Genital Health: Common Concerns and Expert Advice - Internal Medicine

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Hello Dr.
Hong, I would like to ask you a few health education questions.
At the end of last year, I noticed a small lesion on the mucosal area of my glans and went to a urologist for examination.
The doctor was unsure if it was a wart, so they performed electrosurgery for a biopsy.
Later, the report indicated it was a wart, and I was advised to return for follow-up.
I discussed this with my girlfriend, and the doctor recommended that we refrain from sexual intercourse for the time being.
I took her for an examination as well, and she also had a similar issue, but we had not engaged in sexual activity as we had only been dating for less than six months at that time.
When I returned for a follow-up, the doctor said there were no abnormalities and that it should not recur.
As for sexual activity, I was cleared to proceed but advised to use condoms.
Although my girlfriend prefers not to use them, I decided to follow the doctor's advice.
I have two questions for you.
First, given these circumstances, I asked the doctor if it was safe to engage in sexual activity, and he said it should be fine.
However, after finishing, I tidied up the room before washing up.
I would like to know if it is okay for semen to come into contact with my own genital area for about 3-5 minutes before I showered.
The urologist mentioned that it wouldn't matter, and if transmission were possible, it would be more likely through direct contact on the glans or the inner foreskin, not just any skin contact.
He reassured me that as long as there are no open wounds, there shouldn't be an issue, but emphasized the importance of hygiene.
I read online that I shouldn't worry too much, but I just saw that hand contact could also be a concern, which made me a bit anxious.
My second question is about the duration for a virus to completely disappear or become dormant.
Is it true that only PCR testing can confirm this? The urologist mentioned that it wasn't necessary to spend money on that test, and that if there have been no recurrences for 10 months, I should be fine.
Another doctor suggested that three months would be sufficient.
It seems like different doctors have varying opinions on this matter, so I hope to get more insights.
Thank you for taking the time to respond!

Cc, 20~29 year old female. Ask Date: 2020/10/06

Dr. Hong Yuanbin reply Internal Medicine


Hello, regarding the first question, there is indeed no need to worry, as transmission is usually more likely through sexual contact.
As for the second question, there is no standard answer because the clinical diagnosis of genital warts primarily relies on the observation of lesions on the skin or mucous membranes, rather than PCR testing.
A small number of individuals may remain asymptomatic and have latent infections.
It can be said that the longer the duration without recurrence, the higher the chance of eradication of the genital warts.
Thank you for your inquiry.

Reply Date: 2020/10/06

More Info


Understanding genital health is crucial, especially when dealing with concerns such as lesions or infections. It seems you have been through a challenging experience with a genital lesion that was biopsied and found to be benign. It's understandable to have lingering questions and concerns about your health and that of your partner.

Firstly, regarding your concern about semen contact with your genital area, it’s important to clarify that while bodily fluids can carry infections, the risk of transmission through casual contact (like touching your own genital area after ejaculation) is generally low, especially if there are no open wounds or lesions present. Your urologist's advice is sound; the primary concern for transmission is through direct contact with mucous membranes or broken skin. Cleaning yourself afterward is a good practice for hygiene, but the risk of transmission in the scenario you described is minimal.

As for your second question regarding the duration of viral presence and detection, it’s essential to understand that many viruses can remain dormant in the body after the initial infection. For example, human papillomavirus (HPV), which is often associated with genital warts, can sometimes be cleared by the immune system over time. The timeline for this varies significantly among individuals. Some may clear the virus within a few months, while others may take years.
Your urologist's recommendation of 10 months without recurrence as an indicator of being in the clear is a reasonable guideline. However, it's also important to note that some strains of HPV can remain dormant and may not show symptoms for a long time. Regular follow-ups and monitoring are crucial, especially if you have a history of lesions.
PCR testing is indeed a method to detect viral presence, but it may not always be necessary if you are asymptomatic and have had no recurrence of symptoms. The differing opinions among healthcare providers can be confusing, but they often reflect the variability in individual cases and the evolving nature of medical understanding regarding viral infections.

In summary, while your concerns are valid, the advice you've received from your healthcare providers seems appropriate. Maintaining open communication with your partner about health concerns, practicing safe sex, and following up with your healthcare provider as recommended will help ensure both your health and that of your partner. If you have further concerns or if new symptoms arise, don’t hesitate to seek medical advice. It’s always better to err on the side of caution when it comes to health matters.

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