title: Prevalence of HPV Infection in Croatian Men during a 12-year Period: a Comparative Study of External Genital and Urethral Swabs.
abstract: OBJECTIVE
  The aim of the study was to compare the prevalence and distribution of both low-risk and high-risk HPV infection of the urethra and outer genital region in Croatian men. Thus far there is a consensus that sampling the coronal sulcus and glans of the penis is essential for adequately assessing HPV status in men but less agreement is noted for urethral sampling.
  
  
  METHODS
  External genital brushing and urethral swabs were taken from 1,342 men during a 12-year period and tested with the hc2 HPV DNA Test using Hybrid Capture 2 technology.
  
  
  RESULTS
  The overall prevalence of male HPV infection in this study was 36.66%. Infection with high-risk HPV types (44.72%) was significantly more frequent than infection with low-risk HPV types (28.86%) or co-infection with both low-risk and high-risk HPV types (26.42%). HPV was more frequently demonstrated in the outer genital area (58.33%) when compared to the sole infection of the urethra (17.89%) or infection of both genital sites (23.78%).
  
  
  CONCLUSIONS
  Results from this study indicate high prevalence of HPV infection in men and suggest that optimal sampling method for the testing of men is the combination of external genital and urethral swabs. Further research about the proper collection of biological samples and testing methods for HPV detection in men is necessary since our future end-goal is to implement standardized guidelines on sampling and diagnostic testing of males.
authors.affiliation: Clinical Microbiology and Parasitology Unit, Polyclinic "Dr. Zora Profozić", Zagreb, Croatia.
authors.forename: Zora
authors.initials: Z
authors.lastname: Profozić
authors.affiliation: Clinical Microbiology and Parasitology Unit, Polyclinic "Dr. Zora Profozić", Zagreb, Croatia.
authors.forename: Tomislav
authors.initials: T
authors.lastname: Meštrović
authors.affiliation: Department of Urology, Dubrava University Hospital, Zagreb, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Savić
authors.affiliation: Internal Medicine Unit, Polyclinic "Dr. Zora Profozić", Zagreb, Croatia.
authors.forename: Velimir
authors.initials: V
authors.lastname: Profozić
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017523:Croatia / Q000453:epidemiology; D005837:Genitalia, Male / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology*; D015995:Prevalence; D014521:Urethra / Q000821:virology*
keywords: HPV; human papillomavirus; men; penile swab; prevalence; urethral swab