Penile discharge

Template:Search infobox Steven C. Campbell, M.D., Ph.D.

Overview

Penile discharge is commonly associated with STD's. A thorough sexual history along with a complete medical history and physical exam are necessary. In addition, cultures for STD's should be taken though rarely are nonsexually transmitted diseases the cause.

Causes

Common Causes

• Carcinoma of the urethra
• Foreign body in the urethra
• Infection
• Nonspecific urethritis
• Prostatitis
• Reiter's syndrome

Risk Factors

A patient that is not circumscised is at higher risk for STD's.

Diagnosis

History and Symptoms

• History includes:

• Personal history
• Sexual history

• Note: onset, color, type and duration of discharge

Physical Examination

• Genital exam

Laboratory Findings

• Blood culture
• CBC
• Hepatitis B
• Hepatitis C antibodies
• HIV
• RPR
• Urethral cultures - gold standard for gonorrhea and chlamydia
• Urinalysis
• Wet mount for trichomonas

X Ray

• X-ray for detection of foreign bodies, when necessary.

Treatment

• Penile discharge should be treated as an STD until definitivly ruled out.

Medical Therapy

Pharmacotherapy

Acute Pharmacotherapies

• Chlamydia - PO azithromycin, ofloxacin for seven days, doxycycline for seven days or erythromycin for seven days
• Trichomonas - Single dose metronidazole for seven days
• Gonorrhea - Ceftriaxone single dose IM (in office) / PO cefixime / ciprofloxacin

Primary Prevention

• Suggest the patient inform all sexual partners of disease so they can seek treatment.
• Discuss safe sexual practices.

Related Chapters

• Discharge
• STD's