Oral Mucosa and Urethroplasty: It’s Time to Change

Abstract

In this issue of European Urology, Kero and colleagues reported on the Finnish Family HPV Study, a longitudinal cohort study looking at the prevalence and incidence of oral human papillomavirus (HPV) infection in healthy men followed for 7 yr [1]. The most relevant findings they reported were a high prevalence of male oral HPV, ranging from15% to31%, and the confirmation that themost frequent genotype was HPV-16. In their conclusion, they advise the reader that oral mucosa is an important reservoir for the virus. These data raise the following questions, which we will address below: (1) What does oral mucosa HPV infection have to do with urology? (2) Why should European Urology readers be interested in it? (3) What was the European Urology editor thinkingwhen he decided to cover this topic? HPV is the most common sexually transmitted infection worldwide [2] and, as such, should receive more attention from urologists. The overall HPV transmission rate was estimated to be 58.8 per 100 person-years from penis to cervix and20.8 per 100person-years fromcervix to penis [3]. Less is known about oral HPV transmission. According to a recent survey, oral HPV infection is three times more common inUSmales than females [4]. As part of theNational Health andNutritional Survey, 5579males and females aged 14–69 yr were screened for oral HPV. Analysis showed that 10.1% of men and 3.6% of women tested positive for the infection. Now Kero et al. have reported a higher prevalence, and their data support the theory that men are the primary risk group for oropharyngeal HPV-positive cancer [1]. Is this topic relevant for urology? Absolutely. The increase in HPV-positive cancers of the oropharynx inmales has risen by225%since1980, and this increasemightbeattributable to the increasingly widespread practice of oral sex [4]. Urologic medical associations and urologic journals need to take