Treatment Options for Genital Warts and Ureaplasma

Genital warts (condylomata acuminata) - Treatment-related inquiries?

Hello Doctor,
First of all, I would like to express my gratitude for this platform and for the physicians who take the time to care for patients online! I am currently abroad and seeking treatment for condyloma and Ureaplasma.
However, I have some questions that I couldn't get answers to during my local outpatient visits, so I am asking here.
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Basic case information: I am 25 years old.
In August 2014 and March 2016, I had sexual encounters with two partners.
Although I only penetrated slightly due to pain and did not use condoms (which I deeply regret...), I went to a gynecologist in Taiwan after the first encounter in August 2014 due to issues with odor and discharge (no bleeding).
However, the doctor did not perform a speculum examination and diagnosed me with vaginitis based on visual inspection.
I took medication for a week but did not return for follow-up (which I also regret).
After having sexual relations 4-5 times with the first partner, I stopped contacting him, but the odor and discharge issues occasionally recurred.
Abroad, after having sexual relations with the second partner in March 2016 (4-5 times), I experienced some bleeding due to forceful penetration.
In April 2016, I visited a local gynecologist who performed a pelvic exam and Pap smear, diagnosing me with condyloma and Ureaplasma.
I am currently undergoing treatment for Ureaplasma with oral medication (three times a day for three weeks) and injections (two shots per visit for a total of ten shots).
The medication for Ureaplasma has been stopped, and I will return in a week for testing to see if it is still present.
The doctor mentioned that for the condyloma, I can have it treated with electrosurgery later (I currently have a small flesh-colored wart on the labia and a flesh-colored protrusion near the anus, which I am unsure if it is a hemorrhoid or condyloma).
However, every time I ask the doctor related questions, he seems impatient and unwilling to answer, possibly due to cultural differences, as he may feel that my questions imply distrust in the hospital's expertise.
I just want to understand my condition better and hope to recover soon!
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Here are my current related questions:
1) Regarding "condyloma excision surgery," some online users suggest that dermatology may be the most appropriate specialty.
I am unsure if there are distinctions between gynecology, dermatology, and urology in this regard.
PS.
I want to do cryotherapy at the current "foreign gynecology clinic," but the doctor said they do not have cryotherapy equipment and that electrosurgery would suffice.
However, I have heard that the recovery period for electrosurgery is long, and I cannot take time off work, so I am considering whether I need to transfer to another specialty.
2) Currently, I am only taking medication to treat Ureaplasma, and it has been three weeks since I discovered the condyloma (with no sexual activity during this period).
However, it seems to have grown worse (from pointed to somewhat elongated).
Can I proactively ask the doctor for a prescription for imiquimod (Aldara) or podofilox (Condylox)? Or can I purchase it over the counter without a prescription?
3) During the treatment for Ureaplasma, I discovered a small flesh-colored protrusion near the anus (about 0.5 cm, with 80% of the area inside the anal canal).
Recently, I have experienced bleeding and pain during bowel movements.
I am unsure if it is a hemorrhoid or condyloma.
Although I have not engaged in anal intercourse, I am worried it might be a transfer of condyloma.
Are there proactive measures to prevent the transfer of condyloma from the labia to the vagina/cervix/anal area?
4) The examinations I have undergone at the foreign gynecology clinic include a.
Pap smear (no cervical lesions or gonorrhea, but Ureaplasma was detected) b.
Blood tests (no HIV or syphilis).
If I want to know whether the virus causing my condyloma is closely related to cervical cancer, specifically HPV types 16 or 18, is the HPV DNA chip test a viable option? Are there any other testing methods available?
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Thank you again for taking the time to read this lengthy description of my experience with condyloma over the past three weeks.
My anxiety and concerns have not subsided, and I hope to receive professional answers from a physician.
I sincerely appreciate it!

Xiwang gangkuai hao qilai, 20~29 year old female. Ask Date: 2016/05/01

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the main treatment methods for warts in the country are electrosurgery and topical medication (which can only be considered for small areas).
Generally, electrosurgery does not affect work.
The growth near your anus could also be warts or Ureaplasma.
I'm sorry, but I'm not sure what it is; is there an English diagnosis? As for the cervix, you can undergo testing for HPV types 16 or 18.
Wishing you good health.

Reply Date: 2016/05/01

More Info

Thank you for your detailed inquiry regarding your current health situation involving genital warts (condyloma acuminata) and Ureaplasma infection. It’s understandable to feel anxious about these conditions, especially when navigating treatment options in a foreign healthcare system. I will address your questions one by one, providing insights based on medical knowledge.

1. Specialty for Wart Removal: The removal of genital warts can indeed be performed by various specialists, including gynecologists, dermatologists, and urologists. Each specialty may have different approaches and techniques for treatment. Gynecologists typically handle warts in the genital area, while dermatologists may be more experienced with skin lesions. If your current gynecologist does not have the necessary equipment for cryotherapy (freezing treatment), and you are concerned about recovery time from electrosurgery, it may be worth consulting a dermatologist. They might offer alternative methods or be able to perform the procedure with a shorter recovery time.

2. Requesting Additional Treatments: It is reasonable to inquire about additional treatments for genital warts, such as topical medications like imiquimod (Aldara) or podofilox (Condylox). These treatments can be effective for some patients. However, it is essential to have a healthcare provider's prescription for these medications, as they are not typically available over the counter. If you feel that your current doctor is not addressing your concerns adequately, consider seeking a second opinion or discussing your treatment options more assertively.

3. Concerns About Anal Lesions: The small, flesh-colored protrusion near your anus could be either a hemorrhoid or a wart. Given your history and the context, it’s wise to have it evaluated by a healthcare professional. While you may not have engaged in anal intercourse, HPV can still be transmitted through skin-to-skin contact. To minimize the risk of transmission, maintaining good hygiene and avoiding direct contact with warts is crucial. If you are concerned about the potential spread of warts, discuss preventive measures with your doctor, including the possibility of HPV vaccination, which can protect against certain strains of the virus associated with genital warts and cervical cancer.

4. Testing for HPV Types: To determine if the HPV strain causing your warts is one of the high-risk types (such as HPV 16 or 18), you can request an HPV DNA test. This test can identify the specific type of HPV present. It’s important to discuss this with your healthcare provider, as they can guide you on the appropriate testing methods available in your area. HPV DNA testing is typically performed on cervical samples, so ensure that you communicate your concerns clearly to your doctor.

In summary, it’s crucial to have open communication with your healthcare provider about your concerns and treatment options. If you feel that your questions are not being adequately addressed, seeking a second opinion may provide you with the reassurance and clarity you need. Remember that managing your health is a collaborative process, and you have the right to understand your treatment options fully. I hope this information helps alleviate some of your anxiety and guides you toward effective treatment.

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