Urethral Discharge: Causes and Treatment Options

Urinary tract infection (UTI)

Initially, after exercising in the evening, I noticed a white discharge from my urethra that dried and stuck to my underwear (some of the dried discharge appeared yellow).
After researching online, I initially suspected it might be gonorrhea (I used condoms during sexual intercourse), and I promptly scheduled an appointment with the urology department at the hospital.
However, by the next morning, I observed that the urethral discharge had ceased to be white.
The doctor performed a culture and prescribed both an injection and oral antibiotics, after which I went home.

During a follow-up visit, the doctor confirmed it was not gonorrhea and mentioned that if I had no symptoms, I did not need to return.
However, after a few days, I still experienced pain during urination, so I visited a different hospital's urology department (as I was in another county at the time).
The urologist asked me to collect a midstream urine sample for testing, which indicated no bacterial infection.
Consequently, the doctor only prescribed Tylenol and an antihistamine (Allegra), suggesting it was tissue pain following an infection.
A few days later, I noticed white discharge again one morning, and I still experienced a burning sensation while urinating.
I returned to the urology department at the first hospital and informed the doctor that my symptoms had not improved.
The doctor mentioned that besides gonorrhea, another type of bacteria could also cause urethral infections and prescribed a different antibiotic (Doxycycline).
He also suggested that the morning white discharge might be prostatic fluid (although I had not experienced such discharge before the urethral discomfort).

I am currently undergoing a seven-day course of antibiotics, but two days ago, I noticed itching and redness along the underside of the glans, with surrounding foreskin swelling.
The next day, I discovered a sizable blister beneath the glans that contained fluid (possibly tissue fluid).
I have also researched online, wondering if it could be trichomoniasis, balanitis, or condyloma.
Thank you.

Fabrizio, 20~29 year old female. Ask Date: 2016/03/18

Dr. Li Xinyi reply Urology

The possibility of Trichomonas, Mycoplasma, and Gonorrhea cannot be ruled out.
It is recommended to continue seeing a urologist for further examination and to discuss with the physician.

Reply Date: 2016/03/18

More Info

Understanding urethral discharge and its associated symptoms can be quite complex, especially when multiple potential causes are involved. Based on your description, it appears that you have experienced a range of symptoms including urethral discharge, pain during urination, and irritation around the glans penis. Let's break down the potential causes and treatment options for your condition.

Potential Causes of Urethral Discharge
1. Infections: The most common cause of urethral discharge is an infection. While you have ruled out gonorrhea, other sexually transmitted infections (STIs) such as chlamydia can also cause similar symptoms. Additionally, non-STI infections, including urinary tract infections (UTIs), can lead to discharge and discomfort.

2. Prostatitis: Inflammation of the prostate gland, known as prostatitis, can cause urethral discharge, pain during urination, and discomfort in the pelvic area. The presence of white discharge in the morning could be related to prostate fluid.

3. Balanitis or Posthitis: Inflammation of the glans penis (balanitis) or the foreskin (posthitis) can lead to irritation, redness, and discharge. This condition can be exacerbated by poor hygiene, irritants, or infections.

4. Allergic Reactions or Irritants: Sometimes, the use of certain soaps, lotions, or even condoms can cause allergic reactions leading to irritation and discharge.

5. Other Conditions: Conditions like trichomoniasis or other fungal infections could also be responsible for your symptoms, especially if there is associated itching or irritation.

Treatment Options
1. Antibiotics: Since you are currently on a course of doxycycline, it is essential to complete the full regimen as prescribed. This antibiotic is effective against a variety of bacterial infections, including those that may not be sexually transmitted.

2. Symptomatic Relief: Over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen can help alleviate discomfort. Antihistamines may also help if there is an allergic component to your symptoms.

3. Topical Treatments: If there is evidence of balanitis or posthitis, topical antifungal or antibacterial creams may be beneficial. However, these should only be used after consulting with a healthcare provider.

4. Follow-Up Care: Given the persistence of your symptoms, it is crucial to maintain communication with your healthcare provider. If symptoms do not improve or worsen, further evaluation may be necessary, including additional cultures or imaging studies.

5. Avoid Irritants: Until your symptoms resolve, avoid any potential irritants such as scented soaps, lotions, or tight-fitting clothing that may exacerbate your condition.

When to Seek Further Medical Attention
- If you experience fever, chills, or worsening pain, it is essential to seek immediate medical attention.

- If the discharge persists despite antibiotic treatment, or if new symptoms develop (such as increased swelling, severe pain, or systemic symptoms), further evaluation by a urologist may be warranted.

Conclusion
Urethral discharge and associated symptoms can arise from various causes, and it is essential to approach treatment systematically. Continue to follow your healthcare provider's recommendations, complete your antibiotic course, and monitor your symptoms closely. If you have any concerns or if your symptoms do not improve, do not hesitate to seek further medical advice. Your health and comfort are paramount, and addressing these issues promptly will help ensure a better outcome.

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