Penile discharge (or urethral discharge) is the leakage of liquid from the opening at the tip of the penis (urethral meatus). This fluid, that’s neither urine nor semen, can have different colours and appearance, ranging from transparent and viscous to yellowish and dense. The cause of the urethral discharge is the irritation or infection of the urethra (urethritis). Transparent and viscous spillage is due to the production of regular urethral liquid by the periurethral gland in response to sexual stimulating. Purulent discharge instead, is always a sign of infection (most of the bacterial instead of a virus).
It has a transparent and viscous appearance, and it is the result of the normal production of the small glands we can find in the urethral walls. These periurethral glands produce this slimy liquid physiologically in response to arousal (pre-ejaculate). However, they can increase the production in response to irritation like urine hyperdensity and acidic (dehydration, spicy foods, alcohol abuse), trauma (prolonged and intense sexual intercourse) or bath soaps.
Normal penile discharge may occur also after bowel movements. It is due to the squeeze effect on the prostate while hard stools pass through the bowel.
We do not consider as normal any white and yellowish penile discharge which is not associated with sexual arousal. The causes can be:
The collection of the liquid or a urethral swab is useful to identify the bacteria involved in the infection. We collect and send the sample to the laboratory where it is processed and put in culture media. After 3-4 days the results are usually ready. Most of the times, we do not wait for the results but we start antibiotic treatment immediately. According to the characteristics of the discharge and to the associated symptoms, we can set an empiric antibiotic treatment that will be confirmed with the lab results. Usually, the effective treatment is the one that can give a great improvement already after 12-24 hours.
The treatment of painful urination depends on the disease that is causing it. Since infectious diseases, sexual or not, are the most frequent causes, we use almost always antibiotics.
The correct treatment should be prescribed by the doctor, according to the type of infection. Incorrect use of antibiotics might get it worse, get it chronic, or increase bacterial resistance.
Progressive worsening painful urination is always a good reason to see a doctor, especially if it comes with discharge, blood, and fever.