Symptoms of Urethral Discharge

a puslike urethral discharge that may he yellowish, cloudy, green, white, or bloodstained.

frequent need to urinate.

burning sensation while urinating.

severe pelvic and lower abdominal pain.

constant urge to move bowels (anal gonorrhea):

nausea; vomiting, fever, chills.

pain during intercourse.

reddened, irritated tip of penis.

severe sore throat; pain on swallowing (pharyngeal gonorrhea).

Before we try to understand the illnesses associated with the penis, we will try to understand the structure of penis. In the penis, they are three cylinders. These are called corporas. The urethra or urine passage is situated in one of these cylinders called corpora spongiosum.

The urethra or urine pipe is nearly 25 cm long & has two closing mechanisms to prevent leakage of urine. The urethra opens at the glans penis via meatus. The other two cylinders are useful to get an erection. When these two cylinders are full with blood erection ensues.

If there are changes in the length or size / shape of these cylinders various problems can arise in the penis. The illustration shows the details of the anatomy of penis.

The various penile illnesses can be divided into two :

1. Defects present at birth : Due to various problems during the process of birth of a child, following illnesses can occur.

a. Phimosis

b. Small Penis

c. Hypospadius

d. Curvature of penis of erection

e. Completely distorted anatomy of penis & testies, etc.

2. Defects which develop after birth :

a. Baianitis

b. Stricture of urthra or meatus

c. Fracture of penis

d. Rupture of urethra

e. Peyronic's disease (Curvature of penis on erection)

f. Whitish penis

Last time we saw the problems in penis & urethra which are essentially present at birth. Today we will see some problems which arise after birth.

Balanitis :

Due to non cleaning of glans penis with water during bath, sometimes there is infection below the preputial skin. Many times this is associated with narrow opening of the skin [phimosis]. This is more seen with patients with diabetes mellitus, BXO, etc. To avoid this, it is necessary that during bath, a person should retarct the preputial skin, pour a glass of a water & keep the glans clean. There is no need to use soap in this area. If the problem persists, please consult a urologist.

Stricture of the Urethra :

Stricture means narrowing of the water pipe. Due to infections, previous operations on the urethra, trauma, etc. the water pipe can become narrow or small. This results in poor urine flow, difficulty in passing urine, burning micturition, sense of incomplete passing of urine, unable to pass urine, fever, bleeding from the urethra, etc.

This also results in damage to the bladder as it has to use more force to pass urine every time. It is necessary to see an urologist at the earliest in such a situation.

If the diagnosis is confirmed, he well make the urethra bigger by an operation with the help of a telescope.

If that does not help over a longtime, it may be necessary to repair it by an open operation called Urethroplasty.

Urethroplasty is far more successful than the telescopic operation & results in permanent cure in 90 to 95% patients.

Fracture of the Penis :

When the penis is erect & if it gets a traumatic blow, it can get fractured or break on the inside. There will be swelling due to internal bleeding. When this occurs, urologist should be contacted immediately.

The broken fracture area will be repaired immediately. This will help in avoiding a long term risk of permanent erection problems or curvature of penis. A person should not be afraid of this problem & should get in touch with an urologist immediately.

Rupture of Urethra :

In road traffic accidents or after major trauma, a person can have rupture of his urethra. The rupture can be partial or complete.

There will be bleeding at the tip of the urethra or difficulty or inability to pass urine in such a case.

It is necessary to get in touch with a urologist immediately.

If a catheter can not be passed in the bladder, then a catheter may be passed by making a small hole in the lower part of abdomen.

There will be special X-rays of urethra done after few weeks about the site & length of rupture. Then the urologist will decide about further plan of treatment in the form of Urethroplasty, etc.

We will now try to understand these problems in details.

Small Penis :

Some people have a small length of penis. It is called micro phallus or short penis. Actually, many a times, if it is measured by scientific ways, it is found to be correct.

Most of these short penises are structurally normal. This is a very rare problem.

In children if a child has a short penis, it is possible to increase the length of penis by medicines. In adults sometimes the penis is buried. It is possible to increase the length in such cases.

Most of these persons have incorrect views about this issue. If someone is in gross doubt about the length of the penis, he should get in touch with a urologist.

Hypospadius :

As we have seen about the urethra or the urine pine opens at the tip of penis. In patients with hypospadius, the opening of the urethra is situated in the lower part of the penis much before the actual opening site. Sometimes the penis is also curved. In the diagram this defect is shown. This may be associated with absence of testies in scrotum.

It is possible to form a new urethra & get the opening to the tip of the meatus. The penis is also made straight during this operation. This is very delicate operation & is done only be experts.

Curvature of Penis on Erection :

Sometimes penis becomes curved on erection. This may because of short skin on one side. If one of the cylinders inside the penis is small, it can also lead to curvature of penis. With the help of operation, this problem can be corrected & the penis can be made straight.

Completely Distorted Anatomy of Penis & Testies :

Due to hormonal disturbances when the child is still developing, sometimes there is complete distortion of penis & testis & scrotum.

Various type of abnormal arrangements are seen in such persons. After multiple delicate surgeries these problems are corrected.

Phimosis :

The skin in front of the glans can not slide back over glans penis because of its small opening. Therefore it ballons whenever the child tries to pass urine.

Infection can occur below this skin due to accumulation of urine & other substances. This gives pain & burning micturition. if the skin can go back slightly, a glass of water should be poured on the opening everyday at the time of bath.

If after a week it does not help to reduce the pain, a urologist should be consulted regarding further treatment.

The tight skin can also give discomfort during erections when the person becomes an adult. Circumcision is required to correct this problems.

These are some of the problems of penis seen at birth. We will see the problem which develop during the course of life next time.

Curvature of Penis on Erection :

Some persons may notice curvature of penis on erections, mostly after some years of active intercourse.

They may also feel a firm to hard swelling in the penis. If this problem arises, it is necessary to consult a urologist regarding a possibility of peyronie's disease.

This illness is to be treated by operation only after 1 year & only if there is significant curvature of penis to cause interference during intercourse.

Short Frenulum :

Though this problem is present since birth, it starts creating problem at the time of intercourse. Due to short frenulum, the tip of the penis gets curved on erection making it difficult to carry on with intercourse due to pain & occasional bleeding. Urologist will correct this problem with a minor operation. These are some of the commonly seen associated with penis. It is to be noticed that most of these problems are curable. n

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