Separation from the genitals in men is a discharge 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, prostate ducts, urethra and bulboretral glands open into the urethra.
In a healthy man, only urine and ejaculate flow through the urethra. This is a physiological secretion from the penis and should not cause discomfort. Unfortunately, this is not always the case.
For various reasons, men's health is shaken and instead of a normal flow, an unusual flow appears or urine and semen change
Variants of physiological secretions
Criteria for normal excretion corresponding to the functions of the genitourinary system:
- Urine - clear, from straw to golden-yellow color, practically odorless, without scales or other inclusions;
- The secretion of the prostate has a viscous consistency and whitish hue, has a specific smell of spermine;
- Ejaculate: sperm from the ejaculatory canal mix with secretions from the glands of Littre (urethral), Cooper (bulbourethral) and prostate secretion, acquiring a grayish-white color and consistency of the mucosa;
- Fresh smegma from the preputial glands is like thick white fat; may become yellowish or greenish over time.
The preputial lubricant - smegma - is constantly released, accumulating under the inner layer of the foreskin and in the coronal groove of the penis. The lubricant consists of fat and bacterial residues, is evenly distributed and reduces friction between the skin of the foreskin and the scalp. The maximum activity of the preputial glands is inherent in puberty; with age the secretion decreases and stops completely until old age.
If you ignore the rules of personal hygiene, then smegma can accumulate under the folds of the foreskin. In this case, the fatty part of the lubricant is oxidized, and the protein part decomposes (actually rots) and the masses become greenish, acquiring an unpleasant odor. 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. Accumulation and degradation of the lubricant can lead to chronic balanitis and balanoposthitis (inflammation of the foreskin and glans penis), increasing the risk of developing tumors.
Urethrorea, mucus, colorless secretion from the bulbourethral and urethral glands. Discharge data appear in men with libido-related arousal. The excretion of clear mucus aims to lubricate the urethra and improve sperm flow. The amount of secretion varies from scarce to abundant, these parameters are related to the individual characteristics of the organism and the frequency of sexual activity. After prolonged abstinence, the volume of secretions increases.
Contamination is the spontaneous release of semen that is not related to sexual intercourse. It is usually seen in the morning when testosterone levels rise. It depends on the age and intensity of sexual activity: it occurs in boys during puberty, in older men - during irregular or infrequent intercourse.
Prostatitis, secretion from the urethra of a small amount of clear mucus with grayish-white inclusions. It occurs after tension in the abdominal muscles (for example, constipation) or after urination. The secretion consists of a mixture of semen and the release of the prostate, an increase in volume and opacity may be signs of prostatitis.
Pathological separation
In men, the causes of penile detachment can be sexually transmitted diseases, tumors, nonspecific inflammation of the urogenital organs, various injuries, medical procedures or operations.
The pathological course of the urethra differs from the normal:
- By volume (too abundant or scarce, probably moderate);
- By color and transparency (from white to yellow-green, cloudy);
- Through impurities (blood, pus, lumps of mucus);
- Consistency (very thin or too thick and sticky);
- Smell (sour, rotten, fishy);
- By frequency of occurrence (depending on the time of day, constant or episodic discharge);
- In connection with urination, sexual arousal, alcohol, spicy and spicy foods.
The nature of the discharge depends on the cause of the disease, the state of the immune system, concomitant diseases, as well as the severity and duration of inflammation (acute or chronic).
If the amount, density or color of the discharge changes, if an unpleasant odor occurs, it is recommended to consult a doctor and do tests. Self-diagnosis is not worth it, it is very difficult to correctly recognize the disease by just one symptom.
Discharge from the penis associated with sexually transmitted diseases
Mucosa: clear secretion, viscous and small in quantity, found in chronic chlamydia, mycoplasma or ureaplasma urethritis. Microscopy reveals a moderate number of leukocytes in the secretions (the norm is up to 4 cells per visual field).
Mucopurulent: white secretion, translucent; observed in the exacerbation phase with chlamydia, ureaplasmosis and mycoplasmosis. In chlamydial infections, 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, as the microorganisms irritate the lining of the urethra and the body tries to "wash" it.
It happens that the secret of white color covers the head. This is noted in chlamydia, candidiasis. In the first case, a film is formed, in the second - loose cheese.
The purulent secretion with an unpleasant odor is characteristic of gonorrhea. They are sticky, dense, yellow or greenish in color, with a rotten odor. Microscopic examination of the material showed epithelial cells of the urethra, many leukocytes.
Symptoms accompanying gonorrheal urethritis: persistent and profuse discharge; pain, itching and burning are especially strong 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 usually occur in pairs. The symptoms of such diseases differ from the classical manifestations, the separation of the urethra can also acquire a completely different character. Therefore, modern analytical techniques with a high degree of reliability are used for the final diagnosis, rather than the characteristics of the disposal.
Nonspecific (non-venereal) inflammation
The cause of non-specific inflammation is its own microflora, which is conditionally pathogenic and is activated only in 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 actively multiply and displace beneficial bacteria after hypothermia, prolonged stress, uncontrolled antibiotic treatment, after radiation and chemotherapy.
Non-gonorrheal (nonspecific) urethritis. The inflammatory course is small in volume, visible in the urine as mucopurulent ropes or lumps, which appear at the very beginning of the disease. Symptoms of burning and itching during urination are less pronounced than in gonorrhea, but the desire is common and does not bring relief. In ascending infection, the bladder is first inflamed, followed by the ureters and kidneys; a scar with an admixture of 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 radiation therapy; Sexually transmitted candidiasis in men is rare. Thrush is characterized by an acidic 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 lower back.
Gardnerellosis of the urethra. The fishy smell of the discard is characteristic; they are sparse, yellowish-white or greenish. According to some classifications, gardnerellosis is called STDs, but in men, sexual infection with gardnerella is more likely curiosity. In fact, this disease is associated with a violation of the normal microflora, ie dysbiosis. Immunocorrectors and probiotics (lactic acid bacteria) must be used in its treatment.
Balanoposthitis, inflammation of the foreskin. Abundant purulent discharge is observed locally, an admixture of mucus is possible. Always accompanied by swelling and redness (redness) of the preputial leaves, soreness of the head of the penis.
In prostatitis, cloudy secretion appears at the end of urination, profuse discharge - in the acute period of inflammation; scarce and white - with the transition of the disease to a chronic form. Prostatitis is usually complicated by difficulty urinating and poor erection, in severe cases - to anuria (complete lack of urine leakage) and impotence.
Discharge that is not associated with inflammation
Spermatorrhea - discharge in the form of passively flowing semen, occurring outside of intercourse or masturbation, without a feeling 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 decreased vascular tone.
Hematorrhea, spotting. It often occurs in injuries of the urethral canal, received during the buoyancy, after catheter placement or when taking a smear from the mucosa. In these cases the blood is fresh, without clots, the amount is small, the bleeding stops quickly. When small kidney stones or sand pass, blood is excreted during or immediately after urination, hematorrhea is accompanied by very severe pain (renal colic). The excretion of blood in the hematuric form of glomerulonephritis (inflammation of the renal glomeruli) is combined with edema and constant high blood pressure, the appearance of protein in the urine.
Brown secretions, with clots of blood or mucus, with an admixture of pus appear in malignant tumors coming from the prostate, urethra or bladder. Brownish mucus may form during the healing of mucosal wounds and be secreted in polyps of the urethra and / or bladder.
Prostatitis is the secretion of the prostate gland that leaks from the urethra. Occurs in chronic prostatitis, prostate adenoma, impaired innervation (neurogenic bladder).
Algorithm of examination in the presence of pathological flow from the penis
- Examination of the perineum, penis, foreskin and glans. The aim is to identify deformities of the genitals, traces of their injury, signs of external inflammation, secretion, rash, etc. On underwear sometimes traces of currents are observed.
- Palpation of the inguinal lymph nodes, assessment of their condition: size, hotter or colder than the surrounding tissues, painful or not, soft or dense, mobile or adherent to the skin, whether there are ulcers above them.
- Finger examination of the prostate; massage the prostate through the rectum and obtaining a secretion for microscopic examination. Before the massage it is recommended to refrain from urinating for 1-2 hours. In prostate adenoma, its lobes enlarge approximately uniformly, dense fibers are felt. Malignant tumor is characterized by uneven growths and their consistency, during palpation of the prostate blood may separate with clots from the urethra.
- Material - smears for microscopy and culture. When examined under a microscope, the stained smear shows blood cells, epithelium, semen, fat inclusions, some pathogens (Escherichia coli, gonococci, gardnerella, yeast). Elevated white blood cell count is characteristic of acute urethritis or exacerbation of chronic inflammation, eosinophils - for urethritis with allergies. Erythrocytes are found in severe inflammation, tumors, injuries of the genitourinary system, urolithiasis. A large amount of epithelium is a sign of chronic urethritis, urethral leukoplakia. In spermatorrhea the sperm are found in a smear, in urethorrhea - mucus, prostatorrhea - lipid nipples. For informative content and reliability of the results the smear is taken not earlier than 3 days after the local application of antibiotics, antifungals and disinfectants. If antibiotic treatment is systemic, then at least 3 weeks should elapse after the course. Before taking a smear, do not wash, try not to urinate for 2-3 hours.
- General clinical analysis of blood, blood sugar - in the morning, on an empty stomach. Extended urine analysis (morning portion, immediately after sleep).
- Ultrasound of the prostate, bladder and kidneys; CT and urography.
If the manifestations of genital inflammation are severe, then before receiving the test results, the patient is immediately prescribed broad-spectrum antibiotics. In case of heavy bleeding, hospitalization and active actions to stop the bleeding are indicated. Confirmation of suspicion of a malignant tumor can only be the result of a biopsy, the final diagnosis is made on the basis of histological examination.
Important:
- Discharge from the penis is just one symptom that cannot be guided by the diagnosis.
- Self-employment of the farm is unacceptable. drugs, even if the manifestations seem obvious for a particular disease.