Human papillomavirus-associated lesions of the penis: colposcopy, cytology, and histology.

The diagnosis and therapy of human papillomavirus infections in men is of potential benefit because it may decrease the reservoir of virus from which genital condylomata or squamous neoplasia may arise in women. To investigate the efficacy of diagnostic methods, we examined the 127 male sexual partners of 127 women with cervical intraepithelial neoplasia. Eighty-three mostly asymptomatic men (65%) had from one to 50 (median three) small (median 3 mm) human papillomavirus-associated lesions consisting of condylomata (80 cases) and penile dysplasia (three cases). The colposcope aided diagnosis or was necessary for diagnosis of 59% of the lesions. Routine application of 3% or 5% acetic acid yielded white or grayish epithelial changes in 22% of the cases, which would have been missed without this technique. Papular, flat, spiked, and mixed lesions were more common (85%) than papillary changes or classic condylomata acuminata (15%). In contrast to smears from the external penile surface, smears obtained from the male urethra were satisfactory in most cases and yielded positive results in nine men (7%). Condylomata are common in male partners of women with cervical intraepithelial neoplasia, but the lesions are frequently not apparent unless magnification and acetic acid are used. Cytologic smears may aid in the diagnosis of condylomata in the urethra.