What types of discharge are there and what are they talking about?
There are physiological and pathological discharges. Normal ones include a small amount of clear fluid during arousal and a drop of secretion after a nocturnal emission. Pathological discharge appears outside of excitement, often in the morning before the first urination, leaves marks on the underwear and is usually accompanied by a burning sensation. Abundant yellowish-green discharge with pain is typical for gonococcal infection, scanty mucous with itching - for chlamydia and mycoplasma, foamy with irritation - for trichomoniasis, white curdled - for candidiasis. But only laboratory research gives an accurate answer.
- Transparent when excited - a variant of the norm
- Purulent yellow-green - possible gonorrhea
- Scanty mucous membranes - non-gonococcal urethritis
- Foamy - likely trichomoniasis
- Curds - candidiasis
- Bloody - require urgent examination
Reasons
Most cases are associated with sexually transmitted infections: gonococcus, chlamydia, mycoplasma genitalium, trichomonas. Less commonly, urethritis is caused by opportunistic bacteria and fungi, especially in diabetes mellitus and after antibiotic therapy. There are also non-infectious causes: trauma to the mucous membrane after catheterization or instrumental examination, chemical irritation with antiseptics and gels, allergies to latex and lubricants, reactive arthritis. Discharge also occurs with prostatitis, when prostate secretions are released after defecation, and with narrowing of the urethra.
- Gonococcal infection
- Chlamydia and mycoplasma genitalium
- Trichomoniasis
- Candidiasis and opportunistic flora
- Trauma and chemical irritation of the urethra
- Prostatitis and urethral stricture
Survey
It is optimal to come to the doctor in the morning without urinating for 2-3 hours - this way the smear will be more informative. The urologist examines the genitals, takes a smear from the urethra for microscopy and material for PCR for major infections. Additionally, urine is examined in two portions, which helps to understand where exactly the inflammation is occurring. In case of repeated and prolonged cases, a culture is performed to determine sensitivity to antibiotics, TRUS of the prostate and ultrasound of the scrotum. Be sure to offer screening for syphilis, HIV and hepatitis: these infections are often combined.
- Urethral smear with microscopy
- PCR for gonococcus, chlamydia, trichomonas, mycoplasma
- Two-glass urine sample
- Sowing with sensitivity during prolonged flow
- TRUS of the prostate and ultrasound of the scrotum according to indications
- Screening for syphilis, HIV and hepatitis
Treatment
Therapy is selected according to the identified pathogen, and this is the main difference between competent treatment and self-medication. The regimens for gonococcal and chlamydial infections are different, and when they are combined, both drugs are needed. The course is taken in full, even if the discharge stops after a day. During treatment, sexual intercourse is excluded or a condom is used, and partners are examined and treated at the same time, otherwise re-infection will occur. Alcohol is excluded during the course. After completion of treatment, a control study is carried out at a time prescribed by the doctor.
- Antibiotic for the identified pathogen
- Simultaneous treatment of sexual partners
- Full course without early cancellation
- Refusal of sexual intercourse until control
- Avoiding alcohol during treatment
- Control tests after the course
Complications and prevention
Untreated or undertreated urethritis rises higher and leads to prostatitis, vesiculitis, inflammation of the epididymis, and in the long term - to narrowing of the urethra and problems with conception. Some infections are almost asymptomatic, so a man can infect his partner for a long time, who develops inflammatory diseases of the pelvic organs. Prevention is simple and reliable: barrier contraception for casual contacts, regular examination when changing partners, refusal of self-medication and timely treatment at the first symptoms.
- Prostatitis and vesiculitis with the spread of infection
- Epididymitis and the risk of infertility
- Urethral stricture due to chronic inflammation
- Reactive arthritis due to chlamydial infection
- Barrier contraception as the main prevention
- Examination when changing sexual partners
