Urethral discharge
Urethral discharge from the urinary meatus may be purulent, mucoid, or thin; sanguineous or clear; and scant or profuse. It usually develops suddenly, most commonly in men with a prostate infection.
History
Ask the patient when he first noticed the discharge, and have him describe its color, consistency, and quantity. Does he experience pain or burning on urination? Does he have difficulty initiating a urine stream? Does he experience urinary frequency? Ask the patient about other associated signs and symptoms, such as fever, chills, and perineal fullness. Explore his history for prostate problems, sexually transmitted disease, or urinary tract infection. Ask the patient if he has had recent sexual contacts or a new sexual partner.
Physical assessment
Inspect the patient’s urethral meatus for inflammation and swelling. Using proper technique, obtain a culture specimen. (See Collecting a urethral discharge specimen, page 664.) Then obtain a urine specimen for urinalysis, culture, and possibly a three-glass urine test. (See How to perform the three-glass urine test, page 665.) In the male patient, the prostate gland may have to be palpated.
Medical causes
Prostatitis
Acute prostatitis is characterized by purulent urethral discharge. Initial signs and symptoms include sudden fever, chills, low back pain, myalgia, perineal fullness, and arthralgia. Urination becomes increasingly frequent and urgent, and the urine may appear cloudy. Dysuria, nocturia, and some degree of urinary obstruction may also occur. The prostate may be tense, boggy, tender, and warm.
Although chronic prostatitis commonly produces no symptoms, it may produce a persistent urethral discharge that’s thin, milky, or clear and sometimes sticky. The discharge appears at the meatus after a long interval between voidings, as in the morning. Associated effects include a dull aching in the prostate or rectum, sexual dysfunction such as ejaculatory pain, and urinary disturbances such as frequency, urgency, and dysuria.
Reiter’s syndrome
Reiter’s syndrome is a self-limiting syndrome that usually affects males. Urethral discharge and other signs of acute urethritis occur 1 to 2 weeks after sexual contact. Asymmetrical arthritis, conjunctivitis of one or both eyes, and ulcerations on the oral mucosa, glans penis, palms, and soles may also occur.
Urethritis
Urethritis, which is commonly sexually transmitted (as in gonorrhea), typically produces scant or profuse urethral discharge that’s either thin and clear, mucoid, or thick and purulent. Other effects include urinary hesitancy, urgency, and frequency; dysuria; and itching and burning around the meatus.
Special considerations
To help the patient relieve symptoms, suggest that he take hot sitz baths several times daily, increase his fluid intake, void frequently, and avoid caffeine, tea, and alcohol. Monitor him for urine retention.
Pediatric pointers
Carefully evaluate a child with urethral discharge for evidence of sexual and physical abuse.
Geriatric pointers
Urethral discharge in elderly males isn’t usually related to a sexually transmitted disease.
Patient counseling
Advise the patient with acute prostatitis to discontinue sexual activity until acute symptoms subside. However, encourage the patient with chronic prostatitis to regularly engage in sexual activity because ejaculation may relieve pain.
Pictures
Book Source Details
- Book Title: Signs & Symptoms: A 2-in-1 Reference for Nurses
- Author(s): Springhouse
- Year of Publication: 2007
- Copyright Details: Signs & Symptoms: A 2-in-1 Reference for Nurses, Copyright © 2007 Lippincott Williams & Wilkins.
Other Book Chapters Related to Penis pain
Read excerpts from these other book chapters related to Penis pain:
Medical Books Excerpts
- PRIAPISM
- "Algorithmic Diagnosis of Symptoms and Signs" (2003)
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- PRIAPISM
- "Differential Diagnosis in Primary Care" (2007)
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- Priapism
- "Handbook of Signs & Symptoms (Third Edition)" (2006)
- [ read ]
- Priapism
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
- [ read ]
- Priapism
- "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
- [ read ]
- Urethral Discharge
- "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
- [ read ]
- Priapism
- "Nursing: Interpreting Signs and Symptoms" (2007)
- [ read ]
- PRIAPISM
- "Differential Diagnosis in Primary Care" (2007)
- [ read ]
Copyright Details: Signs & Symptoms: A 2-in-1 Reference for Nurses, Copyright © 2008 Williams & Wilkins.
More About Causes of Penis pain
» Next page: Genital lesions, male (Nursing: Interpreting Signs and Symptoms)
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