Men and HPV: Diagnosis and treatment

What are the symptoms of a man recently infected with HPV?

As we already mentioned, the majority of HPV infected men have only subclinical (not visible) lesions which are not usually accompanied by any symptoms, and therefore go unnoticed. Only genital warts are noticed, because they are visible.

How are genital warts diagnosed?

Genital warts are usually visible by the patient, who seeks a medical opinion. Diagnosis is based on clinical examination, that is assisted by the use of a magnifying glass. In very few cases is a biopsy required to confirm the diagnosis.

How are subclinical infections and precancerous lesions diagnosed?

Subclinical lesions are by definition not visible to the naked eye. A section of the tissue (biopsy) must be examined under the microscope and the epithelium must be studied, in order to diagnose them. This procedure is not generally recommended for detecting simple infections, since they usually subside on their own.

Biopsies are taken when precancerous lesions are suspected on the penis and anus. The location of the biopsy is decided by the doctor. An acetic acid solution is frequently used, the same one used during colposcopy for women.

The anal canal is checked with the use of a colposcope and an acetic acid solution (the same technique with the colposcopy). The examination is internationally referred to as a “high-resolution anoscopy.”

A high-resolution anoscopy is recommended in cases of anal warts, especially in immunosuppressed patients.

Can a man be tested to find out if he has been infected with HPV in the past?

Most infections from HPV go unnoticed and subside spontaneously. As long as an HPV infection is active on the epithelium, the doctor may take a biopsy and confirm it under a microscope.
After the lesions subside, there is nothing visible, not even under a microscope. There is also no test for detecting HPV antibodies in the blood, like there is for other viruses (herpes, etc.). There is no diagnostic test, therefore, to find out whether someone was once infected, unless he reports genital warts in his history.

An active HPV infection on the cervix can be detected with a Pap test and an HPV test. A similar process can be used by collecting material from the anal canal. This does not apply, however, to the penis area, because it is impossible to collect appropriate material and the results of the test are considered unreliable.

What treatment should men get?

No treatment is recommended for subclinical infections. Only genital warts, precancerous lesions, and, of course, the rare cases of cancer are treated.

Genital wart treatment

Patients are initially advised to quit smoking, because smoking affects the immune system and decreases the success rates of the treatment, while it increases recurrence rates.

Precancerous lesion treatment

Precancerous lesions in male genital organs and the anus are treated the same way as similar lesions in women. The lesions are destroyed or removed if a detailed examination of the tissue under a microscope is required to exclude the possibility of invasive cancer.