Penile discharge

Template:Search infobox Steven C. Campbell, M.D., Ph.D.

Overview

Penile discharge is commonly associated with STDs. A thorough sexual history along with a complete medical history and physical exam are necessary. In addition, cultures for STDs should be taken though rarely are nonsexually transmitted diseases the cause. A patient that is not circumscised is at higher risk for STDs.

Differential Diagnosis

• Carcinoma of the urethra
• Foreign body in the urethra
• Infection
• Nonspecific urethritis
• Prostatitis
• Reiter's Syndrome

Diagnosis

History and Symptoms

• History includes:

• personal history
• sexual history

• Note: onset, color, type and duration of discharge

Other

• Genital exam

Laboratory Findings

• Blood culture
• CBC
• Hepatitis B
• Hepatitis C antibodies
• HIV
• RPR
• Urethral cultures - Gold standard for gonorrhea and chlamydia
• Urinalysis
• Wet mount for trichomonas

X Ray

• X-ray for detection of foreign bodies, when necessary

Treatment

• Penile discharge should be treated as an STD until definitivly ruled out

Medical Therapy

Pharmacotherapy

Acute Pharmacotherapies

• Chlamydia - PO azithromycin, ofloxacin for seven days, doxycycline for seven days or erythromycin for seven days
• Trichomonas - Single dose metronidazole for seven days
• Gonorrhea - Ceftriaxone single dose IM (in office) / PO cefixime / ciprofloxacin

Primary Prevention

• Suggest the patient inform all sexual partners of disease so they can seek treatment
• Discuss safe sexual practice