A PAP TEST FOR MEN - MALE URETHRAL SMEARS AS SCREENING TOOL FOR DETECTING SUBCLINICAL HUMAN PAPILLOMAVIRUS INFECTION

We have explored the potential of using immunoperoxidase staining and in situ DNA hybridization techniques to detect the HPV common antigen and HPV DNA (subtypes 6/11 and 16/18) in urethral smears obtained from men with no grossly visible urethral lesions, with or without HPV-related clinical history. A total of 91 such smears were studied of which 25 (27.5 %) were positive for HPV antigen. Of the latter, 20 (80 %) were positive for HPV 6/11 DNA, 3 (12 %) were positive for HPV 16/18 DNA, one smear (4 %) was positive for both, and one was negative for both. The technique of obtaining male urethral smears and immunostaining them for HPV antigen is simple, rapid, specific, and far more sensitive than conventional morphologic observations. Since antigen-positive cells are the source for spreading HPV infection, identifying individuals with such cells can help limit the spread of infection by alerting sexual partners, and also can be used to monitor the infectious status of the patient after therapy. DNA subtyping of HPV-positive patients may be useful in predicting the potential for malignant transformation which varies among the different HPV subtypes.