OBJECTIVES--To evaluate the accuracy of peniscopy for identifying human papillomavirus (HPV) lesions in male sexual partners of women with HPV infection. The predictive value of the medical history for HPV infection was also evaluated. DESIGN--Examination of voluntary male partners of the women with HPV infection using colposcopy (peniscopy after acetic acid), cytology and surgical biopsy, the latter being analysed by light microscopy, in situ hybridisation (ISH) and polymerase chain reaction (PCR) for HPV DNA. A detailed medical history was to be taken, too. SETTING--Department of Gynaecology and Obstetrics, Kuopio University Central Hospital, Finland. SUBJECTS--A series of 101 voluntary male partners of 101 women invited for examination, treatment and follow-up for their genital HPV infections on the basis of abnormal Papanicolaou (PAP) smears. RESULTS--On peniscopy 64 (63.4%) of the men presented with lesions either typical of (34.7%) or suspicious for (28.7%) HPV infection. Of the latter, 89% were flat lesions mostly undetectable by the naked eye. The cytologic smear was positive in only nine men. On light microscope, 85.7% of the peniscopically typical lesions were found to be consistent with (68.6%) or suspicious for (17.1%) HPV infection. HPV DNA was found in 33 (34.5%) of the 96 typed biopsies, and never in biopsies from peniscopically healthy areas. In logistic regression analysis of the historical data recorded, only the contact time with the current sexual partner was of predictive value for histologically proven HPV infection. CONCLUSIONS--Peniscopy is an applicable means for the identification of penile lesions due to HPV infection, but it is not a conclusive diagnostic tool capable of differentiating HPV from non-HPV findings.
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