Penile Discharge

Overview

Penile discharge is any fluid that comes from the urethra (the tube that carries urine and semen) other than urine or semen. This discharge can vary in color, consistency, and amount. While some discharge may be normal, it often indicates an infection or other medical condition requiring treatment.

Common Causes

Sexually Transmitted Infections (STIs)

  • Gonorrhea: Thick, yellow or green pus-like discharge
  • Chlamydia: Clear or cloudy discharge, often minimal
  • Trichomoniasis: Frothy, foul-smelling discharge
  • Mycoplasma genitalium: Clear to white discharge
  • Ureaplasma: Usually clear discharge
  • Herpes simplex: Clear discharge with painful sores

Non-STI Causes

  • Urinary tract infection (UTI): Cloudy or bloody discharge
  • Balanitis: Inflammation of penis head
  • Prostatitis: Prostate inflammation
  • Urethritis: Non-specific urethral inflammation
  • Smegma: Normal secretion (not from urethra)
  • Pre-ejaculate: Normal clear fluid during arousal
  • Chemical irritation: From soaps, spermicides
  • Trauma: Injury to urethra

Associated Symptoms

  • Burning or pain during urination (dysuria)
  • Frequent urge to urinate
  • Itching or irritation at urethral opening
  • Pain during or after ejaculation
  • Testicular pain or swelling
  • Lower abdominal or pelvic pain
  • Fever (with severe infections)
  • Swollen lymph nodes in groin
  • Rash or sores on genitals
  • Blood in urine or semen

Diagnosis

  • Medical history: Sexual history and symptoms
  • Physical examination: Genital and urethral exam
  • Urethral swab: Sample of discharge for testing
  • Urine tests: First-void urine sample
  • STI panel: Testing for multiple infections
  • Urine culture: To identify bacteria
  • Blood tests: For certain STIs like HIV, syphilis

Treatment

  • Antibiotics: Specific to identified infection
  • Azithromycin: For chlamydia
  • Ceftriaxone: For gonorrhea
  • Metronidazole: For trichomoniasis
  • Partner treatment: Essential to prevent reinfection
  • Abstain from sex: Until treatment completed
  • Follow-up testing: To ensure cure

Prevention

  • Use condoms consistently and correctly
  • Limit number of sexual partners
  • Regular STI screening if sexually active
  • Avoid sharing sex toys
  • Urinate after sexual activity
  • Practice good genital hygiene
  • Avoid irritating products on genitals

When to Seek Immediate Care

Contact a healthcare provider promptly if you have:

  • Any penile discharge (always warrants evaluation)
  • Severe pain or swelling
  • High fever with discharge
  • Blood in discharge
  • Inability to urinate
  • Testicular pain and swelling
  • Recent unprotected sexual contact
  • Partner diagnosed with STI

Important: All sexual partners should be notified and treated to prevent reinfection and further spread of infection.