In the case of women, having a Pap smear is no mystery: it is one of the common tests during regular visits to the gynecologist. And it is always done because it offers a lot of information: it involves taking a sample of cells from the cervix and then analyzing it to check that there are no anomalies that could reveal the presence of infections, inflammation or even cancer. It is something necessary and completely established in the women’s calendar, it does not allow discussion. But the popular imagination links it so much to women’s health that many times, when a doctor tells a man that he should have a cytology, he usually has a moment of mental short circuit, like ‘there is a mistake here, that’s right. just for them, right?’ Followed by another moment (very childish) of ‘please, please, let it be a mistake’ (because they begin to understand that something is going to be introduced somewhere and, of course, the idea is not very attractive).
Well yes, ladies and, above all, gentlemen, at the risk of breaking the balance of the cosmos, we are going to make a revelation: men also have cytology tests. What’s more, they should have them done. The question that many may be asking right now is where (anatomically) the issue is going (since, obviously, they do not have a vagina). Well, there are several ‘unisex’ options: the oral one (pharyngeal culture, in which a sample taken with a swab is analyzed), the genitourinary one (culture of fluid from the urethra collected with a swab) and the anal one ( where a sample is taken from the area with a brush).
Amaia Sanz and Fernando Jiménez, proctologists at Proktos Clinic and specialists in General and Digestive Surgery, explain it very clearly: “Cytology in women is universal and known, but not in men, who do not know they have to have them done.” . Nor are there different types.
In the case of anal exams, the main reason for men to have it done (obviously, women can also have it done) is to detect the human papillomavirus (HPV), which is a sexually transmitted infection (STI-ETS). And like other ailments of this type, the number of cases is on the rise. Doctors attribute this increase to the fact that condoms are used less and less among men who have sex with men and among the trans community. An increase that they attribute, among other things, to the consumption of PrEP, a drug that prevents the spread of AIDS and that has led to decreasing use of condoms. But what about the rest of the diseases?
In the case of HPV, it is transmitted by direct contact between epithelia (mucous membranes), causes lesions in those it infects and generates warts, “which is what the population is most familiar with,” experts say. «But there are more than two hundred strains of HPV described and there are some that, without producing warts, can cause lesions. That is, they are noticeable with a microscope but not with the naked eye… and they can be precancerous. What do they want to tell us? That cytology is necessary.
“Normally it is temporary and between 80 and 90% disappear in one to two years, but there is clear evidence of the relationship between HPV and the appearance of certain tumors,” experts warn. In addition, it is used to diagnose other diseases: chlamydiosis, gonorrhea, syphilis, lymphogranuloma venereum and herpes simplex. To dispel fears and clarify doubts, specialists describe the process of anal cytology: «With a small brush with soft bristles, samples are taken from the anal canal. No preparation needed. “It is a quick and painless test,” proctologists reassure.
Doctors advise performing them if you have had risky oral sex. It consists of extracting a sample of mucous membranes using a swab. “Depending on sexual practices, oral cultures (and not other types) are taken to detect sexually transmitted diseases in men,” they clarify. Of course, it is also used in other infections not related to sex.
If there is fluid discharge from the urethra, it may be an indicator of a bacterial infection or STI. In this case, a urethral exudate is performed, a test in which a sample of fluid is collected from this duct using a swab… Yes, you have to put a ‘stick’ about two centimeters long through the hole in the penis. . With this test, sexually transmitted infections such as gonorrhea and chlamydia can be detected, a problem of global dimensions. The WHO counted 82 million people affected by gonorrhea in 2020 and chlamydia is increasing alarmingly in Europe. And, of course, the number of cytology tests that men have is growing at the same time.