Recurrence of Genital Warts: Seeking the Right Diagnosis

Cauliflower

Hello, I am a woman in a monogamous relationship, and my boyfriend is as well.
However, over a year ago, I was diagnosed with genital warts.
After applying medication for a period of time, my doctor informed me that I was cured.
Recently, I returned to the clinic due to an increase in vaginal discharge, and the doctor told me that I had a recurrence! It has been a little over six months since the doctor declared me cured, and now I am being told I have a recurrence.
Because my mother is concerned, she insisted that I get checked at another large hospital.
After the examination, the doctor there told me that it was not genital warts! He explained that genital warts are "papillomatous," while what he observed was "rounded." I would like to ask, in this situation, which doctor's judgment should I trust? Or what other methods can I use to confirm whether I have an infection in my genital area?

Xuan, 20~29 year old female. Ask Date: 2009/02/13

Dr. Chen Changfu reply Obstetrics and Gynecology

Histopathological examination can confirm the diagnosis of genital warts, commonly known as "cauliflower." Genital warts may recur or reinfect.
If they persist and do not heal, it is advisable to discuss with a physician whether a histopathological examination is necessary.

Reply Date: 2009/02/13

More Info

When it comes to genital warts, also known as condylomata acuminata, caused by the human papillomavirus (HPV), it is understandable to feel confused and concerned about the diagnosis and recurrence. Your situation involves conflicting opinions from two different healthcare providers regarding the presence of warts, which can be quite distressing.
Firstly, it is important to understand that genital warts can sometimes be challenging to diagnose, especially if they are not in their typical presentation. The appearance of warts can vary significantly; they may be flat, raised, or have a cauliflower-like appearance. The distinction between "pointed" and "rounded" lesions, as mentioned by the doctors, can be crucial. Pointed lesions are typically associated with HPV, while rounded lesions could represent other conditions, such as seborrheic keratosis or other benign skin lesions.

In your case, since you were previously diagnosed with genital warts and treated, the possibility of recurrence is indeed plausible. HPV can remain dormant in the body, and while the immune system may suppress the virus, it can reactivate, leading to the development of warts again. The time frame for recurrence can vary widely among individuals, and it is not uncommon for warts to reappear months or even years after initial treatment.

To address your concerns about which doctor's opinion to trust, consider the following steps:
1. Seek a Third Opinion: If you are still uncertain, it may be beneficial to consult a third healthcare provider, preferably a dermatologist or a gynecologist who specializes in sexually transmitted infections (STIs) and HPV-related conditions. They can provide a fresh perspective and may conduct a thorough examination.

2. Diagnostic Tests: Ask about the possibility of performing a biopsy of the lesions. A biopsy can provide definitive information about the nature of the growths and whether they are indeed HPV-related warts or something else entirely. Additionally, HPV typing tests can help determine the specific strain of HPV, which can be useful for understanding the risk of recurrence and potential complications.

3. Visual Inspection and History: A thorough visual inspection by an experienced clinician is essential. They can assess the lesions in detail and take into account your medical history, including the previous diagnosis and treatment.

4. Monitoring Symptoms: Keep track of any changes in your symptoms, such as the appearance of new lesions, changes in discharge, or any discomfort. This information can be valuable for your healthcare provider in making an accurate diagnosis.

5. Education on HPV: Understanding HPV and its implications can empower you in discussions with your healthcare providers. HPV is a common virus, and while it can lead to genital warts, many people clear the virus without treatment. However, some strains are associated with a higher risk of cervical cancer, so regular screenings (like Pap smears) are essential.

6. Follow-Up Care: Regardless of the diagnosis, regular follow-up appointments are crucial. If you are diagnosed with genital warts, treatment options include topical medications, cryotherapy, or surgical removal, depending on the size and location of the warts.

In conclusion, given the conflicting opinions, it is advisable to seek further evaluation from a specialist who can provide clarity on your condition. Remember that your health and peace of mind are paramount, and obtaining a definitive diagnosis will help you make informed decisions about your treatment and management moving forward.

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