Urethral Wart

Hi there,

I noticed a urethral wart approx 0.5cm below the opening on the tip of my penis in July. I went to see a urologist who diagnosed this as Condyloma Acuminata / HPV. He removed the wart using electrocautery and a local anesthetic in late July. Everything looked fine when I self-inspected at the end of August. However about a week ago, I noticed a larger urethral growth than before (a very tiny part actually extended out past the opening) so I made an appointment for a follow up. I went to see him again today, and he performed another electrocautery procedure, but said in his experience the only way to prevent recurrence is via a urethral meatotomy. This sounds very unpleasant and I'd rather avoid this option. I also brought up the idea of using imiquimod during this post-surgery time to help fight the virus. He said he'd never heard of it, but he's going to write me a prescription. I've seen mixed data on using this for warts in the urethra.

Can you please give me some advice for treatment options and suggestions? Thank you very much.

[Kevin Pho, MD]

I agree with the treatment approach thus far.

Surgery, cryotherapy, imiquimod, interferon, 5-FU gel are all options to treat condylomata acuminata.  Normally, the imiquimod is not indicated for internal use.  

If this option fails, you can discuss the other approaches.  A referral to another urologist - preferably at a major academic medical center - or an infections disease specialist can be helpful.

Until treated, I would suggest barrier contraception to reduce the risk of transmission.

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.
kevinmd_

[dcelement]

Also...is there any risk of unprotected sex with the same partner if we are both monogamous and she just got checked out for HPV and tested positive as well.

[dcelement]

Thank you Kevin.

I obtained some imiquimod (aldara) as an rx from my dr. I know it is not intended to be used internally, but I've read some reports that indicate it is helpful (just hasn't been "proven" in studies but say there is no harm in doing this). Can you comment on this please? I wanted to wait until the surgery heals a bit better (it's still bleeding a little bit since the surgery on 9/20 and the inside of my urethra looks a bit cut up still) and then apply 2-3x/week  a thin layer inside the tip of the urethra, approx. 1 cm in depth, and then urinate after ~6-8 hr to clear it.

Thank you so much.