INDICATIONS FOR URETHROSCOPY IN MALE-PATIENTS WITH PENILE CONDYLOMATA

Benson et al recommended that to detect condylomata, urethroscopy shou ld be performed on the male partners of women with cervical dysplasia. Considering this, in April 1990 we began to perform urethroscopy on a ll of our patients who presented with genital condylomata. Between Apr il 1990 and January 1993, 84 patients were referred for initial evalua tion of condylomata. The penis, scrotum, perineum and perianal areas w ere inspected, and the penis was reinspected after staining with 5% ac etic acid. Intraurethral condylomata were detected in 13 patients (15% ), 11 of whom had visible lesions on physical examination with spreadi ng of the meatus. Urethroscopy confirmed these lesions to be limited t o the fossa navicularis. Two patients had lesions of the fossa not vis ible at the meatus. No patient in this series had lesions of the more proximal urethra. All patients eventually determined to have intrauret hral lesions had external condylomata on the distal penis (glans, coro na or frenulum). Using the presence of distal penile lesions as the cr iterion for urethroscopy, 30 patients (36%) would have undergone ureth roscopy, including all 13 eventually diagnosed to have intraurethral c ondylomata, for a yield of 43%. A total of 54 patients (64%) who faile d to meet this criterion would have been spared the procedure. Conside ration of dysuria or urinalysis did not improve the yield. When evalua ting male patients with genital condylomata, we recommend spreading th e urethral meatus during the examination. Urethroscopy is indicated on ly for those with distal penile or meatal lesions.