การตรวจหาเชื้อ HPV ในผู้ชาย: สิ่งที่วิธีโพลีเมอเรสเชนรีแอกชัน (PCR) จากปัสสาวะบอกคุณได้และบอกไม่ได้

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Men ask about HPV testing after a partner has had an abnormal smear, or after finding a lump, or simply out of worry. The test exists, it is easy, and it is worth understanding what it does before requesting it — because the honest answer to should I be tested? is less straightforward than the availability of the test suggests.

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Start here: there is no HPV screening programme for men

This was absent from the earlier version of this article, and it changes how everything below should be read.

Women have cervical screening because there is a treatable pre-cancerous stage that can be found and removed. No equivalent exists for men. There is no routine HPV screening recommended for men anywhere, and — this is the part that matters — there is no treatment for a positive HPV result in the absence of visible disease. You cannot take anything to clear it.

So a man who tests positive, has no warts and no lesion, leaves with a piece of information and nothing to do about it except what he should be doing anyway. That is not an argument that the test is worthless — it is an argument for knowing in advance what a result will and will not give you. This page sets that out rather than assuming the test answers the question that prompted it.

The reassuring part, which was missing

Most HPV infections clear on their own, usually within one to two years, without anything being done. HPV is close to universal among sexually active adults, and the large majority of people who acquire it never develop any consequence from it.

A positive test therefore describes a moment, not a verdict. It says the virus is detectable now — not that it will persist, and not that it will cause anything. Persistent infection with a high-risk type over years is what carries risk, and a single test cannot distinguish that from an infection your immune system is already clearing.

And the point that prevents real harm

An HPV test cannot say when the infection was acquired, or from whom. It can lie dormant for years. A positive result in one partner is not evidence of recent infidelity, and it is used that way often enough that it deserves stating plainly. If a couple is testing to settle that question, the test cannot settle it.

How the urine test compares with a swab

HPV lives in genital skin and secretions, so a swab of the site remains the reference method. Swabs are uncomfortable and many men decline them, which is why urine testing was developed.

• Around 81.5% agreement with a genital swab in the study usually cited. That figure is genuinely useful — and it should be read in both directions: roughly one infection in five that a swab would find is missed by urine. A negative urine result does not exclude HPV, and the earlier version of this article gave the number without that consequence.
• Use the first urine of the morning, and the first part of the stream rather than a mid-stream sample — that fraction carries cells washed from the urethra and is what the test needs.

What the test reports

The GenoArray PCR method identifies 21 types:

• 15 high-risk types, associated with cancer — 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68.
• 6 low-risk types, associated with genital warts — 6, 11, 42, 43, 44 and 81.

Knowing the type is of some use: 16 and 18 carry the highest cancer association, while 6 and 11 cause most warts and carry essentially no cancer risk. What it does not do is change treatment, because there isn’t any for the virus itself.

What HPV actually causes in men

The earlier version named penile cancer as the risk. It is real and it is rare, and framing it as the main concern gives a misleading picture. In men the more relevant HPV-related cancers are anal cancer — with substantially higher risk in men who have sex with men and in anyone immunosuppressed — and cancers of the mouth and throat, which are rising. Genital warts are far commoner than all of them and are the usual reason a man ends up in clinic.

None of these is screened for by a urine HPV test.

So what is actually worth doing

• Get vaccinated if you have not been. This is the one intervention that changes anything, it is licensed to 45, and previous exposure does not make it pointless — see HPV vaccination for men.
• Have anything visible examined rather than tested for. A lump, wart or ulcer is diagnosed by looking at it and, if necessary, biopsying it — not by a PCR.
• Stop smoking, which impairs clearance of the virus and multiplies the risk of HPV-related cancer.
• Make sure your partner keeps her cervical screening appointments. That is where HPV is actually acted upon, and it is more useful than any test done on you.
• Use condoms with new partners — they reduce transmission without eliminating it, since HPV spreads by skin contact beyond the covered area.

Where the test does have a place is in a man who wants to know his status with informed expectations, or as part of a broader sexual health assessment alongside testing for other infections — several of which, unlike HPV, are curable and genuinely worth finding.

Findings that need examining rather than testing

ในกรณีฉุกเฉินในประเทศไทย โทร 1669.

• An ulcer, non-healing sore or persistent white patch on the penis — this needs looking at, not a PCR.
• A lump on the penis that is growing, bleeding or ulcerating.
• Anal bleeding, pain or a lump, particularly in anyone at higher risk.
• A neck lump, persistent hoarseness or difficulty swallowing lasting more than a few weeks.

Frequently Asked Questions About HPV Testing in Men

Should men be tested for HPV?

There is no routine HPV screening programme for men, because there is no treatable pre-cancerous stage to find as there is on the cervix, and no treatment for a positive result without visible disease. Testing is available and can be done with informed expectations; it is not a screening test and a result will not change what is done next.

Can HPV be detected in urine?

Yes. Urine PCR shows around 81.5% agreement with a genital swab, which also means roughly one infection in five that a swab would detect is missed. A negative urine result does not exclude HPV. Use the first urine of the morning and the first part of the stream.

My test was positive. What now?

Most HPV infections clear on their own within one to two years, and a positive test describes the present moment rather than predicting an outcome. There is no medication that clears it. What helps is vaccination if you have not had it, stopping smoking, having anything visible examined, and your partner keeping her cervical screening appointments.

Does a positive result mean my partner was unfaithful?

No. An HPV test cannot establish when an infection was acquired or from whom, and the virus can remain dormant for years. It cannot settle that question, and it should not be used to try.

Which types does the test report?

Twenty-one types: fifteen high-risk types associated with cancer (16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68) and six low-risk types associated with warts (6, 11, 42, 43, 44, 81). Types 16 and 18 carry the highest cancer association; 6 and 11 cause most warts and carry essentially no cancer risk.

การนัดหมายเพื่อปรึกษา

Dr. Soarawee Weerasopone sees patients confidentially at โรงพยาบาลกรุงเทพ สำนักงานใหญ่ และที่โรงพยาบาล สมิติเวช ศรีราชา ในจังหวัดชลบุรี เมื่อวันที่ 088-022-1445. If there is something visible, that is the reason to come — it is examined rather than tested for.

โรงพยาบาลกรุงเทพฯ มีบริการแพทย์ทางไกลสำหรับผู้ป่วยที่ไม่สามารถมาพบแพทย์ด้วยตนเอง รวมถึงผู้ป่วยต่างชาติ กรุณาแจ้งล่วงหน้าทางอีเมลไปยังแผนกศัลยกรรมทางเดินปัสสาวะที่ bhquro@bdms.co.th. Samitivej Sriracha ให้บริการเฉพาะการพบแพทย์ด้วยตนเองเท่านั้น สอบถามเรื่องค่าใช้จ่ายได้ที่โรงพยาบาลโดยตรง ไม่ใช่ผ่านทางเว็บไซต์นี้.

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