STDs Expert Forum
Condyloma
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Condyloma

Hello Doctor,

I am a 30 years old married woman. i have been with my husband in a committed and exclusive relationship for almost 6 years now. about 7 years ago i dated a guy for a year and we always had protected sex with condoms. after a few months he told me that he has Condyloma. i went to the doctor and he sent me to a test that showed that i do not have HPV. ever since i been doing a regular yearly check up and pap-smears that always come back normal.
2 months ago i discovered a small bump on my vagina, near the opening. at first, i thought that it was due to shaving but a few days ago i discovered another tiny bump down there. i went to my doctor and he said that it is in fact condyloma and sent me to do a colposcopy exam and now i'm waiting for my appointment. i asked the doctor how can it happen after all those years with my husband and he said that sometimes it takes years for it to outbreak, but that "he doesn't want to get in our pants"
my questions are:
1) is it possible to have a first breakout of condyloma years after the first contact with it?
2) if it is possible, why now? does it mean that something in my body isn't right?
3) if i did catch it years ago, it didn't break out until now because i have a good immune system?
4) if it isn't possible that me or my husband got it years ago, and if we both were faithful (i know i was and i believe when he says that he was also), could i have gotten it in a non-sexual way?

Thank you!
Tags: condyloma
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239123_tn?1267651214
Welcome to the forum.  These are good questions.  I'll try to help.  Perhaps the most important take-home message is that this situation is not suspicious for sexual infidelity, either on your husband's part or yours.

Genital HPV infections often behave in mysterious ways.  Seemingly new infections commonly appear at unexpected times in people seemingly not at risk.  Usually it isn't possible to know when or from whom any particular HPV infection is acquired.

Not all genital bumps are warts, so the first thing for you to do is discuss with your doctor how certain he is that your genital bump indeed is a wart.  (Wart and condyloma are synonymous.)  If there is any doubt, you could see a dermatologist or talk with your doctor about a biopsy.  But if he is certain, then probably the diagnosis is correct.

Even though you had no symptoms at the time your partner had warts 7 years ago, if he was still infected, you probably caught it.  Even with consistent condom use, after many episodes of sex, most partners become infected.

To your specific quetions:

1) Yes.  You could have caught HPV from your partner 7 years ago, had an asymptomatic infection at that time, and now have first apparent symptoms with late onset of warts.  This isn't very common, but not all that rare either.  However, it is also possible that your husband has been infected with a wart-causing HPV strain --perhaps for many years -- and that you only recently caught it.  This is what I meant by my comments about usually not knowing when and where HPV is actually acquired.

2,3) Recurrent HPV/warts occur almost entirely in people with completely normal health and immune systems.  There is usually no obvious explanation; it appears to be random.

4) Because warts or other HPV infections sometimes appear in people at little or no risk for sexual transmission, it is believed by some experts that a small minority of genital HPV infections may not be sexually acquired.  However, this is a minority view -- and in my opinion it occurs very, very rarely if at all.  You should assume that you acquired the infection sexually, perhaps from your partner several years ago.

At this point, you really should not dwell on the origins of the infection.  It will just frustrate you, because you'll never have a clear answer.  The important thing is to concentrate on the immediate health implications.  In other words, follow your doctor's advice.  If you do, you can be very confident you will never have any serious health outcome.  Among other things, the wart-causing types of HPV rarely cause cancer -- so even if you have an abnormal pap smear or abnormal coposcopy, most likely it will not amount to anything serious.

My final advice is to print out this thread and discuss it with your doctor.  My prediction is that he will agree with all I have written.

I hope this helps.  Best wishes--  HHH, MD
11 Comments
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Avatar_m_tn
Thank you for your fast reply.
My Gynecologist just took a look down there and immediately said that it is condyloma. i asked him how can it be because it is so small and doesn't look at all like the images i saw online. his answer was that he is an expert and "just know". i also asked him how come all this years my pap-smears were perfectly fine and why my first Colposcopy exam (7 years ago after i found out my ex had it) also came out normal? he said that it may have been hidden and that it doesn't matter how and why.
has i said - it seems strange to have regular check-up all this years and suffer from it now. i will go to a dermatologist expert just in case.
Thank you again.
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239123_tn?1267651214
Having genital warts is entirely consistent with having normal pap smears.  The pap is not a diagnostic test for HPV.  It only detects certain cellular abnormalities that HPV causes -- but not all HPV infections cause such changes.

That said, from your description, I have to wonder a little bit about the diagnosis.  Has the "wart" been treated?  If not, it might be a good idea to get a second opinion, perhaps from a gynecologist.  Maybe it's not a condyloma after all.
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Avatar_m_tn
Hi Doctor, thanks for your patience towards my many questions.

The wart haven't been treated yet, since they were only diagnosed yesterday. my Gynecologist just asked me where i saw the wired skin bumps (2 of them), looked at it a little and said it was Condyloma. i was a bit confused and told him that it doesn't look at all like the photos online, but rather small and resemblance to skin tags. his answer was that it is a "very small condyloma" and that the photos online are of far more severe cases.

I than asked him how could my last colposcopy years back came normal and same for my normal Pap's and he said that it may have been "hidden" for all these years.  Then he added that he is a "specialist" and sent me to take another Colposcopy.
I guess i seemed worried, so he added that i don't need to worry about my husband's commitment to me and that i will still be as "cute and nice" as i was before.
Thank you again for your time and patience.
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239123_tn?1267651214
This doesn't change my opinion or advice.  I still suggest a second opinion.  But that's all I can say for now.  Let me know how it all sorts out.
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Avatar_m_tn
I made an appointment with another Doctor, but the only available time was 2 weeks from now. In the meantime i read a lot about the HPV virus at international sites and in Local Doctor's site (I live in Israel). what i don't understand is why those sites claim that smoking makes these disease spread fast, i am a heavy smoker and has been for the past 15 years (one pack a day), and still, only now suffer from Condyloma. also, they say that when it does spread, it is because the immune system is weak, which is weird cos it happens to healthy and normal people all the time and cos i hardly ever get sick, even when everyone around me is down with the flu.
BTW, i added a photo of these bumps to my profile, sure will appreciate a second opinion b4 my next Doctor appointment...  
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239123_tn?1267651214
Users' personal pages are intended for identifying photos, not clinical images; the photo will be removed.

We normally don't examine clinical photos on this forum but I broke our own rules and looked at yours.  The two lesions almost certainly are warts and I don't think you need to see a second physician. Your current doctor is correct.

Smoking isn't known to make any difference in growth of warts, and I stand by what I already said about delayed appearance of warts and the immune system; re-read my replies above.  There is a lot of misinformation on the web; you need to limit your web searching to professional sites.  You can trust the expertise on this forum.

That will be all for this thread.  As discussed above, your situation is not very unusual and you need to work to accept that genital warts are a minor health problem -- and inconvenience, not a serious health risk.  Follow your doctor's advice; and if you have any additional questions, ask him or his office staff.  I won't have anyhting more to say.
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Avatar_m_tn
Hi Doctor,
Just wanted to make a quick follow-up. I did the colposcopy Exam and the result were practically Normal. as for the lesions - the doctor said that they maybe a tiny condyloma, but actually can be just due to shaving. he can't tell for sure, but say's it has no real significant and that i don't have to treat it if i don't want to, only if i may wish.
I would also like to personally thank you and apologize for my stress and many questions. thanks to you i realized that even if it was condyloma, it doesn't mean anything about my health or about who i am. You really do an amazing and important job, helping and telling the true facts about STD'S to those who look online for information and peace of mind, but mostly find stressful un-based and incorrect data from so may different website.
Thank you again and God bless :)  
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239123_tn?1267651214
The lesions I saw in your posted photo for sure were not due to shaving (and in any case, I doubt you shave your labia minor and clitoral area).

That said, I'm glad to hear your current perspective, and I appreciate your kind comments about the forum.  Take care.
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Avatar_m_tn
Hello Dr. and sorry to bother you again.
I went on my follow-up exam yesterday and everything was fine, PAP smear was negative, Colposcopy also negative and the lesion went away after only 3 days with Condylox. so far so good.
The problem is that the Doctor said that from now on and until we will want to get pregnant, my husband and i must use condoms, in order to prevent re-appearance of the lesion. this comment made me a little confused since from what i understood of the info provided in this forum, the hpv lesion doesn't pass between partners like "ping pong".
It doesn't sound rational or realistic that a monogamous long time married couple will use condoms, is it really necessary?  
Thank you and sorry again
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239123_tn?1267651214
Since you have obviously had your HPV infection for a long period of time (regardless of when the wart actually appeared), your husband has obviously been repeatedly exposoed to the infection. Indeed, as we discussed, he might have been the source of your wart.  Either way, you can assume he already is (or has been) infected with the same HPV strain you have.  It is too late to prevent him from becoming infected, and you are correct that warts and other HPV infections generally do not get transmitted back and forth between partners.  In my opinion, there is no reason you need to use condoms; you and your husband can continue unprotected sex together.  And anyway, condoms probably wouldn't effective in the long run anyway.  Your husband should be on the lookout for warts of the penis, but if none appear, nothing need be done.

As I suggested in my initial response, you might consider printing out this thread and discussing it with your doctor.

Best wishes-- HHH, MD
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