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Biopsy to rule out HPV?
Hi,
Last week I noticed a small, flesh-colored bump on the shaft of my penis. I went to my general practitioner and he diagnosed it as a genital wart. He told me to make an appointment with a dermatologist to have it frozen off. Thankfully, my dermatologist concluded that it wasn't a genital wart. He called in another doctor and they both looked at the bump closely, using a magnification instrument. Both dermatologists concluded that it was *most likely* not a genital wart (I believe they suggested that it was a cyst).
My question is: is it unethical for me to continue to have sex (sometimes unprotected sex) with multiple partners without having this bump biopsied to be 100% sure it is not HPV? Obviously, I don't want to have the bump biopsied because I don't want to receive confirmation that it is HPV, which would require my disclosing my status to partners (thus, greatly reducing my number of partners as women won't want to have sex with me and catch HPV). Or is two dermatologists saying it's not HPV (and actually advising against a biopsy) enough to allow me to proceed with having sex with multiple women sometimes without condoms?
From an ethical standpoint, do I need this biopsy if I plan to have multiple partners and sometimes practice unprotected sex?
Thanks for your insight.
Last week I noticed a small, flesh-colored bump on the shaft of my penis. I went to my general practitioner and he diagnosed it as a genital wart. He told me to make an appointment with a dermatologist to have it frozen off. Thankfully, my dermatologist concluded that it wasn't a genital wart. He called in another doctor and they both looked at the bump closely, using a magnification instrument. Both dermatologists concluded that it was *most likely* not a genital wart (I believe they suggested that it was a cyst).
My question is: is it unethical for me to continue to have sex (sometimes unprotected sex) with multiple partners without having this bump biopsied to be 100% sure it is not HPV? Obviously, I don't want to have the bump biopsied because I don't want to receive confirmation that it is HPV, which would require my disclosing my status to partners (thus, greatly reducing my number of partners as women won't want to have sex with me and catch HPV). Or is two dermatologists saying it's not HPV (and actually advising against a biopsy) enough to allow me to proceed with having sex with multiple women sometimes without condoms?
From an ethical standpoint, do I need this biopsy if I plan to have multiple partners and sometimes practice unprotected sex?
Thanks for your insight.
MEDICAL PROFESSIONAL
If you like, let me know what the biopsy shows. I see no point in playing "what if" speculative games until then.
Thanks for your insight, Doctor.
I appreciate your admonition to consider the merits of safer sex and will strongly consider wearing condoms more often in the future.
I was hoping you could provide insight into a new development:
Since my last posting, I saw a dermatologist for a second opinion. This dermatologist was less experienced than the first one (4 years of experience as opposed to 17). She looked at the bump and concluded that it was too difficult to tell whether it was a wart or a cyst without a biopsy. Under her advice, I agreed to the biopsy and am now awaiting the results.
My question to you is: can I ethically ignore her phone call and forget about the issue? Obviously, I am seeking to avoid learning that I am positive for genital warts (as remote as this possibility may be).
On the one hand, I was not obligated to get a second opinion. On the other hand, now that I have a second opinion from another dermatologist who said a biopsy was necessary, I have additional information (namely, that this second dermatologist recommended a biopsy and was unsure about the status of my bump).
From where I stand, only bad news can come from this biopsy (i.e., being positive for warts, having to inform future partners of this fact and thus experiencing a sharp reduction in future partners).
But, at the same time, I feel bad having sex with others knowing that there is a dermatologist out there who was unsure of my status, who recommended a biopsy, which I then decided to ignore.
From a legal standpoint, I know there is no precedent for recovery against a person who gives you warts. But, from an ethical standpoint, I feel queasy about this, especially if I'm going to have unprotected sex in the future...
I would greatly appreciate your insight into the question of whether I can ethically ignore this biopsy result.
Thanks for your time.
I appreciate your admonition to consider the merits of safer sex and will strongly consider wearing condoms more often in the future.
I was hoping you could provide insight into a new development:
Since my last posting, I saw a dermatologist for a second opinion. This dermatologist was less experienced than the first one (4 years of experience as opposed to 17). She looked at the bump and concluded that it was too difficult to tell whether it was a wart or a cyst without a biopsy. Under her advice, I agreed to the biopsy and am now awaiting the results.
My question to you is: can I ethically ignore her phone call and forget about the issue? Obviously, I am seeking to avoid learning that I am positive for genital warts (as remote as this possibility may be).
On the one hand, I was not obligated to get a second opinion. On the other hand, now that I have a second opinion from another dermatologist who said a biopsy was necessary, I have additional information (namely, that this second dermatologist recommended a biopsy and was unsure about the status of my bump).
From where I stand, only bad news can come from this biopsy (i.e., being positive for warts, having to inform future partners of this fact and thus experiencing a sharp reduction in future partners).
But, at the same time, I feel bad having sex with others knowing that there is a dermatologist out there who was unsure of my status, who recommended a biopsy, which I then decided to ignore.
From a legal standpoint, I know there is no precedent for recovery against a person who gives you warts. But, from an ethical standpoint, I feel queasy about this, especially if I'm going to have unprotected sex in the future...
I would greatly appreciate your insight into the question of whether I can ethically ignore this biopsy result.
Thanks for your time.
MEDICAL PROFESSIONAL
Welcome to the forum.
Going straight to the central question: in my opinion, no, it is not inappropriate or unethical to continue your normal and usual sexual practices, without informing partners of this issue.
First, it sounds quite certain you don't have genital warts. Second, you have had HPV for sure and, given your implied sexual lifestyle, probably will have additional infections in the future. Third, the same is likely true of your current or future sex partners. Therefore, informing them of the slight possibility that this bump was a wart will have little or no effect on their risk of new HPV infections or genital warts in the future.
In fairness, though, I should point out that many equally qualified experts would disagree with me and would advise you to inform partners. Still, I don't think this issue is worth having a biopsy.
Now here comes somthing of a lecture: hold onto your hat. I supposey ou know you're playing with fire with your "plan to have multiple partners and sometimes practice unprotected sex". HPV doesn't matter much, and because condoms provide only weak protection against HPV, your risk of future HPV infections (or of infecting partners) won't be much different with or without consistent condom use. But you'll probably care a lot if you catch one of the big league STDs or infect a partner. And frankly, you're expessing conflicting ethics. You're concerned about potentially putting partners at risk for one of the least serious STDs while at the same time risking infecting them with serious ones.
Sorry for the lecture, but you obviously touched one of my sensitive buttons. In any case, at this point I don't think you should be concerned about genital warts or informing partners.
Best wishes -- and please do consider the merits of safe sex!
HHH, MD
Going straight to the central question: in my opinion, no, it is not inappropriate or unethical to continue your normal and usual sexual practices, without informing partners of this issue.
First, it sounds quite certain you don't have genital warts. Second, you have had HPV for sure and, given your implied sexual lifestyle, probably will have additional infections in the future. Third, the same is likely true of your current or future sex partners. Therefore, informing them of the slight possibility that this bump was a wart will have little or no effect on their risk of new HPV infections or genital warts in the future.
In fairness, though, I should point out that many equally qualified experts would disagree with me and would advise you to inform partners. Still, I don't think this issue is worth having a biopsy.
Now here comes somthing of a lecture: hold onto your hat. I supposey ou know you're playing with fire with your "plan to have multiple partners and sometimes practice unprotected sex". HPV doesn't matter much, and because condoms provide only weak protection against HPV, your risk of future HPV infections (or of infecting partners) won't be much different with or without consistent condom use. But you'll probably care a lot if you catch one of the big league STDs or infect a partner. And frankly, you're expessing conflicting ethics. You're concerned about potentially putting partners at risk for one of the least serious STDs while at the same time risking infecting them with serious ones.
Sorry for the lecture, but you obviously touched one of my sensitive buttons. In any case, at this point I don't think you should be concerned about genital warts or informing partners.
Best wishes -- and please do consider the merits of safe sex!
HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
