[Low yield of HPV DNA determination in the distal region of the male urethra]. / La baja utilidad de la determinación del ADN del VPH en la región distal de la uretra masculina.

OBJECTIVE: To assess the prevalence of Human Papillomavirus (HPV) Deoxyribonucleic acid (DNA), and of clinical and subclinical condilomatosis in men whose sex partners had been diagnosed with cervical intraepithelial neoplasia. MATERIAL AND METHODS: A cross-sectional study was conducted from October 1997 to August 1998, among 200 men aged 17 to 64 years referred to the Oncology Department of the National Institute of Perinatology in Mexico City. A physical examination of the penis (penoscopy) was performed after applying 3-5% acetic acid. A colposcope was used to identify acetowhite areas and vascular abnormalities associated with HPV infection. HPV DNA was detected by PCR and reverse line hybridization. The exploratory and univariant statistical analysis was made with the package Stata V6.0. RESULTS: The beta-globin gene was present in 93.5% (n = 187) of the 200 urethral exfoliated cell samples collected. HPV DNA was detected in only 2% (4/187) of the study subjects. Penoscopy data showed the presence of acetowhite areas in 43% (81/187) of subjects. CONCLUSIONS: Study findings show that the presence of HPV DNA in urethra is uncommon, as has been reported in several previous studies. Research is needed to evaluate the presence of HPV DNA in the coronal sulcus, as compared with the distal urethral region. The English version of this paper is available at:http://www.insp.mx/salud/index.html.

Patient acceptance and the psychological effects of women experiencing telecolposcopy and colposcopy.

BACKGROUND: The purpose of the study was to assess patient acceptance and psychological effects in women experiencing telecolposcopy compared with colposcopy. METHODS: Convenience samples of 150 and 263 women scheduled for colposcopy or telecolposcopy, respectively, completed questionnaires assessing anxiety (Prime MD), depression [Center for Epidemiologic Studies/Depressed Mood Scale (CES-D)], health beliefs and concerns, coping style (Miller Behavioral Style Score) and examination acceptance and satisfaction. Test scores and subject responses were compared using the t test and Wilcoxon rank sum test. RESULTS: Mean scores representing mild anxiety (1.3 and 1.2, P =.7) and mild depression (35.4 and 36.3, P =.4) were reported for the telecolposcopy and colposcopy groups, respectively. The telecolposcopy group indicated significantly greater mean scores for the examination, saving them time and money compared with the colposcopy group. Women in both groups were highly satisfied with their examinations and care. CONCLUSIONS: In general, women reported very high levels of satisfaction with telecolposcopy and colposcopy. Potential savings of time and money and improved health care were considered of particular value to women examined by telecolposcopy. Telecolposcopy seems to be well accepted by rural women.

Psychological effects women experience before and after a colposcopic examination and primary care appointment.

OBJECTIVE.: To estimate the psychological impact, health and behavior concerns, and coping styles of women awaiting colposcopic examination compared with women awaiting a scheduled primary care appointment. MATERIALS AND METHODS.: A convenience sample of 150 women presenting for a scheduled colposcopy examination and 201 women scheduled for a primary care appointment were assessed for demographic status, depression (Center for Epidemiologic Studies/Depressed Mood Scale), anxiety, health beliefs and concerns, and coping style (Miller Behavioral Style Score). Subjects also completed a postexamination questionnaire. Mean responses were compared using Wilcoxon rank sum test. RESULTS.: Mean anxiety scores were considered "mild" and equivalent for women in the two groups. Although the colposcopy group had a significantly greater mean depression score (36.3) compared with the noncolposcopy group (33.4, p = .03, Wilcoxon test), both mean scores indicated mild depression. Women undergoing colposcopy reported greater mean scores for concern about their disease, the procedure, and potential consequences (p < .01, Wilcoxon test). CONCLUSION.: Women scheduled for colposcopy have a similar level of mild anxiety and mild depression as women scheduled for a primary care appointment. Consequently, universal, instead of selective, use of anxiolytic agents before colposcopy appears unjustified. Avoidance of triage to colposcopy for atypical squamous cells of undetermined significance Pap smear results may be unwarranted based on concerns for causing excessive anxiety. In fact, colposcopy provides substantial reassurance.

La baja utilidad de la determinación del ADN del VPH en la región distal de la uretra masculina / Low usefulness of HPV DNA determination in the distal region of the male urethra

OBJETIVO: Determinar la prevalencia uretral del ácido desoxirribonucleico del virus de papiloma humano, condilomatosis clínica y subclínica, en hombres cuyas parejas sexuales tuvieron el antecedente de neoplasia intraepitelial cervical. MATERIAL Y MÉTODOS: De octubre de 1997 a agosto de 1998 se hizo un estudio transversal; se incluyeron 200 hombres de entre 17 a 64 años de edad, referidos a la Coordinación de Oncología del Instituto Nacional de Perinatología, de la Ciudad de México, porque sus parejas regulares sexuales tuvieron el antecedente de neoplasia intraepitelial cervical. Se llevó a cabo un examen físico del pene (penoscopía) con la aplicación de ácido acético a 3-5 por ciento, y con el uso de un colposcopio se localizaron y evaluaron zonas acetoblancas y cambios vasculares, interpretados como anormales, asociados con la infección por el virus del papiloma humano. La determinación del ADN de VPH se verificó por PCR e hibridación en línea reversa. El análisis estadístico exploratorio y univariante se realizó con el paquete Stata V6.0. RESULTADOS: En las 200 muestras recolectadas de células exfoliadas de la uretra el gen de beta-globina estuvo presente en 93.5 por ciento (187/200), y el ácido desoxirribonucleico del virus del papiloma humano fue detectable solamente en 2 por ciento (4/187) de los sujetos. Por medio de la penoscopía se observó la presencia de zonas acetoblancas en 43 por ciento (81/187) de los sujetos. CONCLUSIONES: En este estudio se observa que la presencia del ácido desoxirribonucleico del virus del papiloma humano en la uretra masculina es poco común, como lo reportan estudios internacionales. Es necesario realizar investigaciones que evalúen esta presencia en glande y surco balano prepucial, en comparación con la región distal de la uretra.