Grayish White Bumps on the Urethral Opening: Possible Causes

Q: Grayish White Bumps on the Urethral Opening: Possible Causes

Hello： Please refer to http：//www.ktgh.com.tw/Public/tbDrug/201806291614557055.pdf for recommendations on follow-up visits. <br>If a patient has not engaged in sexual activity for over eight months and the last encounter was protected with a condom, is there still a possibility o

There is a grayish-white hard lump at the glans urethral opening?

Hello, doctor.
I haven't had any sexual intercourse for about 8 months, only masturbation.
Two weeks ago, I noticed a small white, pimple-like protrusion on the side of the glans urethra.
After going to the hospital for examination, I was informed that it was likely genital warts (without a biopsy).
I applied phenol and found that a grayish-white membrane developed on the upper and lower parts of the urethral opening.
Initially, I thought it was just the ointment sticking to it and didn't pay much attention.
After applying it for over a week, I noticed that the membrane had turned into some hard lumps, and now the entire urethral opening has a layer of grayish-white hard lumps, with some areas crusting over and turning brown before falling off.
After they fall off, I can see deep red skin tissue, but after applying the medication, it turns back into a white mucous membrane.
Sometimes, the skin breaks and a little blood comes out (the glans rubs against my underwear, causing slight abrasions at the tip).
It looks like a piece of mucosa, not like the genital warts I’ve seen online.
Occasionally, I feel mild discomfort while urinating, with a very slight pain that is more noticeable when I first wake up.
At other times, urination is fine.
The white pimple that the doctor diagnosed as genital warts seems to have shrunk a bit, but now the entire glans urethra has turned grayish-white, which looks quite unpleasant.
I would like to ask the doctor what this could possibly be.
Given that I haven't had sexual intercourse for over 8 months and the last time I used a condom, is it still possible to have genital warts?

Xiao Wang, 20~29 year old female. Ask Date: 2021/12/27

Dr. Du Shixi reply Urology

Hello: Please refer to http://www.ktgh.com.tw/Public/tbDrug/201806291614557055.pdf for recommendations on follow-up visits.
If a patient has not engaged in sexual activity for over eight months and the last encounter was protected with a condom, is there still a possibility of contracting genital warts? -- Genital warts can take over a year to develop, so the likelihood is low, but it is still possible.
Wishing you good health.

Reply Date: 2021/12/27

More Info

The symptoms you are describing, particularly the grayish-white bumps and the thin membrane around the urethral opening, can be concerning and warrant careful consideration. Based on your description, it seems that you have been diagnosed with condyloma acuminatum, commonly known as genital warts, which is caused by the human papillomavirus (HPV). However, the progression of your symptoms, including the development of a grayish-white membrane and the presence of hard lumps, suggests that there may be more going on than just simple warts.

Firstly, it is important to understand that HPV can remain dormant in the body for long periods, and even if you have not engaged in sexual intercourse for eight months, it is still possible to have contracted the virus previously. The use of condoms can reduce the risk of transmission, but they do not provide complete protection against HPV, as the virus can be present on skin that is not covered by the condom.

The grayish-white membrane you are observing could be a result of several factors. It may represent a buildup of keratin, which is a protein that can accumulate in response to irritation or infection. The fact that you are experiencing slight bleeding and discomfort during urination indicates that there may be some inflammation or irritation occurring in the area, possibly due to friction or the presence of the lesions.

In addition to HPV, other potential causes for the symptoms you are experiencing could include:
1. Secondary Infection: The presence of warts or lesions can lead to secondary bacterial infections, which may cause additional symptoms such as redness, swelling, and discharge.

2. Lichen Sclerosus: This is a chronic skin condition that can affect the genital area, leading to white patches and discomfort. It is characterized by thinning of the skin and can cause pain and irritation.

3. Other Dermatological Conditions: Conditions such as psoriasis or eczema can also affect the genital area, leading to changes in skin texture and color.

4. Fungal Infections: A fungal infection could also lead to changes in the appearance of the skin, including the development of a white or grayish coating.

Given the complexity of your symptoms and the potential for various underlying conditions, it is crucial to seek further evaluation from a healthcare professional, preferably a dermatologist or a urologist. They may recommend a biopsy to obtain a definitive diagnosis, especially since the lesions have changed in appearance and have become symptomatic.

In the meantime, it is advisable to avoid any irritants, such as harsh soaps or lotions, and to practice good hygiene. Keeping the area clean and dry can help prevent further irritation. If you experience increased pain, bleeding, or any other concerning symptoms, do not hesitate to seek immediate medical attention.

In summary, while your initial diagnosis of genital warts may still be valid, the progression of your symptoms suggests that a more thorough investigation is necessary to rule out other potential conditions. Early diagnosis and treatment are essential for managing any underlying issues and preventing complications.

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