HPV: Symptoms, Treatment, and Prevention of Warts

Suspected infection of genital warts?

Hello, doctor.
Last Friday, I went to the urology department for a routine urine test due to slight discomfort (a mild burning sensation) while urinating.
I suddenly remembered that I had previously noticed a small growth resembling a polyp under my scrotum, which was slightly darker than the surrounding skin (I also have a polyp on my neck, which the doctor confirmed is indeed a polyp and not a wart).
The doctor diagnosed it as likely being a wart (initially stating it was a 50/50 chance, but later said there was a 70% likelihood).
That same day, I scheduled an afternoon laser vaporization surgery and sent the sample for biopsy.
During the procedure, the doctor discovered another small growth on the other side, which I had not noticed despite being attentive to changes in my body.
The doctor mentioned it was even smaller.
Since the report will take two weeks, I have been increasingly anxious.
I have also noticed a very small white growth on the inner thigh that resembles the previous ones.
If I were to scratch it, would it bleed?
1.
Can warts grow as a single lesion, or can they appear as very small, thin projections?
2.
Since this growth has been present for some time (I recall it being around three to four months), and there has been no increase in size or number, if it is indeed a wart, would touching the scrotum and then other areas of the genital region lead to infection in those areas? Or is it only if I scratch it that it could cause infection elsewhere?
3.
If it is confirmed to be a wart, would you recommend laser treatment or topical medication? The clinic doctor mentioned that topical medication should not be used since the original lesion has already been treated with laser, as it might trigger the emergence of new lesions.
4.
Does receiving the nine-valent HPV vaccine really reduce the recurrence rate?
5.
I have seen some information online suggesting that oral medications can enhance the immune system to eliminate HPV.
Is it possible for the body’s immune system to completely clear the virus?
6.
If follow-up testing after one year shows no detectable viral load, does that mean I am cured? Or will the virus coexist with my body for life, potentially reactivating if my immune system declines again?
7.
Can warts cause a mild burning sensation or discomfort while urinating?
I apologize for the lengthy message, and I appreciate your answers.
Thank you.

Wei, 20~29 year old female. Ask Date: 2021/10/12

Dr. Cai Zhuorong reply Urology

Based on your description, it is difficult to determine whether it is genital warts.
The most accurate method is to perform a surgical excision and conduct a pathological examination of the tissue.
As for your earlier questions regarding the diagnosis of genital warts, those methods are not very accurate.
Questions four through six pertain to whether it will heal or recur.
The methods you mentioned do not have scientific evidence supporting their effectiveness, but there is no need for excessive concern; just maintain safe sexual practices and a healthy lifestyle.
Genital warts typically do not cause discomfort during urination, but if you experience any symptoms, it is advisable to seek further examination.

Reply Date: 2021/10/12

More Info

Human Papillomavirus (HPV) is a common sexually transmitted infection that can lead to various health issues, including genital warts and certain types of cancer. Understanding HPV, its symptoms, treatment options, and prevention strategies is crucial for maintaining sexual health.

1. Nature of HPV and Transmission: HPV is primarily transmitted through direct skin-to-skin contact during sexual activity, including vaginal, anal, and oral sex. It is not a congenital infection, meaning it is not passed from mother to child during childbirth. While there are over 100 types of HPV, not all are associated with warts or cancer. Low-risk types, such as HPV 6 and 11, are commonly linked to genital warts, while high-risk types, such as HPV 16 and 18, are associated with cervical and other cancers.

2. Symptoms and Diagnosis: Genital warts, often referred to as "cauliflower-like" growths, can appear as small, flesh-colored or gray swellings in the genital area. They can be single or multiple and may vary in size. It's important to note that HPV can be asymptomatic, meaning many individuals may carry the virus without showing any signs. If you notice any unusual growths or changes in your genital area, it is essential to consult a healthcare provider for a proper diagnosis.

3. Treatment Options: Treatment for genital warts can include topical medications, cryotherapy (freezing), laser therapy, or surgical removal. The choice of treatment depends on the size, number, and location of the warts. While some healthcare providers may recommend topical treatments, others may prefer more invasive procedures like laser therapy, especially if warts are recurrent or extensive. It's crucial to follow your doctor's recommendations regarding treatment and to avoid self-treatment, as this can lead to complications.

4. Vaccination: The HPV vaccine, particularly the nine-valent vaccine, is effective in preventing infections from the most common high-risk and low-risk HPV types. Vaccination is recommended for preteens but can also benefit adults who have not been previously vaccinated. While the vaccine does not treat existing infections, it can significantly reduce the risk of future infections and associated complications.

5. Immune Response and Clearance: The body's immune system plays a vital role in clearing HPV infections. In many cases, the immune system can eliminate the virus within two years. However, some individuals may experience persistent infections that can lead to health issues. There are no specific antiviral medications that can cure HPV, but maintaining a healthy lifestyle, including a balanced diet, regular exercise, and avoiding smoking, can support immune function.

6. Follow-Up and Monitoring: Regular follow-up with your healthcare provider is essential, especially after treatment for HPV-related conditions. If follow-up tests show no detectable virus after a year, it is a positive sign, but it does not guarantee that the virus is completely eradicated. HPV can remain dormant in the body and may reactivate if the immune system weakens.

7. Symptoms Related to HPV: While HPV itself does not typically cause urinary symptoms, the presence of genital warts or other related conditions may lead to discomfort during urination. If you experience persistent symptoms such as burning or discomfort while urinating, it is essential to seek medical attention to rule out other potential causes, such as urinary tract infections or other sexually transmitted infections.

In conclusion, understanding HPV is crucial for prevention and management. Regular screenings, vaccinations, and open communication with healthcare providers can help mitigate the risks associated with HPV. If you have concerns about HPV or related symptoms, do not hesitate to seek medical advice for personalized care and treatment options.

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