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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
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.
Remember
Copyright, 2011.
John L. Pfenninger, M.D.
Andro Pt Ed/jw11/10