Genital Warts: Misdiagnosis and Treatment Concerns

Q: Genital Warts: Misdiagnosis and Treatment Concerns

Hello： 1. <br>It is really impossible to make a diagnosis based solely on your written description without an examination. <br>2. <br>If you currently have any wounds in your vulva caused by intercourse, you should seek medical attention promptly. <br>For treatment, you should fo

The issue of cauliflower?

Hello Doctor, thank you for taking the time to read my message.
I have a few questions I would like to ask you: Six months ago, a gynecologist diagnosed me with genital warts (condyloma) by visual inspection, and I underwent electrosurgery the next day.
However, I have seen various descriptions and photos of genital warts online, and they look very different from what I had at the vaginal opening six months ago.
I am still questioning whether what I had was indeed genital warts.
After the electrosurgery, the tissue that was removed was sent for examination, and during my follow-up, the doctor confirmed it was genital warts, but since it was already removed, the clinic is unlikely to admit any diagnostic error.
I have some doubts, so I would like to describe what I had at the vaginal opening and seek your advice:
1.
There was only one lesion, but it did not resemble the small, granular appearance that is commonly described.
It looked like a small mushroom, completely flesh-colored and not white.
To describe its size clearly, it was about the size of the cap of enoki mushrooms that we use in hot pot, located at the vaginal opening.
2.
It did not have the fuzzy, fine texture typical of genital warts.
I carefully examined the top of the lesion with a mirror, and it appeared to have a single line on the outer top, resembling a line that divided the mushroom cap in half.
3.
Additionally, in the area between the vaginal opening and the anus, there was a deep brownish piece of tissue that was neither a polyp nor mushroom-like.
I could even pull on that piece of tissue, which was about one centimeter long at that time.
Could you please tell me if genital warts can look like this? I am concerned that I may have been misdiagnosed.
Now, six months later, I have noticed a small white-grayish attachment next to the same area of the vaginal opening.
The same doctor said I have had a recurrence.
However, this new lesion is not granular; it is a small flat area about 0.3 centimeters in size, and I cannot remove it with a cotton swab.
This time, I decided to use a topical treatment called LedaMed.
I have been applying it for only two days (three days), and the flat area has disappeared.
Now, the affected area appears normal.
If this was indeed genital warts, how could it have healed so quickly? Six months ago, it was not granular, and now it is a flat grayish-white attachment.
Could it be that it was never genital warts at all? Currently, there are no lesions in the genital area, and even if I wanted to switch doctors, there is nothing for them to diagnose.
I have only been using LedaMed for a week, and I am unsure what to do.
Additionally, it seems that the affected area has become thinner from using LedaMed.
My boyfriend wants to have intercourse, and I asked him to use a condom.
Unfortunately, the affected area got scraped and started to bleed (the same area where the mushroom-like lesion was located).
I am worried that this could allow the virus to enter (though I realize that it was already a site of infection).
I applied the international neomycin ointment that I purchased after the electrosurgery to the wound, and I continued to apply LedaMed to the surrounding area.
Is this appropriate? I am not unwilling to accept that I am a genital warts patient; I just have doubts based on the information I have researched.
Thank you!

Chen, 20~29 year old female. Ask Date: 2007/03/02

Dr. Li Guanghan reply Obstetrics and Gynecology

Hello: 1.
It is really impossible to make a diagnosis based solely on your written description without an examination.
2.
If you currently have any wounds in your vulva caused by intercourse, you should seek medical attention promptly.
For treatment, you should follow your physician's advice and it is best not to apply any over-the-counter products like Leda Mei on your own.
Hsinchu City Hospital, Department of Obstetrics and Gynecology.

Reply Date: 2007/03/02

More Info

Genital warts, also known as condylomata acuminata, are caused by certain strains of the human papillomavirus (HPV). They are typically characterized by soft, flesh-colored or gray growths that can appear in the genital area, including the vulva, vagina, cervix, and anus. Your concerns about misdiagnosis and treatment are valid, especially given the complexity of HPV-related conditions and the variability in how they present.

From your description, it seems you have undergone a procedure for what was diagnosed as genital warts, but you are now questioning the accuracy of that diagnosis based on the characteristics of the growths you observed. It’s important to note that genital warts can vary significantly in appearance. They can be small, raised, and cauliflower-like, or they can appear as larger, smoother lesions. The fact that your growth resembled a "mushroom" shape and was flesh-colored does not automatically rule out the possibility of it being a wart, as HPV can produce a range of lesions.

The presence of a flat, grayish-white area after treatment could indicate several things. It might be a residual effect of the treatment, a new growth, or even a different condition altogether. The fact that you have noticed a change in the appearance of the lesions after using a topical treatment like LedaMed (which is a topical medication often used for skin conditions) and that the area appears normal now is a positive sign. However, it does not definitively confirm or deny the presence of HPV or genital warts.

Regarding your concerns about the potential for the virus to spread, it is important to understand that HPV can remain dormant in the body and may not always present as visible warts. Engaging in sexual activity, even with a condom, can still pose a risk of transmission if the virus is present on skin that is not covered by the condom. If you have a history of genital warts, it is advisable to communicate openly with your partner about your condition and consider using protection to minimize the risk of transmission.

If you are still uncertain about your diagnosis, it may be beneficial to seek a second opinion from a healthcare provider who specializes in sexually transmitted infections or dermatology. They may recommend a biopsy or other diagnostic tests to clarify the nature of the lesions. Additionally, if you experience any new symptoms, such as pain, itching, or unusual discharge, it is crucial to consult a healthcare professional promptly.

In summary, while your initial diagnosis of genital warts may have been accurate, the variability in presentation and the changes you have observed warrant further evaluation. It is essential to have open discussions with healthcare providers about your concerns and to explore all available options for diagnosis and treatment. Your health and peace of mind are paramount, and seeking clarity on your condition is a proactive step towards managing your health effectively.

Similar Q&A

Understanding Genital Warts: Differentiating True and False Symptoms

The sexual partner has been consistent, and the male has received the 9-valent HPV vaccine. Recently, the female discovered several papular lesions on the inner labia (near the anal area). She visited two gynecological clinics, where the doctors merely looked and diagnosed it as ...

Dr. Xu Wencang reply Urology
Not necessarily! Generally, it is an irregular protrusion. Next time, a biopsy and electrosurgery can be performed, and a gynecological examination for cervical viruses should be conducted. Vaccination can be administered, followed by close monitoring. The medication such as Alda...

Understanding Genital Warts: Key Questions and Answers for Women

Hello, Doctor. I have a few questions I would like to ask you: 1. I have two white lesions in my genital area. Two days ago, I went to the hospital, and the doctor said they are warts. However, I have only had one sexual partner, who is my current boyfriend, and his genital app...

Dr. Zhang Kunmin reply Obstetrics and Gynecology
Hello, the current treatment methods for genital warts include various options such as cryotherapy, electrosurgery, topical medications, and laser treatment. These methods are limited to removing visible warts and do not completely eradicate the virus, with a recurrence rate of a...

Conflicting Diagnoses: Understanding Your Vaginal Symptoms

Initially, I noticed some growths in my genital area that are not round and resemble warts. However, I have never had sexual intercourse. I consulted Dr. A, who diagnosed it as genital warts and prescribed me a topical treatment called Aldara, but it hasn't been effective. L...

Dr. Zhang Kunmin reply Obstetrics and Gynecology
Hello, based on your description, a definitive diagnosis cannot be confirmed. The identification of genital warts relies on the appearance of the lesions, the location of the infection, and histopathological examination of the biopsy. Typically, during the onset, a flat protrusio...

How is Genital Warts Diagnosed and Treated?

Hello Doctor, around June or July of this year, I noticed two small, grain-sized lumps connected on the left side near the base of my penis. They are not painful or itchy. At first, I didn't think much of it and continued to have unprotected sexual intercourse (oral and vagi...

Dr. Chen Jiansheng reply Urology
Generally, a definitive diagnosis through physical examination requires the excision of the lesion and subsequent pathological examination. The topical medication is designed to induce an immune response in the body to combat the virus, and the response may vary among individuals...