Bowenoid Papulosis Diagnosis- 40yo male

[hpvnewbie]

Good Doctors,

My dermatologist removed and biposied a 'mole' on the shaft of my penis last week.  He called today to inform me that I had Bowenoid Papulosis and needed to see a well respected urologist.  The urologist expedited my initial consultation for early next week.

I researched "Bowenoid Papulosis"... HPV Type 16 probably, typically runs a benign course, treated with topicals or laser, cyro, surgery.  

So is this an STD?  I'm recently divorced from a 'lady with loose morals' :|  We were married for 10 years.  I think she had a pap that came back abnormal but there was no discussion of HPV.  I guess I need to tell my current girlfriend.

WHat treatment methods are typical and what influences a URO to choose one over the other?  My dermatologist removed the largest BP... about 3mm for biopsy.  I do see several small 'light freckles' in the area that will be considered suspect I suppose.

I'm not flipping out or anything, but the dermatologist told me things like: "pre cancerous", "this is skin cancer", in-situ squamous cell,  etc.  

My appointment is Tuesday.  I like to know about everything.  Can you shed light on what I might expect?  What might a competent URO do?

I will also tell him about my weak urine stream, post-pee dribble, low grade burning, etc.  I've had this for years.  I guess I'll probably have to submit to my first 'digital test'... can't wait!

Anyway, would someone who has experience treating Bowenoid Papulosis respond to all of the above?  I'll wait for a good, comprehensive answer.

Thanks in advance...

[Kevin Pho, MD]

Bowenoid papilosis is a type of "carcinoma in situ" that almost always has a benign course.  You are correct in that its associated with HPV.  There are rare cases where it can transform to squamous cell carcinoma - hence the urology evaluation.  Thus, it is true that it is a "pre-cancerous lesion", but its actual transformation to cancer is rare.

If the lesion involves the urethra, then a urologist is typically consulted.  As for modalities of removal, I am not aware of studies where one method is significantly better than the other.  It may come down to the urologist's or dermatologist's preference.

An article about it can be found here:
http://www.emedicine.com/derm/topic60.htm

As for the urine stream, you may want to have the prostate examined - since enlargement can lead to the symptoms you describe.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com

[DC26]

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