Why does the male urethral orifice sting and discharge pus?

Stinging and discharge of pus from the male urethra may be caused by gonococcal urethritis, non-gonococcal urethritis, prostatitis, urinary tract infection, urethral injury, etc. It can be relieved by antibiotic treatment, local care, lifestyle adjustment, etc. It is recommended to seek medical treatment promptly to determine the cause.

1. Gonococcal urethritis

Gonococcal urethritis is caused by gonococcal infection and manifests as purulent discharge from the urethra with tingling pain, which may be accompanied by frequent urination and urgency. Confirmation requires a secretion smear test or nucleic acid amplification test. For treatment, antibiotics such as ceftriaxone sodium for injection and spectinomycin hydrochloride injection can be used as directed by the doctor. At the same time, sexual partners need to be treated simultaneously. Alcohol and sexual activity are prohibited during treatment.

2. Nongonococcal urethritis

Nongonococcal urethritis is mostly caused by Chlamydia trachomatis or Mycoplasma infection. The discharge is often thin and serous, accompanied by a burning sensation during urination. Diagnosis can be confirmed by PCR testing of urethral swabs. Commonly used drugs include azithromycin dispersible tablets, doxycycline hydrochloride tablets, etc. It should be noted that the disease is prone to relapse, and treatment cycles usually require continuous medication.

3. Prostatitis

Acute bacterial prostatitis may cause purulent urethral discharge, accompanied by perineal distension and warmth. Digital rectal examination reveals an enlarged prostate. Treatment requires drugs with strong ability to penetrate the prostate capsule, such as levofloxacin tablets, celecoxib capsules, etc. Patients with chronic prostatitis need to cooperate with warm water sitz bath and regular semen ejaculation.

4. Urinary tract infection

Ascending urinary tract infection may cause congestion and exudation of the urethral mucosa, leading to purulent discharge. The common pathogenic bacteria is Escherichia coli. Routine urine and urine culture examinations can be performed. For mild cases, fosfomycin trometamol powder and nitrofurantoin enteric-coated tablets can be taken orally, while for severe cases, intravenous antibiotics are required. Drinking water should be sufficient every day.

5. Urethral injury

Urethral instrument examination, stone expulsion or external force impact may cause damage to the urethral mucosa, resulting in purulent secretions following secondary infection. A urethrogram is required to assess the extent of the injury. Treatment includes indwelling urinary catheter and use of cefaclor extended-release tablets to prevent infection. Straddle exercise should be avoided during the recovery period.

When symptoms of pus discharge from the urethral orifice occur, sexual intercourse should be stopped immediately and avoid sharing personal items such as towels. Wash the perineum with warm water every day and choose pure cotton breathable underwear. The diet should be light and limit the intake of spicy foods. During treatment, observe changes in secretion properties. If fever or pain worsens, timely follow-up is required. All medications must be used strictly in accordance with medical advice and the entire course of treatment must be completed to prevent the development of drug resistance.