<b><i>Objectives:</i></b> Human papillomavirus (HPV) is a well-known oncogenic virus associated with anogenital carcinomas. Despite the anatomical proximity of the bladder and the anogenital region, the relationship between HPV and urothelial carcinoma of the bladder (UCB) is still a controversial issue. This study aimed to test the urethral swabs and first-void urine samples of patients with UCB for HPV-Deoxyribonucleic acid (DNA) using polymerase chain reaction (PCR) assay and to compare the results with a control group. <b><i>Materials and Methods:</i></b> Sixty-nine patients who were diagnosed with UCB between January and December 2018 were included in this case-control study. Sixty-nine patients who visited the urology outpatient clinic for non-oncological reasons within the study period were designated as the control group. Urethral swab and first-void morning urine samples were collected from each patient. HPV-DNA presence was investigated using a PCR kit that can detect a total of 22 HPV genotypes, of which 18 are high-risk and 3 are low-risk genotypes. <b><i>Results:</i></b> The mean age of the patients included in the study was 63.2 ± 12.6 years and the male to female ratio was 5.3. HPV-DNA was detected in 28.9% (20/69) of the patients in the case group and in 8.7% (6/69) of the patients in the control group. HPV-DNA positivity was significantly higher in the case group (OR 4.24; 95% CI 1.63–12.34). No statistically significant relationship was found between HPV-DNA positivity and tumor grade (<i>p</i> = 0.36). <b><i>Conclusion:</i></b> A statistically significant relationship exists between HPV infection and UCB, regardless of the tumor grade.

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Background The effectiveness of microscopy of Gram-stained smear (GSS) for the detection of male urethral infection is debatable, especially in cases with low inflammation and no visible urethral discharge. This clinical study compared GSS samples collected with the conventional swab method and our new technique, the kissing slide method, together with polymerase chain reaction results to demonstrate the effectiveness of this new method in men with acute urethritis. Methods The study included 64 men who presented to the urology outpatient clinic with complaints of acute urethritis between October 2019 and January 2020. Two GSS samples were collected from each patient, first using the kissing slide method (applying the slide directly to the urethral mucosa), followed by the conventional method. The results were compared with polymerase chain reaction findings. Results The patients' mean age was 37.4 ± 7.8 years, and 68.7% had no visible urethral discharge on physical examination. At a GSS threshold of ≥5 polymorphonuclear leukocytes/high-power field, sensitivity values were 60% (95% confidence interval [CI], 42.32%–75.41%) for the kissing slide method and 23.33% (95% CI, 11.79%–40.93%) for the conventional method. At a threshold of ≥2 polymorphonuclear leukocytes/high-power field, sensitivity values with the kissing slide and conventional methods were 80% (95% CI, 62.69%–90.5%) and 50% (95% CI, 33.15%–66.85%) in all patients, and 66.67% (95% CI, 41.71%–84.82%) and 20% (95% CI, 7.047%–45.19%) in cases without visible urethral discharge, respectively. Conclusion The new kissing slide method is a noninvasive alternative method that may have better sensitivity than the conventional GSS sampling method in the diagnosis of male acute urethritis. Randomized studies are needed to verify these findings.

Acute male urethritis is inflammation of the urethra in men. It is often caused by sexually transmitted pathogens and poses a serious medical, social and economic burden worldwide. Microscopy of a urethral gram stain smear (GSS) is an inexpensive and easily performed alternative method for differential diagnosis. Not only can GSS diagnose acute urethritis, but it can also reveal the presence of Neisseria gonorrhoeae through findings of intracellular Gram-negative diplococci. However, as interpreting GSS requires experienced personnel, the test is prone to intra-and interobserver errors. (Smith et al., 2003). Nucleic acid amplification tests such as polymerase chain reaction (PCR) have significantly improved the management of acute urethritis in recent years. Identifying urethritis pathogens by conventional methods is both difficult and time-consuming, whereas PCR tests allow the rapid identification of multiple pathogens in a single sample with high sensitivity and specificity. (Sarier et al., 2017) Today,PCR is the guideline-recommended method for pathogen identification in acute urethritis. (Bonkat et al., 2020;Walensky et al., 2021).