Post-Wart Infection: Concerns About Anal Exams and HPV Risks

After cauliflower infection, questions about undergoing other examinations?

Hello Doctor: Two months ago, I discovered an infection resembling genital warts at the vaginal opening, which has been treated with electrosurgery.
I am currently undergoing regular follow-up visits.
I am concerned that the anal area may also be infected (no anal intercourse), so I underwent an anoscopy.
The doctor said there were no lesions and recommended that I observe for three months.
I check my genital and anal areas daily and have not seen any signs of recurrence.
I would like to ask the doctor: 1.
After the anoscopy, can it be concluded that there is no virus in the anal area? How long should I observe to completely rule out the possibility of anal infection? 2.
Recently, due to gastrointestinal discomfort, I have scheduled a colonoscopy.
I am worried that the colonoscope passing through the anus for further examination might cause an infection with the wart virus in the anal area or intestines.
I am quite anxious and would like to know if my condition allows me to undergo a colonoscopy.
3.
I have completed the second dose of the nine-valent vaccine.
Does this mean I have some level of protection? Will it reduce the likelihood of recurrence? Thank you very much for your answers!

AA, 20~29 year old female. Ask Date: 2019/06/27

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Two months ago, I discovered an infection resembling genital warts at the vaginal opening, which has been treated with electrosurgery.
I am currently undergoing regular follow-up appointments.
I am concerned that the anal area may also be infected (despite no anal intercourse), so I underwent an anoscopy.
The doctor stated that there were no lesions and recommended monitoring again in three months.
I check my genital and anal areas daily and have not seen any signs of recurrence.

My questions are:
1.
After the anoscopy, can I conclude that there is no virus in the anal area? How long should I observe to completely rule out the possibility of anal infection?
Answer: After the anoscopy, the possibility of anal infection can currently be ruled out.
2.
Recently, I have been experiencing gastrointestinal discomfort and have scheduled a colonoscopy.
I am worried that the colonoscope passing through the anus for further examination might cause an infection with the wart virus in the anal area or intestines.
I am anxious and unsure if I can undergo the colonoscopy given my situation.

Answer: You can undergo the colonoscopy.
3.
I have completed the second dose of the nine-valent vaccine.
Does this mean I have some level of protection?
Answer: You need to complete the third dose of the nine-valent vaccine and wait seven months for it to provide protective efficacy.
4.
Will this reduce the likelihood of recurrence?
Answer: Yes, it can reduce the likelihood of recurrence.

Reply Date: 2019/06/27

More Info

When it comes to concerns about HPV (human papillomavirus) and its potential risks following a wart infection, it's important to understand the nature of HPV transmission and the implications of medical examinations. Let's address your questions one by one.

1. Anal Examination and HPV Detection: The anal examination you underwent, specifically the anal pap smear or anoscopy, is a useful tool for detecting any visible lesions or abnormalities in the anal area. However, it is important to note that while these examinations can identify existing lesions, they do not guarantee the complete absence of HPV. HPV can be present in areas that are not easily visible or accessible during the examination. The virus can also remain dormant in the body for extended periods. Therefore, while your doctor’s assessment is reassuring, it is prudent to continue monitoring for any symptoms or changes. Regular follow-ups, as suggested by your healthcare provider, are essential. Generally, if no lesions are observed and you remain symptom-free, the risk of having an active infection is low, but it is wise to maintain vigilance for at least six months to a year.

2. Concerns About Colonoscopy: Regarding your upcoming colonoscopy, it is understandable to have concerns about the potential for infection during the procedure. However, the risk of transmitting HPV through the colonoscope is extremely low. The instruments used in colonoscopy are thoroughly sterilized, and the procedure is performed under strict hygienic conditions. While HPV is primarily transmitted through direct skin-to-skin contact, the likelihood of it being transmitted through a medical instrument is negligible. If you have concerns, discuss them with your gastroenterologist, who can provide reassurance and address any specific precautions that may be taken during your procedure.

3. Effectiveness of the HPV Vaccine: You mentioned that you have received the second dose of the nine-valent HPV vaccine. This vaccine is designed to protect against several strains of HPV, including those that cause genital warts and cervical cancer. While the vaccine is most effective when administered before the onset of sexual activity, it still provides significant protection even after exposure to the virus. The vaccine does not treat existing infections but can help prevent future infections from the strains it covers. After completing the vaccination series, you should have a good level of protection against the types of HPV that are most commonly associated with warts and cancer. However, it is important to continue regular screenings and follow-ups as recommended by your healthcare provider.

In summary, while your concerns about HPV and its implications are valid, the combination of regular medical examinations, the HPV vaccine, and ongoing monitoring can significantly reduce your risks. It is essential to maintain open communication with your healthcare providers, follow their recommendations, and report any new symptoms or concerns promptly. Remember, knowledge and proactive health management are your best tools in navigating HPV-related health issues.

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