Abstract
A series of 65 male sexual partners of 65 women attending an STD clinic in Bologna, Italy for examination and treatment of genital human papillomavirus (HPV)-infections during 1990–1991, were examined using peniscopy and surgical biopsy, the latter being analysed by light microscopy, in situ hybridization (ISH) and polymerase chain reaction (PCR) for HPV DNA. A detailed medical and sexual history was recorded from all men. Of the 65 men, 17 (26.2%) gave a history of a previous STD. The male partners with previous genital condylomata (14, 21.5% of men) were significantly associated with the detection of HPV DNA in the current lesions; 21.4% (3 of 14) and 10.2% (5 of 51) in those with and without previously treated condyloma, respectively. On colposcopy, 63 (96.9%) men presented with an abnormal pattern, the vast majority (49 of 65, 75.4%) showing an acetowhite lesion, and only 12 (18.5%) lesions being classified as condyloma acuminatum. HPV DNA was found, however, in only 4 of 12 (33.3%) condylomas by ISH and PCR, and in 4 of 49 (8.2%) and 6 of 49 (12.2%) acetowhite lesions by ISH and PCR, respectively. In a total of 41 (63%) patients, the biopsy was classified as non-HPV on light microscopy. HPV DNA detection rate was significantly higher in all morphologically HPV-suggestive lesions, compared with the non-HPV where ISH was invariably negative. PCR, however, disclosed HPV DNA in 4 of 41 (9.8%) cases. PIN (I or II) was present in 6 of 65 (9.2%) men. HPV DNA detection rate increased in parallel with the increasing grade of lesion, both HPV 16-positive cases containing a PIN lesion. Altogether, HPV DNA was found by ISH in 8 of 65 (12.3%) biopsies, and PCR amplification increased the detection rate by only two cases. HPV DNA was never present in men with only a single sexual partner, but increased significantly when the number of partners was increased, being highest (27.3%, 3 of 11) in those reporting 11–20 partners. HPV detection rate was lowest in those men whose partner had a flat condyloma, but significantly higher in those who presented with condyloma acuminatum (40%, 2 of 5), or HPV-CINI and II lesions. Of interest was the finding that HPV DNA was never demonstrated in the men whose partner had only vaginal HPV lesions. Peniscopy is an applicable means of finding the abnormal patterns remaining undetectable by the naked eye, but because of its limited resolution, it is not a conclusive diagnostic tool capable of differentiating HPV- from non-HPV-lesions.
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