Abnormal Penile Discharge and Urinary Symptoms

Q: Abnormal Penile Discharge and Urinary Symptoms

Hello： <br>1) Recently, after waking up, my urine has had a strong ammonia smell, even though I haven't eaten any spicy or heavily flavored foods, just one cup of black coffee daily. <br>Is this normal? --> If your lifestyle is normal, with minimal spicy or fried foods, adequate

Penile discharge

Hello, doctor.
I have a few questions I would like to ask:
1) Recently, I have noticed a strong ammonia smell in my urine during the first few times I urinate after waking up.
I haven't consumed any spicy or heavily flavored foods, just one cup of black coffee daily.
Is this normal?
2) Similarly, I have been experiencing a clear, sticky discharge from my glans, resembling the pre-ejaculatory fluid.
After a while, it develops a strong foul odor that persists even after wiping.
3) Occasionally, I feel a sharp sensation in my urethra, and there is pain during urination.
I also experience a frequent urge to urinate, but after sleeping or waiting for a while, the sharp pain subsides.
I have visited a nearby hospital and a urology clinic for tests, including a urinalysis, and all results were normal with no signs of urethritis.
However, this is quite distressing.
Should I seek further evaluation at another hospital or undergo more detailed testing?
P.S.
Could this possibly be related to oral sex with my girlfriend if her oral hygiene is not good? Thank you.

L, 20~29 year old female. Ask Date: 2021/08/23

Dr. Du Shixi reply Urology

Hello:
1) Recently, after waking up, my urine has had a strong ammonia smell, even though I haven't eaten any spicy or heavily flavored foods, just one cup of black coffee daily.
Is this normal? --> If your lifestyle is normal, with minimal spicy or fried foods, adequate hydration, and good hygiene, this should not occur.
2) Similarly, I have noticed that my glans often has a clear, sticky discharge when urinating, resembling the pre-ejaculatory fluid.
After a while, it develops a strong foul odor, which persists even after wiping.
--> It is advisable to check your urine.
3) Occasionally, I experience a prickling sensation in my urethra, along with pain during urination.
During this period, I also feel an increased urge to urinate, but after sleeping or after some time, the prickling sensation subsides.
--> It is recommended to check your urine and increase your fluid intake.
I have already visited a nearby hospital and urology clinic for urine tests, and all reports came back normal with no signs of urethritis, but this is really troubling.
Should I seek further evaluation at another hospital or undergo more detailed tests? (Since the symptoms are not obvious, tests may not yield results when asymptomatic; testing during symptomatic periods is more likely to be informative.)
P.S.
Could this possibly be caused by my girlfriend performing oral sex without proper oral hygiene? --> It's hard to say.
Wishing you good health.

Reply Date: 2021/08/23

More Info

Understanding abnormal penile discharge and urinary symptoms can be quite complex, as these symptoms can arise from various underlying conditions. Let's break down your concerns one by one.

1. Ammonia Smell in Urine: The strong ammonia smell in your urine can be attributed to several factors. Dehydration is one of the most common causes; when you are not drinking enough fluids, your urine becomes more concentrated, leading to a stronger odor. Additionally, certain foods, medications, and supplements can also affect the smell of urine. While coffee can contribute to dehydration, it is unlikely to be the sole cause. If you are consistently experiencing this symptom, it may be worth increasing your fluid intake and monitoring any changes.

2. Clear Mucous Discharge: The presence of clear, mucous-like discharge from the glans (tip of the penis) can be normal in certain situations, particularly if it resembles pre-ejaculatory fluid. However, if this discharge is accompanied by a strong odor, it could indicate an infection or another underlying issue. The odor you describe could be due to bacterial growth, which can occur if there is a buildup of smegma or if there is an infection. It is essential to maintain proper hygiene and consult a healthcare professional if the discharge persists or worsens.

3. Painful Urination and Frequency: The symptoms of sharp pain during urination and increased frequency can be indicative of a urinary tract infection (UTI), urethritis, or prostatitis. Even if your initial urine tests came back normal, it is important to consider that some infections may not be easily detectable through standard urinalysis. The intermittent nature of your symptoms, along with the pain and frequency, suggests that further evaluation may be necessary.
Regarding your concern about the possibility of your girlfriend's oral hygiene affecting your symptoms, it is possible for bacteria from the mouth to be transferred during oral sex, potentially leading to infections. However, this is just one of many potential causes for your symptoms.

Next Steps: Given the persistence and variety of your symptoms, it would be prudent to seek further evaluation from a urologist. They may recommend more specific tests, such as a urine culture, which can help identify any bacterial infections that may not have been detected in your initial tests. Additionally, they may consider other diagnostic procedures, such as a cystoscopy, to visually inspect the urinary tract for any abnormalities.

In summary, while some of your symptoms may be benign, the combination of strong odors, discharge, and pain during urination warrants further investigation. It is essential to communicate openly with your healthcare provider about all your symptoms and concerns, as this will help them provide the most accurate diagnosis and appropriate treatment. Remember, early intervention can often lead to better outcomes, so don’t hesitate to seek help.

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