penis, head, perineum, and foreskin. As a result, the examination can reveal damage to the mucosa, foci of inflammation of the external genitalia, rash, and other symptoms of the disease, which also cause discharge.
- Palpation of lymph nodes is performed.
- Examination of the prostate, which can also be the cause of discharge.
- The smears of biological material are taken for tests and microscopic examinations.
- A blood test for infection or a virus.
- Urine tests.
- In some cases, ultrasound.
Depending on the results of the diagnosis, the doctor prescribes the treatment of the disease, which led to the discharge from the penis and other symptoms. The earlier you complete an examination, the better the results of treatment will be.
Discharge from the Penis Associated with Sexually Transmitted Diseases
- Mucous discharge from the penis is transparent and viscous with a few leukocytes. It is characteristic for ureaplasmosis, mycoplasmosis, and chlamydia infection.
- Mucous and purulent discharge are a translucent liquid of white and milk color, consisting of urethral mucus, inflammatory exudate, and leukocytes. They are characteristic for trichomoniasis, ureaplasmosis, and chlamydiosis during the exacerbation. Chlamydia is also characterized by sticking of accumulated secretions to the glans penis.
- Purulent discharge is a sticky liquid of thick consistency, yellow or yellow-green color. It consists of urethral mucus, exfoliated epithelium of the urethra, and a significant amount of leukocytes – the most frequent sign of gonorrhea. A characteristic feature of gonorrheal urethritis is the severity of subjective symptoms such as pain, itching (especially when urinating), a significant amount, and the constant nature of the discharge from the urethra.
Today, patients with sexually transmitted diseases often have a combined infection, that is, an infection caused by several infectious agents (trichomoniasis and chlamydia, gonorrhea and chlamydia, mycoplasmosis and ureaplasmosis, etc.), which significantly alters the symptoms and manifestations of the infection. Therefore, a final diagnosis and prescription of treatment are not possible on the basis of only information on the nature of the discharge and the patient’s complaints. It is important to keep in mind that the symptoms of venereal diseases (including discharge from the penis) easily disappear in the process of self-medication with antibiotics. However, in this case, the disappearance of the symptoms does not mean the disappearance of the disease. The disease simply digresses and after the end of antibiotic therapy comes back again. In addition, illiterate treatment leads to the formation of resistance of microorganisms to used antibacterial drugs.
Discharge from the Penis Associated with Nonvenereal Inflammatory Processes
In this case, the agent of the infection is a stimulus of the conditionally pathogenic flora (Streptococcus, Staphylococcus, Candida fungus, and Escherichia coli), which was activated as a result of a decrease of the immune system.
- Non-gonococcal urethritis is inflammation of the urethra. It is accompanied by the appearance of mucopurulent discharge. A characteristic feature is a lack or weak severity of symptoms (pain and itching) and a small amount of the discharge, which appears mainly during the long interruption between urination.
- Discharge during balanitis (inflammation of the prepuce of the penis) is usually very significant, mucopurulent or purulent, accompanied by pain in the glans penis, swelling, and redness of the foreskin.
- Prostatitis (inflammation of the prostate gland) is accompanied by the appearance of mucous and mucopurulent discharge (depending on the severity of the inflammatory process), pulling pains in the perineum, violation of urination, and potency.
- A very frequent disease of male genitalia is thrush (candidiasis). It is an inflammatory process associated with the activation of opportunistic Candida fungi. Typical manifestations of thrush in men are a pronounced reddening of the skin of the penis, the appearance of itching, burning, and also abundant cheesy discharge.
Discharge from the Penis Not Associated with the Inflammatory Process
This is a fairly rare type of secretion associated with traumas and tumor processes in the organs of the reproductive system, as well as diseases of the nervous system.
- Spermatorrhea is a discharge of sperm from the urethra without orgasm, outside sexual intercourse, or masturbation. The main cause of the condition is a violation of the muscle tone of the vas deferens associated with diseases of the central nervous system and less often with chronic inflammatory processes. In some cases, the cause of spermatorrhea cannot be determined.
- Hematuria is the discharge of blood from the urethra. The most common cause of hematuria is the mechanical injury of the urethra due to the introduction of foreign bodies, sampling of a smear, after or during an instrumental examination of the urethra, and the bladder. Also, hematuria occurs with a trauma of the penis, urethra, malignant tumors of the urethra, penis, prostate gland, polyps, stones, and sand in urolithiasis.
- Prostatorrhea is when the secretion of the prostate comes out from the urethra. It is observed with a decrease in the tone of the smooth muscle fibers of the excretory duct of the prostate gland during its chronic inflammation or other diseases (for example, a neurogenic bladder or a prostate adenoma).
Finding the Cause of Discharge from the Penis
Since there are a lot of reasons for the appearance of unusual (non-physiological) discharge from the penis, a qualified urologist should search for the cause of each specific case. When examining a patient with complaints of discharge from the penis, the doctor should carefully examine the skin for rashes, palpate the lymph nodes, and in some cases, inspect the underwear.
The type of discharge from the penis is assessed at the beginning of the examination and after a mild urethra massage, which is performed after 2–3 hours of abstinence from urination. The mandatory tests include blood and urine tests, a blood test for sugar, the sampling of a smear from the urethra, inoculation of urethral discharge, finger examination of the prostate, ultrasound of the bladder and prostate, urography, and computed tomography.
In inflammatory processes, the most valuable information is provided by the study of the urethral smear. The results of this test depend on the severity and duration of the disease. Inflammation is indicated by the presence of 4 or more leukocytes, while the cylindrical and parabasal epithelium indicates the severity and depth of the inflammatory process.
Preparation for Smear Sampling
In order for the results of the smear to be informative and help the doctor in the diagnosis, it is necessary to properly prepare for the procedure for taking the smear. Local use of antibiotics, antiseptics, and antifungal agents should be excluded within 3 days prior to the test. It is necessary to refrain from urination and the external toilet of the genital organs 3 hours before the test. The smears are taken not earlier than 3 weeks after the end of systemic antibiotic therapy.
The Results of the Urethral Smear
- The increase in leukocytes – acute urethritis or exacerbation of chronic urethritis.
- Increased eosinophils – allergic urethritis.
- Increased erythrocytes – trauma, tumors, excretion of stones or sand with urolithiasis, and severe inflammation.
- A large number of the epithelium cells – chronic urethritis or leukoplakia urethra.
- Spermatozoa – spermatorrhea.
- Lipoid grains – prostatorrhea.
- Mucus without blood cells – urethra.
- Key cells (small sticks on epithelial cells) with a small number of neutrophils – urethritis.
In a normal smear, there are up to 4 white blood cells and the bacterial flora is represented by single cocci and sticks.
The appearance of discharge from the penis is considered a symptom of the disease, the nature of which can be determined only by a doctor. It is impossible for patients to diagnose the pathology that led to the emergence of the discharge. Therefore, it is inappropriate to treat it without first consulting a professional. Self-medication attempts, in this case, do not lead to recovery, but only distort the symptoms of the disease, which makes it difficult to treat it.