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ANDROSCOPY - PATIENT INFORMATION
Androscopy is a procedure for examining the male genitals in a very detailed and thorough fashion. This is done using a special microscope (the colposcope) and is carried out in the office.
Androscopy is done specifically to identify signs of genital warts. The medical term for these warts is condyloma accuminata. They are caused by the human papilloma virus. These lesions are very contagious and are passed readily by sexual intercourse. There is an 80% chance of getting the wart virus with just one sexual contact with an infected person. They can occasionally be picked up without sex but this is very rare. The wart virus may lay dormant or inactive for up to 20 years after infection before they show up.
Long-term effects on males are not totally certain, although there is a rare chance it may cause penile cancer. Recent studies suggest a possible link to rectal cancer. It is more clear that infection with this virus is the primary cause of cancer of the cervix in females. If there is evidence of infection in the female, which is often picked up on a Pap smear, then the male sexual partner may also need to be examined. We now know that, even when a patient is “cured” of visible lesions, the virus can come back at any time. The virus is suppressed, much like herpes in a cold sore, but it is still present. The cervix can be treated and cancer prevented 99% of the time, but it is difficult to completely eradicate the virus from the penis, vagina and rectal areas. Indications to treat the male include symptoms (visible lesions, itching, or a large number of lesions seen on staining.) Even with treatment, the warts, whether visible or not, frequently come back; and the man must assume he is contagious for the rest of his life.
Although many warty-type lesions are visible to the naked eye, many others are too small to be seen and require examination with great magnification to identify or confirm their warty nature. During the procedure, vinegar will be sprayed on the penis. This causes the warty tissues to turn whiter than the surrounding skin, thus making it easier to identify and examine. Men can have the virus and look totally normal before staining and examination. Thus, they can be spreading warts – and cervical cancer – without knowing it.
Men who are infected are advised to be monogamous so as not to spread the disease further. Condoms make sex safer but not totally safe. Previous partners should be advised to be sure they get their Pap smears regularly and possibly have a colposcopic examination since the Pap smear is known to miss a significant number of infections.
Women who smoke have twice the risk of cervical cancer. EVEN IF YOU SMOKE, your partner’s risk for cervical cancer increases. It is recommended that you stop smoking.
DESCRIPTION OF THE PROCEDURE
The procedure itself will take approximately 15-20 minutes. You will be asked to undress from the waist down and will be draped appropriately. You will be placed in a lying position with your feet in stirrups, similar to the position for doing pelvic examinations on females. The penis and entire genital area will be soaked with vinegar for at least 5 minutes.
You will then be examined first with the naked eye to detect any visible lesions, then with the colposcope (a special microscope) at 5 to 10 power to confirm the nature of the lesions.
Once warty lesions have been identified, they may be biopsied to confirm their diagnosis. Larger lesions may be treated by excision, strong acid, cryocautery (freezing) or laser vaporization. All these modalities are quite simple, and no time off work (other than for the office visit) is necessary. You may also be prescribed a cream, either Aldara or Efudex, to treat these warts. See a special handout on this if it is used.
There will need to be follow up examinations with the microscope to confirm resolution of all lesions treated and to identify any recurrent or new lesion. Times for these rechecks will vary depending on the treatment used. You will be advised by your doctor.
Videotapes which discuss the above information more in detail are available in our office for your viewing at home. Ask the receptionist for details. It often helps to review the tapes prior to your examination.
Copyright, 2011. John L. Pfenninger, M.D. Andro Pt Ed/jw11/10