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Short report
High-grade and low-grade HPV-induced urethral lesions treated by CO2 laser under colposcopy
  1. Olivier Aynaud1,
  2. Bernard Huynh1,
  3. Christine Bergeron2
  1. 1 Operative Colposcopy Center, Ambroise Pare - Hartmann Private Hospital, Neuilly sur Seine, Ile de France, France
  2. 2 Anatomopathology, CERBA Laboratory 30 bd de Vaugirard, 75015 Paris, Paris, France
  1. Correspondence to Dr Olivier Aynaud, Operative Colposcopy Center, Ambroise Pare - Hartmann Private Hospital, 48 ter bd Victor Hugo 92200 Neuilly sur Seine, Île-de-France, France; aynaud{at}aol.com

Abstract

Objectives This study is reporting the CO2 laser treatment efficiency on urethral lesions caused by human papillomavirus (HPV) and the correlation between the type of lesion high-grade and low-grade on the histology and the HPV genotype(s).

Methods Sixty-nine patients (59 men and 10 women) with urethral lesions were screened for HPV genotype(s) by in situ hybridisation and PCR. HPV lesions were biopsied and p16INK4a expression was tested to confirm urethral high-grade squamous intraepithelial lesions (U HSIL) on the histology prior to CO2 laser treatment under colposcopy. The patients were followed up for 12 months.

Results We observed urethral low-grade squamous intraepithelial lesions (U LSIL) in 54/69 cases (78.3%) and U HSIL in 7/69 cases (10%) confirmed by p16INK4a staining. Then we looked at the HPV genotype present in each lesion. We observed the following: 31/69 (45%) patients have a unique HPV genotype, with 12/31 (38.7%) of high risk; 21/54 (38.8%) of U LSIL and 1/7 (14%) of U HSIL have HPV low-risk and high-risk coinfections. Efficient treatment with CO2 laser under colposcopy was done using a meatal spreader to help visualisation of 20 mm in the distal urethra. We cured 64/69 (92.7%) patients at 3 months with 4/69 (5.7%) meatotomy and persistent 1/67 (1.4%) urethral stricture at 12 months.

Conclusions HSIL was present in the urethra without being able to define specific clinical criteria. Treatment with a CO2 laser under colposcopy with a meatus spreader is a simple surgical procedure with high efficiency and few complications that could prevent the risk of HPV-induced carcinoma.

  • COLPOSCOPY
  • Papillomaviridae
  • URETHRITIS
  • Neoplasms

http://dx.doi.org/10.1136/sextrans-2022-055503

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    Footnotes

    • Handling editor Jo Gibbs

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.