The incidence of reporting of penile intraepithelial neoplasia (PIN) by genitourinary medicine clinics in the UK is rare. The reporting of higher incidence, in most international studies, is suggestive of under-diagnosis of PIN lesions in the UK, which leads to improper therapy and follow-up. A systematic literature review is undertaken, regarding the current state of management of PIN and the possible avenues of improvement in the diagnosis and follow-up. The role of genitourinary medicine clinics is examined, in view of the high number of patients that present with genital dermatological conditions, in whom there are patients with non-identified PIN lesions. The notable increase in reporting of vulval intraepithelial neoplasia has been associated with an increase in vulval cancer, especially in younger patients. The possibility of a similar trend in penile lesions needs to be observed and the association between high risk human papillomavirus (HPV) types, and genital intraepithelial neoplasia and cancer, is recognized and therefore an increased incidence in the diagnosis of HPV associated lesions must be considered.