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What Are Causes for Penile Discharge?

Learn to spot the signs of infection

Published on 05/22/2017
Mind and BodySexual HealthSexualitySexually Transmitted DiseaseMale Sexual HealthWestern
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Penile discharge is the presence of leaking fluid from the penis and can be cause for concern. There are several possible causes for discharge, ranging from sexually transmitted diseases to bacterial infections. The fluid can be clear and watery, contain pus, and even contain blood. Here are a few of the causes of penile discharge.

Sexually Transmitted Diseases (STDs)

Several sexually transmitted diseases (STDs) can cause penile discharge. Examples include chlamydia, gonorrhea, and infections with Trichomonas. Syphilis can also produce penile discharge; although it is rarer. Pus-filled discharge with blood is an additional symptom associated with these infections. Pus develops from the body’s response to try to fight off the infection. Blood develops from the inflammation that leads to bleeding. Other symptoms can include pain with urination (known as dysuria) and an increased urgency to want to urinate.

Table 1. Sexually Transmitted Diseases with Penile Discharge
Condition Cause Treatment

Chlamydia

Bacteria 
(Chlamydia trachomatis)

1) Single dose: Oral Azithromycin 1 gram

OR

2) Seven-day course: Oral Doxycycline 100 mg twice daily

Gonorrhea

Bacteria 
(Neisseria gonorrhoeae)

1) Intramuscular Ceftriaxone 250 mg

AND

2) Oral Azithromycin 1 gram

Syphilis

Bacteria 
(Treponema pallidum)

The treatment depends on the stage of syphilis:

Primary and secondary phase: Penicillin

(For those with penicillin allergies, alternatives may be discussed with a physician)

Trichomoniasis

Parasite 
(Trichomonas vaginalis)

1) Single dose: Oral Metronidazole 2 grams

OR

2) Seven-day course: Oral Metronidazole 500 mg twice daily

Bacterial Infections

In some cases, penile discharge can occur when there is a urinary tract infection. Urinary tract infections (UTIs) are rarer in men compared to women, and this is most likely because the urinary tract is longer in men before getting to the bladder. In some men, their prostate can become infected and inflamed, known as prostatitis, and this can lead to fever, bloody penile discharge, and pain during urination.

Several issues increase the risk for men to develop urinary tract infections:

  • An enlarged prostate can block the flow of urine out of the bladder, increasing the risk of infection.
  • Diabetes[1] can increase the likelihood of UTIs. 
  • An indwelling catheter that is left in place to help with urinary incontinence. This is more frequently seen in those that are in nursing homes.
Table 2. Urinary Tract and Prostate Infections
Condition Cause Treatment

Urinary Tract Infection

Bacteria
(most common is E. coli)

Antibiotics based on culture results, kidney function, and your existing allergies. A serious infection may require hospitalization. Your physician can give you more information.

Prostatitis

Non-bacterial and bacterial causes are possible

A physician may perform additional examinations and testing (including an examination of the prostate and evaluation of the urine) to better identify the cause for the prostatitis. Antibiotics may be used in cases where infection is a concern. 

Signs of Infection 

Regardless of the cause, if you have penile discharge, a medical professional should evaluate it to determine the cause and the appropriate treatment options. There are a few symptoms that you should pay close attention to and relate to a medical professional who is evaluating you:

  • Pain: Detail the level of pain. If you have pain, try to see if the pain is constant or if acts, such as urination, make the pain come on. Track if the pain is the worst before, during, or after urination.
  • Urgency to urinate: Keep track of whether you feel an urgency to urinate, as these infections may increase your feeling to urinate.
  • Pus and blood: Pay attention to whether you have blood or pus in your discharge. Sometimes you will only notice the blood in the toilet after urinating.

What Can You Do to Prevent Sexually Transmitted Diseases (STDs)?

  • Condoms: Latex condoms are an effective method to reduce the spread of sexually transmitted infections. Condoms should be used every time with vaginal, anal, or oral sex. Condoms do not prevent all sexually transmitted infections, as some infections such as Herpes and Human papillomavirus (HPV), are spread by skin-to-skin contact.
  • Vaccination: There are vaccines available that can protect you against Hepatitis B and HPV; these should be completed before you become sexually active.
  • Testing: Prior to sexual contact, you and your partner should get tested for STDs.[2]
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