[Question #10090] Penile Discharge after Bowel Movement?

26 months ago

Hoping you can help with a strange one. Early this year I contracted Chlamydia and was treated with Doxy. I re-tested after 3 weeks and was negative.. About 6 weeks after that I noticed after a bowel movement (that involved some straining) a white discharge from the penis and I wondered what it was. it looked like semen and was not as thick as when I had the infection. I have had this every now again, but no other symptoms such as the discharge after urination. or pain when peeing. Thinking I must have got reinfected I got tested again (via a urine sample) and also for Gonorrhea with both coming up negative. The also gave me a second urine test with the result being my white blood call count was down. They grew some cluture and the diagnosis came back as Urethritis - Corynebacterium Glucuronolyticum. I was prescribed a 2 weeks course of antibiotics (sulphmethoxazole & Trimethoprim). However that did not clear up the discharge, which was only appeared after a straining bowel movement. Do you have any idea of what it could be? Could the infection have got into my prostate somehow? Is it another STI or just either Prostatitis or Urethritis? Could the urine tests miss the 2 STI's? Appreciate your thoughts and suggestions on this.

H. Hunter Handsfield, MD

25 months ago

Welcome to the forum. Thanks for your confidence in our services.

Your question is not a "strange one" at all. You describe a fairly common and entirely normal situation, something experienced by most men at one time or another, and quite frequent in some -- specifically discharge during or immediately after defecation. Increased intraabdominal pressure when straining at stool, and pressure from stool passing over the prostate gland and seminal vesicles, can squeeze out semen or prostate fluid. If it happens especially frequently or is clearly a new problem, it makes sense to see a urologist to confirm that's the only problem, but your description is perfectly consistent with this explanation. An unknown aspect is whether it happens more commonly in men with prostatitis, but this has not been studied in any systematic way.

Corynebacterium species (glucowhatever and others) are entirely normal in the urethra and around the genitals. Since you had no obvious inflammatory symptoms (painful urination, for example) and the antibiotic treatment had no effect, I am confident the culture results meant nothing.

So almost certainly that's what's going on, just the physical effects of defecation -- i.e. nothing is wrong. However, if this is a definite change, happens all the time, and/or continues to concern you, perhaps you should see a urologist. I'm quite confident s/he would confirm my assessment. It's really nothing to be worried about.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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25 months ago

Thank you so much Dr. Handsfield, very helpful and you certainly provide a great service to the community.

So as I understand the urine tests for both Chlaymida and Gonorrhea are highly accurate, I can take comfort with a negative test result that I do not have an STI.

I think I will take up your suggestion to see a urologist to check that there is nothing else going on apart from potential prostatitis. I did also note that I had an amount of a clear liquid "pre cum" during foreplay which I did not have previously. Thank you.

H. Hunter Handsfield, MD

25 months ago

Clear pre-ejaculate fluid is entirely normal. I have to wonder whether it's really new, or if you're just noticing it now because of your heightened awareness, prostatitis, concerns, etc. As I said above, it makes sense to see a urologist about the fluids expressed during defecation. Probably nothing is wrong, but better safe than sorry.---