Abstract

Screening of the asymptomatic male partners of women with genital condyloma or intraepithelial neoplasia has shown that about 50% of the individuals examined present genital HPV-associated lesions. Half to two thirds of these lesions are clinically invisible and are detected only after the acetic acid test. Histological studies have shown that 20% of male partners of women with high-grade intraepithelial neoplasia present lesions histologically defined as high-grade intraepithelial neoplasia. Couples in which both partners present lesions of intraepithelial neoplasia are infected by the same potentially oncogenic HPV type in at least 50% of cases. Also, 50% of subclinical lesions showing only minimal histological changes (acanthosis and papillomatosis, without clear koilocytosis) contain HPV DNA, mostly type 42. In situ hybridization of such lesions indicate HPV-positivity, suggesting that these lesions may be infectious. Cytology does not seem to be specific enough to detect HPV infection in males. Moreover, virological studies do not confirm the hypothesis of an urethral reservoir of HPV. Morphology allows the detection of HPV-associated genital lesions in males. Current treatment protocols allow a 95% cure rate by easily applicable outpatient treatment modalities.