Concerns About HPV Transmission After Year of No Recurrence

Q: Concerns About HPV Transmission After Year of No Recurrence

Hello： 1. Does my girlfriend have genital warts? She needs to see a gynecologist for a diagnosis. 2. Can female urethritis and hematuria be early signs of a genital wart infection? -- No, it is not. She may have been recently infected or could have contrac

I have not had a recurrence of cauliflower for a year, but I am worried about transmitting it to my girlfriend?

Hello, doctor.
I have a lengthy message, and I appreciate your patience in reviewing my condition: In early March last year, I went to a large hospital for examination and was diagnosed with an opening at the urethral meatus, with a cauliflower-like growth.
I initially discovered this due to hematuria and blood during masturbation.
I scheduled a cauterization surgery and also underwent a urethroscopy, which showed no growth inside the urethra.
I returned for follow-up visits twice (two weeks apart, then a month later), and during the last visit, the doctor visually examined me and said there were no abnormalities, feeling that everything was cleared up well.
It has been almost a year since the surgery, and I have been regularly checking the original site with no abnormalities.
However, a recent incident has caused me concern.
I have been dating a new girlfriend for four months, and we have had unprotected sexual intercourse.
Three days ago, after we had sex, she mentioned that urination was painful and there was blood in her urine.
I took her to the hospital for a urine test, and the report showed a long list of infection indicators, diagnosing her with urethritis.
I have been very careful about hygiene, always ensuring to clean thoroughly before intercourse, so I am fearful that I may have transmitted something harmful to her.
I have several questions:
1.
I read that most doctors say if there is no recurrence after three months, there is no need to worry too much.
However, I am afraid of transmitting something to her.
Do you think the possibility of this is high? Could I have infected her?
2.
Can female urethritis and hematuria be precursors to a HPV infection? If so, is it possible that she contracted it recently, or could she have been infected during our first sexual encounter?
3.
When I asked my doctor during my follow-up visit if it was possible for the growth to return in the urethra without my knowledge, he told me not to worry too much, stating that if it did return, it would definitely be accompanied by hematuria.
Do you think this assessment is correct?
4.
I read an article where a doctor stated that even if symptoms are cleared for three months or more without recurrence, the idea that "the virus is just lurking somewhere and can re-emerge" is incorrect and has a low probability.
If there is a recurrence, it is more likely due to reinfection.
Is this true?
5.
I have noticed small, fine bumps on my glans that are not very visible when not fully erect, making the glans appear wrinkled, but they become noticeable when fully erect.
I feel it resembles some form of eczema.
Shouldn't the glans be smooth? I visited a urology clinic two years ago, and the doctor visually assessed it and thought I was overly concerned, suggesting that if I was worried, he could prescribe a topical ointment.
Could these bumps indicate a fungal infection on my glans that has persisted for a long time, potentially causing my girlfriend's inflammation? If it is a fungal infection, what treatment options are available?
6.
Lastly, I have a curious question based on my research.
If a person has the HPV virus and engages in sexual activity with someone who has been vaccinated, it is certain that the vaccinated person will not show symptoms.
However, if that vaccinated person then has sexual relations with others, could they still transmit the virus? I am very afraid that I might still carry the virus without showing symptoms, thus potentially transmitting it to others.
I would greatly appreciate your professional response.
Thank you.

Xiao Shu, 30~39 year old female. Ask Date: 2018/02/08

Dr. Du Shixi reply Urology

Hello:
1.
Does my girlfriend have genital warts? She needs to see a gynecologist for a diagnosis.

2.
Can female urethritis and hematuria be early signs of a genital wart infection? -- No, it is not.
She may have been recently infected or could have contracted it the first time we had intercourse after we started dating.
Diagnosis of genital warts in women is done through a gynecological examination, and it is difficult to determine when the infection occurred.

3.
When I returned for a follow-up, I asked my doctor if it was possible for the warts to grow back in the urethra without my knowledge.
He told me not to worry too much; if they did grow back, it would definitely be accompanied by hematuria.
Do you think this assessment is correct? -- That's about right.

4.
I read an article where a doctor stated that if symptoms are cleared for three months or more without recurrence, the belief that "the virus is just lurking somewhere and can re-emerge" is incorrect and has a low probability.
If there is a recurrence, it is more likely due to reinfection.
Is that true? -- I think that perspective is too subjective.
It is certainly possible for the virus to be cleared or to remain latent; it's just less common.
However, the longer the duration without recurrence, the greater the likelihood of being cleared.

5.
I have had tiny, fine bumps on my glans for a long time.
They are not very noticeable when not fully erect, making the glans appear wrinkled, but they become visible when fully erect.
I think it resembles a type of eczema.
Shouldn't the glans be smooth? -- Not necessarily.
I visited a urology clinic two years ago, and the doctor visually assessed it and thought I was overthinking it.
He suggested that if I was concerned, he could prescribe a topical cream.
Could it be that I have a fungal infection on my glans that has caused my girlfriend to have inflammation? If it is a fungal infection, is there a treatment available? -- I recommend seeing a urologist for examination.
Fungal infections can be treated, but they can also recur easily.
However, treatment is generally not too difficult.

6.
Finally, I have a curious question after doing some research.
If a person has the HPV virus and engages in sexual activity with someone who has been vaccinated, it is certain that the vaccinated individual will not show symptoms (please note this is not absolute).
However, if they engage in sexual activity with others, can they still transmit the virus? -- The vaccine can only prevent certain types of HPV, but there are many strains of the virus.
Do not assume that being vaccinated means one cannot contract HPV.
Additionally, the vaccine does not provide 100% protection against the targeted strains, so safe sexual practices are still necessary.
I believe that if a person with the virus has sexual relations with someone without the virus, and the uninfected person does not contract HPV, they cannot transmit it to others.
Wishing you good health.

Reply Date: 2018/02/08

More Info

Your concerns regarding HPV transmission and related symptoms are valid and reflect a common anxiety among individuals who have had HPV-related issues in the past. Let’s address your questions systematically.

1. Transmission Concerns: After a year of no recurrence of HPV-related symptoms, the likelihood of transmitting the virus to your partner is significantly reduced, but not entirely eliminated. HPV can remain dormant in the body, and while the risk of transmission decreases with time and absence of symptoms, it is still possible for someone to carry the virus without showing signs. If you have been symptom-free and have had no recurrence, the chances of you transmitting the virus are low, but it is not impossible.

2. Symptoms in Your Partner: The symptoms your girlfriend is experiencing, such as painful urination and blood in her urine, are more indicative of a urinary tract infection (UTI) rather than a direct sign of HPV or condylomata (genital warts). While HPV can lead to genital warts, it typically does not cause urinary symptoms. It’s possible that she may have contracted a UTI from other sources, and the timing of her symptoms does not necessarily correlate with your sexual activity.

3. Recurrence of HPV: Your doctor’s reassurance that if HPV were to recur, it would likely present with symptoms such as blood in the urine is generally accurate. However, HPV can sometimes be asymptomatic, and its presence may not always be detectable without specific testing. Regular follow-ups and monitoring are essential to ensure that any potential recurrence is caught early.

4. Virus Dormancy: The notion that the virus could be dormant and may reactivate is a topic of ongoing research. While it is true that some viruses can remain latent, the consensus is that if you have been symptom-free for an extended period (like over three months), the likelihood of the virus reactivating is low. If a recurrence does occur, it is often due to a new infection rather than reactivation of a previous one.

5. Glandular Issues: The small bumps you describe on your glans could be a normal anatomical variation, such as pearly penile papules or Fordyce spots, which are harmless. However, if you are concerned about a fungal infection or any other dermatological issue, it would be wise to consult a dermatologist or urologist for a thorough examination and appropriate treatment.

6. Vaccination and Transmission: Regarding your question about HPV vaccination, it is important to note that while the vaccine significantly reduces the risk of contracting certain strains of HPV, it does not eliminate the risk entirely. If a vaccinated individual engages in sexual activity with someone who has HPV, they may still carry the virus, but the vaccine protects against the strains covered by the vaccine. Therefore, it is possible for a vaccinated person to transmit HPV if they have been exposed to a strain not covered by the vaccine.

In summary, while your concerns are understandable, the risk of transmission after a year of no symptoms is low. It is crucial to maintain open communication with your partner about sexual health and to encourage regular check-ups for both of you. If either of you experiences new or unusual symptoms, seeking medical advice promptly is always the best course of action. Regular screenings and vaccinations remain key components in managing HPV and reducing the risk of transmission.

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