Persistent Urethral Discharge: Symptoms and Treatment Options

There is discharge from the urethra, and medical attention has been sought, but the symptoms persist?

Hello, doctor.
Three weeks ago, I noticed occasional discharge from the urethral opening (white, sometimes yellow like eye discharge).
In the morning, my underwear would also have some stains, but I do not experience discomfort while urinating.
Sometimes, I feel pain during an erection, but it only lasts a few seconds and feels like something is stuck inside.
Initially, I thought it might be gonorrhea, but two weeks ago, I went to see a doctor, described my symptoms, and underwent a urinalysis and X-ray.
The doctor pointed out that there was a significant inflammation in my lower abdomen on the X-ray, but he was unsure of the cause.
He prescribed an antibiotic (I forgot the name, but it had "250G" on it, and the dosage was twice a day for seven days).
I have completed a week of medication, but the same situation persists.
During the consultation, the doctor mentioned that it could also be due to a small object stuck in the urethra.
I would like to ask if conditions like kidney stones could also cause discharge.
Currently, I also feel that the volume of my ejaculation has decreased, and my partner says that the semen has little to no smell.
Thank you, doctor.

Xiao Lin, 20~29 year old female. Ask Date: 2024/05/07

Dr. Li Xinyi reply Urology

Based on your description, it cannot be ruled out that this is a gonorrhea infection.
Both partners must get tested and treated simultaneously; otherwise, cross-infection could lead to persistent issues.
It is recommended that males see a urologist and females see a gynecologist for examination and treatment.

Reply Date: 2024/05/07

More Info

Persistent urethral discharge can be a concerning symptom, and your description suggests that there may be an underlying issue that requires further evaluation. Given your history and the symptoms you’ve described, it’s essential to consider several potential causes and treatment options.

Firstly, the presence of urethral discharge, especially if it is white or yellow, can indicate an infection. Common infections that cause such symptoms include sexually transmitted infections (STIs) like gonorrhea and chlamydia, but other non-STI infections can also occur. The fact that you have experienced some pain during erections and a sensation of something being stuck inside may suggest inflammation or irritation in the urethra.

You mentioned that you had an X-ray that showed significant inflammation in your lower abdomen, but the exact cause was not determined. This inflammation could be due to a urinary tract infection (UTI), prostatitis (inflammation of the prostate), or even a urethral stricture (narrowing of the urethra). The antibiotic treatment you received may have been appropriate for a bacterial infection, but if the discharge persists, it may indicate that the infection has not been fully resolved or that another issue is present.

Regarding your question about whether a stone could cause discharge: while urinary stones typically cause pain, hematuria (blood in urine), and sometimes urinary obstruction, they do not usually cause urethral discharge. However, if a stone is causing irritation or if there is an associated infection, it could potentially lead to discharge.

The decrease in the volume of your ejaculate and changes in the odor of your semen could also be related to several factors, including infection, inflammation, or even hormonal changes. Prostatitis, for example, can lead to changes in semen quality and quantity.

Given that your symptoms have not improved after a week of antibiotic treatment, it is crucial to follow up with your healthcare provider. They may recommend additional tests, such as a urine culture to identify any specific pathogens, or imaging studies like an ultrasound to check for stones or other abnormalities in the urinary tract.
In terms of treatment options, if an infection is confirmed, a different antibiotic may be necessary, especially if the initial treatment was ineffective. If a urethral stricture or another anatomical issue is suspected, referral to a urologist for further evaluation and potential intervention may be warranted.

In summary, persistent urethral discharge, especially in the context of your other symptoms, should be thoroughly evaluated. It is essential to communicate openly with your healthcare provider about all your symptoms, including the changes in your ejaculate, to ensure a comprehensive assessment and appropriate treatment plan. Do not hesitate to seek further medical attention if your symptoms persist or worsen.

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