Urethral Warts: Symptoms, Treatment, and Risks

Condyloma acuminatum (genital warts) at the urethral opening?

Hello Doctor, I discovered a cauliflower-like growth at the urethral opening at the end of last year.
I went to a nearby dermatology clinic and received cryotherapy for a month.
After treatment, there were no lesions at the urethral opening.
The doctor advised me to monitor the situation.
However, a week later, it recurred.
Since I felt that cryotherapy was not effectively curing the issue, I purchased an over-the-counter wart removal gel.
The doctor mentioned that infections at the urethral opening are uncommon and asked if I had noticed any growths elsewhere.
Currently, I have not seen any (on the glans or foreskin), but I researched online and found that deep urethral infections can occur.
The internet suggests that an infection at the urethral opening may indicate an immune system issue and could pose a risk for HIV...
Should I go to a major hospital for further examination? Additionally, I looked into the potential conditions related to deep urethral warts.
I noticed that sometimes when I hold my urine for a longer time, I feel a strong urge to urinate but have to wait a bit before it comes out (it feels like something is blocking it).
Could this be due to the warts, or could it be a stone? (I found out during a health check that I have bladder stones.) Thank you, Doctor!

Mark, 30~39 year old female. Ask Date: 2021/01/24

Dr. Li Xinyi reply Urology

Your concerns can only be addressed through examinations at the hospital.
If you have worries, please seek medical attention for evaluation.

Reply Date: 2021/01/24

More Info

Urethral warts, commonly caused by the human papillomavirus (HPV), can present a variety of symptoms and treatment challenges. It’s understandable that you are concerned about the recurrence of warts after undergoing cryotherapy and the potential implications for your overall health, including the risk of HIV.

Symptoms of Urethral Warts
Urethral warts may appear as small, cauliflower-like growths around the urethra. Symptoms can include:
- Visible Warts: These may be small, raised, and flesh-colored or darker.

- Discomfort or Pain: You might experience discomfort during urination or sexual activity.

- Changes in Urination: As you mentioned, if you feel a blockage or difficulty urinating, this could be due to the warts obstructing the urethra or possibly due to other conditions like urinary stones.

Treatment Options
1. Cryotherapy: This is a common treatment that freezes the warts, causing them to fall off. However, as you've experienced, it may not always be effective for complete eradication.

2. Topical Treatments: Over-the-counter treatments like wart removers can be effective, but they may not be specifically designed for urethral warts, which can be delicate. It's crucial to follow a healthcare provider's guidance when using such products.

3. Surgical Options: If warts persist or recur frequently, surgical removal may be necessary. This can be done through various methods, including excision or laser therapy.

4. Immunotherapy: In some cases, treatments that stimulate the immune system to fight the virus may be considered.

Risks and Considerations
- Recurrence: HPV can remain dormant in the body, leading to potential recurrence of warts. Regular monitoring and follow-up with a healthcare provider are essential.

- HIV Risk: While the presence of warts does not directly indicate an HIV infection, certain strains of HPV are associated with a higher risk of other sexually transmitted infections (STIs). If you have concerns about your immune system or potential HIV exposure, it is advisable to get tested.

- Obstruction Symptoms: The sensation of obstruction during urination could be related to the warts, but it could also indicate other issues such as urinary stones or inflammation. Given your history of bladder stones, it would be prudent to consult a urologist for a thorough evaluation.

Next Steps
Given your symptoms and concerns, it is highly recommended that you seek further evaluation from a healthcare provider, preferably a urologist or a specialist in infectious diseases. They can perform a comprehensive examination, possibly including:
- Visual Inspection: To check for any visible lesions or abnormalities.

- Urinalysis: To rule out infections or other urinary issues.

- Imaging Studies: Such as an ultrasound, to assess for bladder stones or other structural issues.

Conclusion
In summary, urethral warts can be a recurring issue, and their management may require a multifaceted approach. It's essential to stay vigilant about your symptoms and seek medical advice when necessary. Regular follow-ups and open communication with your healthcare provider will help ensure that you receive the most appropriate care for your condition. If you have any further questions or concerns, do not hesitate to reach out to a medical professional.

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