What Causes Pus Discharge from the Male Genitals?

Generally, purulent discharge from the male genitalia may result from various causes, including accumulation of smegma with subsequent irritation, local friction or trauma, non-gonococcal urethritis, gonorrhea, or acute suppurative prostatitis. If such symptoms occur, prompt evaluation at a reputable hospital is recommended for accurate diagnosis and management. A detailed analysis follows:

1. Smegma Accumulation and Irritation

In individuals with phimosis or redundant prepuce who fail to maintain regular hygiene, secretions from the inner preputial surface mix with desquamated epithelial cells to form smegma. Prolonged irritation of the glans penis and coronal sulcus mucosa can trigger an aseptic inflammatory response, leading to mucosal exudation that resembles pus. Daily cleansing with warm water—gently retracting the foreskin—is advised. For patients with phimosis or recurrent inflammation, circumcision may be considered after reaching adulthood.

2. Local Friction or Trauma

Excessive force during sexual intercourse or repeated friction from overly tight underwear may cause microtrauma to the external urethral meatus or glans mucosa. The resulting tissue fluid mixed with minor hemorrhage and secretions may appear as thin, pale purulent discharge. Wearing loose-fitting, 100% cotton underwear and abstaining from sexual activity until complete wound healing are recommended. Maintaining local dryness typically allows spontaneous resolution within 3–5 days.

3. Non-Gonococcal Urethritis (NGU)

NGU commonly results from sexually transmitted infection with *Chlamydia trachomatis* or *Ureaplasma urealyticum*, causing mucosal inflammation of the urethra. Patients may present with thin, pale yellow purulent discharge from the urethral meatus, often accompanied by urethral pruritus or burning. Treatment includes azithromycin dispersible tablets, doxycycline hydrochloride enteric-coated capsules, or minocycline hydrochloride capsules—as prescribed. Sexual abstinence is mandatory during treatment, and sexual partners must undergo concurrent screening and treatment.

4. Gonorrhea

Gonorrhea is caused by *Neisseria gonorrhoeae*, inducing acute suppurative inflammation of the urethral mucosa. Characteristic findings include profuse, thick, yellow purulent discharge from the urethral meatus, frequently associated with dysuria. First-line therapy includes cefixime dispersible tablets, intravenous ceftriaxone sodium, or spectinomycin hydrochloride injection—as directed by a physician. Full-course antimicrobial therapy is essential; sexual activity must be avoided until confirmed cure.

5. Acute Suppurative Prostatitis

This condition arises when bacteria ascend via the urethra to infect the prostate gland, leading to glandular suppuration and necrosis. Rupture of a prostatic abscess into the urethra may result in yellow-green purulent discharge, accompanied by high fever and perineal pain or pressure. Intravenous antibiotics—including levofloxacin hydrochloride sodium chloride injection, cefoperazone sodium–sulbactam sodium injection, or metronidazole injection—are administered under medical supervision. In cases of established abscess formation, transperineal prostate abscess aspiration and drainage are required.

In daily life, proper genital hygiene should be maintained: men with redundant prepuce should regularly retract and cleanse the foreskin. Unprotected or unsafe sexual practices must be avoided. Underwear should be loose-fitting and breathable to minimize local friction. Any purulent discharge warrants prompt medical consultation—self-medication is strongly discouraged.