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warts

thankyou for addressing this question. I will try to be as concise as possible. I am a 34yo, male, smoker Myexposure to hpv would've been almost 14 months ago now through genital contact and receptive anal sex. (a condom was used for the anal sex, but there was genital contact during foreplay.) I have tested negative for chlamydia and gonorrhea, syphilis, hiv, and hsv in three doctors visits over the last year. Also, no indication from urine/blood tests of any infections. Treated with one month of cipro for suspected prostatitis. No improvement. My regular partner, (female), has had no abnormalities in her paps thus far. I was examined by a PA in january visually after I expressed a concern about warts. She said she didn't observe anything out of the ordinary. I, however, feel that though these bumps look like sebaceous glands, they are much more prevalent then they used to be, and are occurring too far away from hair growth to be related to hair follicles. Could an experienced PA at an STD clinic miss an hpv diagnosis like this? I do have some other symptoms. I experience irritation on the perineum and anus which comes and goes. Often in the morning I have profuse moisture/sweating at the base of the spine and buttocks.  Having said all this, here are my questions: 1)Given that its been 14 months since exposure, should I expect my immune system to get control of this soon? 2)Should I just wait it out? 3) Does the temporal persistence of warts depend on the actual strain of hpv? or, more on the immune system and genes of the infected body? 4)I'm resistant to the idea that this is unrelated to that sexual contact given the timing of everything, but could these symptoms indicate something more serious? 5)since "feeling" that the bumps were spreading, (about 6 weeks ago), I've been observing very closely for any new bumps. There have been no new bumps yet. If I were to see a DEFINITE new bump pop up, would this confirm that its hpv?
1 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the STD forum.  I'll try to help.  The bottom line is that I doubt your symptoms are due to HPV or any other STD and I do not believe your girlfriend is at risk for anything you could transmit to her.

Genital-genital contact could theoretically transmit HPV, but usually does not, and your anal sex experience was condom-protected.  Even if the condom failed, your risk there was for HPV of the anus and rectum, not the penis.  Your PA did not think the penile bumps are warts, and you even acknowledge yourself they don't look like typical warts; combining that information with low risk of exposure, plus your belief the lesions look like sebaceous glands, I guess I don't understand why HPV and warts are even on your mind.  As time passes, minor variations in penile skin are normal and sebaceous glands might well appear more prominent.  It doesn't mean anything.  Of course, I cannot say you don't have HPV, since all sexually active people acquire one or more genital HPV infections; having genital HPV is a normal and expected consequence of human sexuality.  But most infections are asymptomatic and cause no harm, and if you have it, there is no relationship to the symptoms you describe.

As for your other symptoms, they really don't hint at any STD, and your multiple medical evaluations and negative tests assure you don't have anything.  If the symptoms continue and you remain concerned, see a health care provider about them.  But you can put STDs aside.

To the specific question:

1) I'm not convinced there is anything abnormal going on, or that you have any condition for your immune system to get control of.  Certainly not HPV or any other STD.

2) Either wait it out or see a provider, as I suggested above.  Your choice.  There certainly is no danger in waiting, except perhaps for the anxiety factor.

3) In general, the high-risk HPV types -- the strains associated with cervical cancer -- tend to persist longer than the types that cause warts.  But this issue is irrelevant to your situation, for the reasons discussed above.

4) Your resistance notwithstanding, I am convinced of my judgment.

5) Stop examining yourself so closely.  A "new bump" could be another sebaceous gland or other minor variation in your skin.

I have to wonder whether the main problem here is emotional. Maybe anxiety or guilt about your sexual choices?  Ambivalence about tendencies toward sex with other men?  Please think about it and consider discussing it with your primary care provider.

Best wishes--  HHH, MD
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