Symptoms and Treatment Options for Urethral Warts

Q: Symptoms and Treatment Options for Urethral Warts

Hello： 1) Warts in the urethra typically do not present significant symptoms and are usually detected through cystoscopy. <br>2) Since the urethral scope is a rigid instrument, the examination, which lasts about 5-10 minutes, can be quite uncomfortable for men due to the length o

Hello, this is a follow-up question regarding article #149623?

I would like to ask the doctor if there are any symptoms or sensations to indicate whether warts have spread deeper into the urethra, aside from performing a urethroscopy.
Currently, I only experience occasional itching at the urethral opening, which has been happening for about a year.
Sometimes the urethral opening itches suddenly for 1-2 seconds, and then it feels normal again.
The itching does not occur frequently; there are times when I go a whole week without it, and other times it happens once or twice a day.
Last year, a urinalysis showed no significant bacteria, only microscopic hematuria.
If I were to undergo a urethroscopy, would anesthesia be necessary? What type of anesthesia is typically used—local, regional, or general? Additionally, regarding the warts at the urethral opening, would the doctor recommend surgical removal or treatment with topical medication? Thank you for your response.

Niming, 20~29 year old female. Ask Date: 2019/08/17

Dr. Du Shixi reply Urology

Hello: 1) Warts in the urethra typically do not present significant symptoms and are usually detected through cystoscopy.
2) Since the urethral scope is a rigid instrument, the examination, which lasts about 5-10 minutes, can be quite uncomfortable for men due to the length of the male urethra (it is much easier for women).
If tolerated, a urethral analgesic lubricant can be used for examination (local anesthesia), and some individuals can manage this, but tolerance is essential.
It is not possible to have no pain at all.
Additionally, after the examination, there may be pain during urination and mild hematuria for about half a day, depending on the individual's constitution.
If the patient moves during the examination, it may cause urethral abrasion, prolonging urinary symptoms.
(As for spinal anesthesia, it is only performed if a problem is confirmed that requires treatment; spinal anesthesia will result in several hours of loss of sensation in the lower body.
General anesthesia involves intravenous medication administered by an anesthesiologist, during which the patient will be asleep, and they will awaken after 10-15 minutes with no pain during the procedure.
However, the symptoms upon waking, such as pain during urination and mild hematuria, will be similar.
Costs may vary by hospital.
Wishing you good health.

Reply Date: 2019/08/17

More Info

Urethral warts, commonly caused by the human papillomavirus (HPV), can present various symptoms and require careful consideration for treatment options. When it comes to understanding whether warts have progressed deeper into the urethra, there are several factors to consider beyond just the use of a urethroscope.

Symptoms to Monitor
1. Itching and Discomfort: You mentioned experiencing occasional itching at the urethral opening. This symptom can be indicative of irritation or inflammation, which may or may not be directly related to the presence of warts. If the itching persists or worsens, it could suggest that the warts are causing irritation or that there is another underlying issue.

2. Changes in Urination: Pay attention to any changes in urination patterns, such as increased frequency, urgency, or pain during urination. These symptoms could indicate that the warts are affecting the urethra or that there is another condition present.

3. Bleeding or Discharge: Any unusual bleeding or discharge from the urethra should be evaluated by a healthcare professional. This could indicate an infection or other complications.

4. Pain: While you have not reported pain, any new onset of pain, especially during urination or in the pelvic area, should be assessed.

Diagnostic Procedures
Regarding the urethroscopy, this procedure is typically performed to visualize the inside of the urethra and bladder. It can help determine the extent of the warts and whether they have spread.
- Anesthesia: Urethroscopy can be uncomfortable, and local anesthesia is often used to minimize discomfort. In some cases, sedation may be offered, but general anesthesia is usually not necessary for this procedure. The choice of anesthesia will depend on the specific circumstances and the healthcare provider's recommendations.

Treatment Options
When it comes to treating urethral warts, there are generally two main approaches: surgical removal and topical treatments.

1. Surgical Removal: If the warts are causing significant symptoms or if there is concern about their progression, surgical removal may be recommended. This can be done through various methods, including excision or laser therapy. Surgical options are often preferred for larger or more symptomatic warts.

2. Topical Treatments: There are topical medications available that can be applied directly to the warts. These treatments may include imiquimod or podophyllin, which can help reduce the size of the warts. However, topical treatments may take longer to show results and may not be as effective for deeper or larger warts.

Conclusion
In summary, while occasional itching at the urethral opening can be a benign symptom, it is essential to monitor for any changes in urination, pain, or unusual discharge. Urethroscopy is a valuable diagnostic tool that can help assess the extent of the warts, and local anesthesia is typically sufficient for this procedure. Treatment options vary based on the severity and symptoms of the warts, with surgical removal often being the preferred method for more significant cases. It is crucial to discuss your symptoms and treatment options with a healthcare provider who can provide personalized recommendations based on your specific situation.

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