Pearly Penile Papules and HPV Concerns: A Urology Guide - Urology

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Questions about the size of pearly penile papules and cauliflower-like infections?


Hello, Doctor Du.
I have several questions, and I appreciate your help!
Question 1: I have some pearly penile papules on the edge of my glans, but they are not all the same size.
Some are smaller in one row, while others are slightly larger, but not by much.
Is this normal?
Question 2: Additionally, there is one pearly papule that is slightly larger, but visually it does not exceed 2mm, also located on the edge of the glans.
When I shine a flashlight on it, it appears white, but upon closer inspection, it has a slightly milky translucent quality that is not very obvious.
I can push it with my fingernail, and it feels like soft tissue, but I cannot remove it.
From the side, it looks somewhat rounded.
It seems similar to the other papules, just a bit larger.
Is this also normal? Could it be genital warts? I have not engaged in any high-risk sexual behavior, such as visiting sex workers or one-night stands.
My girlfriend is my only partner, and I am her only boyfriend.
Question 3: I am currently serving in the military, and all my underwear is washed together in a laundry bag.
Could this lead to an infection with genital warts? My squad leader mentioned that after we shower, our clothes are put in a basket overnight, and the next morning, they are collected for washing.
They are subjected to high-temperature drying for sterilization and are also left in the sun for an hour or two.
He has been in the military for a long time and has never heard of anyone getting genital warts this way.
Additionally, I usually wait a few days before wearing the cleaned clothes.
Is it unlikely that I could get infected this way?
Question 4: Due to a malfunctioning water pump in the military, sometimes there is no water, and the staff uses a large trash bin to store water for handwashing.
Most of us use this water to wash our hands at the sink.
Before using the toilet, I washed my hands with that water because they were dirty, dried them off, and then went back to my dorm to get toilet paper.
After using the toilet, I started to worry that since everyone washes their hands in that bin, there could be genital wart virus present, and when I used toilet paper to wipe my anus, I might get infected.
My fellow soldiers laughed at me for being overly anxious, saying that the genital wart virus does not survive well outside the human body and that the large volume of water would dilute any virus, making it unlikely to infect me.
Should I really be less concerned, or am I overthinking this?
I apologize for the many questions, and I appreciate your assistance, Doctor!

Aqi, 20~29 year old female. Ask Date: 2018/12/08

Dr. Du Shixi reply Urology


Hello: 1) Early-stage warts can resemble pearly penile papules, but initially, there are usually only a few, and they tend to grow larger.
2) If there is any suspicion, it is advisable to seek medical attention, as outpatient physicians may also encounter cases that are not warts, and pathology reports can confirm the diagnosis of warts.
3) As long as you maintain hygiene and avoid wearing others' clothing, there is no risk of transmission.
4) The issues you mentioned do not have the potential for transmission.
Wishing you good health.

Reply Date: 2018/12/08

More Info


Understanding Pearly Penile Papules (PPP) and HPV Concerns: A Urology Guide
Hello! It’s great that you’re seeking information about your health concerns, particularly regarding pearly penile papules (PPP) and HPV. Let’s address your questions one by one.


Question 1: Pearly Penile Papules Characteristics
Pearly penile papules are small, benign growths that typically appear around the corona of the glans (the head of the penis). They are usually uniform in size and shape, but it’s not uncommon for them to vary slightly in size and spacing. The fact that you notice some papules being slightly larger or smaller is generally normal. PPP is a common anatomical variation and is not associated with any disease, including sexually transmitted infections (STIs) like HPV.

Question 2: Size Variation of Papules
Regarding the slightly larger papule you mentioned, if it appears similar in texture and color to the other papules, it is likely still a pearly penile papule. The characteristics you describe—soft, movable, and not painful—are consistent with PPP. However, if you notice any changes in color, texture, or if it becomes painful, it would be wise to consult a healthcare professional for a proper evaluation. It’s important to differentiate between PPP and other conditions, such as genital warts (caused by HPV), which can appear similar but have different implications.


Question 3: Laundry and HPV Transmission
Your concern about potentially contracting HPV through laundry is understandable, but the risk is extremely low. HPV is primarily transmitted through direct skin-to-skin contact during sexual activity. While it is theoretically possible for the virus to survive on clothing for a short period, the conditions (like washing and drying) you described—using hot water and high heat for drying—would effectively kill the virus. Additionally, since you mentioned that you and your girlfriend are each other’s only partners, the likelihood of transmission through laundry is negligible.


Question 4: Hygiene Practices and HPV
Regarding your concern about washing your hands with water from a communal source, it’s important to maintain good hygiene, especially in shared environments. However, as you noted, HPV does not survive well outside the human body. The virus requires direct contact with mucous membranes or skin to transmit. The dilution of the virus in a large bucket of water, combined with the fact that it would be exposed to the environment, significantly reduces any risk of transmission. Your worries about using that water for personal hygiene are understandable, but the risk of contracting HPV in this manner is very low.


Additional Considerations
While it’s good to be cautious and informed about your health, it’s also important to manage anxiety regarding these concerns. If you have ongoing worries about HPV or other STIs, consider discussing them with a healthcare provider. They can offer testing and reassurance, as well as provide guidance on safe sexual practices.


Prevention and Awareness
To minimize the risk of HPV and other STIs in the future, consider the following preventive measures:
1. Vaccination: The HPV vaccine is effective in preventing many strains of the virus, including those that cause genital warts and cervical cancer. It’s recommended for both males and females.

2. Regular Check-ups: Regular health check-ups and STI screenings can help catch any issues early.

3. Safe Sex Practices: Using condoms consistently and correctly can significantly reduce the risk of STI transmission, although they do not provide complete protection against HPV due to potential skin contact.

In conclusion, while your concerns are valid, the likelihood of contracting HPV through the scenarios you described is very low. If you have further questions or notice any changes in your health, don’t hesitate to reach out to a healthcare professional for personalized advice.

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