HPV Warts: Concerns After Treatment and Recovery

Cauliflower, anal warts, hemorrhoids?

Hello, Doctor.
I underwent electrosurgical treatment for genital warts on February 17, which affected the labia, vaginal opening, and anal area.
During my visit to the obstetrics and gynecology department, the doctor mentioned that warts might also develop inside the anus and advised me to see a colorectal surgeon.
Since I had surgery, I have been experiencing bleeding during bowel movements due to the wounds.
As of today, I feel stable and have scheduled a colorectal examination for March 25.
However, yesterday (March 12), I accidentally noticed what appears to be a wart at the vaginal opening (scheduled for follow-up on March 21).
Since I have to wait eight days for my next appointment and the obstetrics and gynecology clinic is closed for staff vacation, I want to avoid unnecessary anxiety and have the following questions:
1.
I discovered a small wart (gray and slightly rough to the touch) on March 12.
I have received the first dose of the HPV vaccine, and I am concerned that the wart might grow larger or worsen over the next ten days before my scheduled electrosurgery.
Is this a common concern?
2.
I just finished electrosurgery, and it has been less than a month since the procedure.
Is it common for genital warts to recur? I have been careful about my sleep schedule, going to bed around 11-12 PM and waking up by 8 AM, ensuring over seven hours of sleep.
What could be the reasons for recurrence? I was shocked to have developed warts (having had only one sexual partner), and I may not fully understand the condition.
I thought that completing the electrosurgery and maintaining a stable routine would prevent recurrence, so discovering new growth has affected my mood.
I hope to gain accurate knowledge to avoid panic.
3.
Does receiving the HPV vaccine trigger the virus? If so, would that be a good thing?
4.
I am also seeing a traditional Chinese medicine practitioner who mentioned that I have low immunity and insufficient qi.
I believe my immunity is indeed low, as I easily catch colds and often develop sinusitis as a complication.
The practitioner suggested ginseng tea, but I read online that ginseng may affect female hormones.
Could my recurrence of warts be due to ginseng or simply my low immunity?
5.
The clinic recommended a self-funded health supplement costing 2000 TWD to boost immunity.
Can genital warts be completely cured? If I purchase this supplement, am I being overly anxious and hasty? Is it unnecessary to buy supplements to enhance immunity?
6.
Is there any impact on the body from undergoing electrosurgery with general anesthesia in a short period?
7.
If the obstetrics and gynecology department confirms that the vaginal opening has warts on March 21, and the colorectal examination also shows warts, will both surgeons perform the surgery, or how will it be handled?
8.
I have external hemorrhoids at the anal area, but they do not affect my daily life.
Should I be concerned? Recently, I feel that the number of external hemorrhoids has increased due to the wart surgery.
Will this affect the wart surgery?
9.
Is the likelihood of developing warts inside the anal area high? Thank you for your response!

Ms. Zhang, 30~39 year old female. Ask Date: 2024/03/13

Dr. Zhang Shuhao reply Surgery

1.
The growth rate of warts varies from person to person, typically depending on the individual's immune system status and the viral load and activity of the virus.
Each person's response to HPV is different, so it is uncertain whether warts will enlarge or worsen while waiting for surgery.
However, lesions that become more pronounced can be more easily identified during the procedure.
It is important to maintain good personal hygiene, avoid squeezing or scratching, and wash clothing separately during this time.
2.
Warts are prone to recurrence because the virus can remain dormant without visible skin lesions, making it difficult to eradicate them completely.
The recurrence of warts is also related to the state of the immune system and the individual's viral load.
It is recommended to continue maintaining a healthy lifestyle and discuss possible preventive measures with your doctor.
3.
The HPV vaccine does not induce HPV infection; rather, it helps prevent specific types of HPV infections, thereby reducing the risk of warts.
Even if someone has had warts before, the vaccine can usually prevent infections from other strains of the virus.
4.
Poor immunity may increase the risk of wart recurrence.
Ginseng may have some regulatory effects on the immune system, but there is currently insufficient scientific evidence to prove that ginseng can directly influence the development of warts.
If you have concerns about any herbs or supplements, be sure to discuss them with your doctor.
5.
While some dietary supplements can be beneficial for health, claims that they can cure warts are somewhat hard to believe.
It is advisable to maintain a healthy lifestyle, including a balanced diet, regular exercise, and adequate sleep.
Spending money on things that bring joy can also enhance mood, which may improve immune function.
6.
Electrosurgery and general anesthesia are generally safe for young individuals in the short term, but it is essential that the procedure is performed by a qualified anesthesiologist who monitors the patient throughout.
7.
If warts are confirmed by both gynecology and colorectal surgery, both doctors can participate in the surgery.
However, the insurance reimbursement for electrosurgery of warts is very low, and clinics typically require out-of-pocket payment.
Details depend on the hospital's practices and the doctor's decisions.
You can inquire about the surgical arrangements with your doctor before scheduling the procedure.
8.
Surgery for hemorrhoids is only necessary when they affect quality of life.
An increase in external hemorrhoids may lead to easier bleeding after electrosurgery, but simultaneous excision during electrosurgery is not required.
9.
The likelihood of warts developing inside the anal canal depends on the exposure to HPV and the status of the immune system.
If there is no direct contact during sexual activity, it does not necessarily mean that warts will develop internally.

Reply Date: 2024/03/13

More Info

Understanding HPV warts, particularly after treatment, can be a source of anxiety for many patients. It's essential to address your concerns with accurate information and guidance. Here’s a comprehensive response to your questions based on the current medical understanding of HPV and its treatment.

1. Potential Growth of Warts: After your recent treatment for genital warts (condylomata acuminata) via electrosurgery, it is indeed possible for new warts to develop within a short period. HPV can be persistent, and while electrosurgery effectively removes visible warts, it does not eliminate the virus from your body. The new growth you observed could be a recurrence of the same virus or a new manifestation. Warts can sometimes grow rapidly, so it’s crucial to monitor any changes closely.

2. Recurrence of Warts: Genital warts can recur after treatment, and this is not uncommon. Factors contributing to recurrence include the immune system's ability to suppress the virus. Stress, illness, or any factor that weakens your immune response can lead to a resurgence of warts. It's understandable to feel anxious after experiencing this, especially if you believed that treatment would lead to a permanent resolution. Remember, many individuals with HPV manage their condition successfully with appropriate follow-up care.

3. HPV Vaccine and Virus Activation: The HPV vaccine is designed to prevent infection from certain strains of the virus, including those that cause warts and cervical cancer. It does not trigger the virus or worsen existing infections. Instead, it helps your body build immunity against the strains included in the vaccine. Therefore, receiving the vaccine is a positive step in protecting yourself against future infections.

4. Immune System and Recurrence: Your concerns about immune function are valid. A compromised immune system can indeed contribute to the persistence or recurrence of HPV-related conditions. Ginseng and other herbal remedies may have varying effects on hormone levels and immune function, but it’s essential to consult with your healthcare provider before starting any new supplements, especially if you have concerns about their impact on your health.

5. Purchasing Supplements: While maintaining a healthy immune system is crucial, the necessity of purchasing specific supplements should be evaluated on an individual basis. A balanced diet, regular exercise, and adequate sleep are foundational to immune health. If you feel that the supplement may provide peace of mind, it could be worth considering, but it should not replace conventional medical advice or treatment.

6. Effects of Electrosurgery: Undergoing electrosurgery is generally safe, and while anesthesia can have side effects, most patients recover well without long-term issues. If you have specific concerns about your health or recovery, discussing them with your healthcare provider is advisable.

7. Coordinated Care for Multiple Areas: If both your gynecologist and colorectal surgeon identify warts, they will likely coordinate your care. Depending on the extent and location of the warts, it may be possible for one surgical team to address both areas simultaneously, or they may refer you back and forth for specialized care.

8. External Hemorrhoids and Treatment: External hemorrhoids can be common and may not require treatment unless they cause significant discomfort. If you notice changes in your hemorrhoids after your wart treatment, it’s essential to inform your healthcare provider, as they can assess whether any intervention is necessary.

9. Risk of Anal Warts: The likelihood of developing warts in the anal region can be higher if there is a history of HPV infection in the genital area. HPV can affect multiple sites, and anal warts can occur, especially in individuals with a history of genital warts. Regular check-ups and open communication with your healthcare provider about any new symptoms are vital.

In conclusion, managing HPV and its associated conditions requires a proactive approach, including regular medical follow-ups, vaccination, and maintaining a healthy lifestyle. If you have further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized advice and support.

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