Genital Warts: Concerns and Treatment Options - Urology

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Genital warts, caused by certain strains of the human papillomavirus (HPV), are a common sexually transmitted infection. They can appear as small, flesh-colored or gray growths in the genital area, and while they are often painless, they can cause discomfort and anxiety for those affected. Your concerns about the lesions you observed on your penis and the subsequent treatments you received are valid, and it's important to address them comprehensively.

From your description, it seems that you initially had some growths that were treated with electrosurgery, a common method for removing warts. It's not unusual for the treated area to have some residual pigmentation or scarring after such a procedure. The blackened area you mentioned could be a result of the electrosurgery, as the process involves burning the tissue to remove the wart. This can lead to changes in skin pigmentation, which may appear darker or different in texture compared to the surrounding skin. The small, granular lesions you see now could be remnants of the original warts or new growths that have developed since the treatment.

Regarding your concern about the possibility of these lesions being cancerous, it's important to note that while certain high-risk strains of HPV are associated with an increased risk of penile cancer, the majority of HPV infections do not lead to cancer. The risk is particularly associated with persistent infections of high-risk HPV types, which is why regular monitoring and follow-up with a healthcare provider are essential.

If you have not engaged in sexual activity since the initial diagnosis, the likelihood of developing genital warts from HPV is reduced, but not entirely eliminated, as HPV can remain dormant in the body. The fact that you have had these lesions for several years without significant change may suggest that they are not aggressive or rapidly growing, which is a positive sign. However, it is still crucial to have them evaluated by a qualified healthcare professional, preferably a dermatologist or urologist, who can provide a thorough examination and possibly a biopsy if there is any suspicion of malignancy.

In terms of treatment options, if these lesions are indeed warts, there are several methods available, including topical treatments (like imiquimod or podofilox), cryotherapy (freezing the warts), or further surgical options if necessary. If they are determined to be benign and not warts, your doctor may recommend monitoring them without immediate intervention.

It's understandable to feel anxious about the potential implications of your symptoms, especially with the history of HPV and concerns about cancer. I encourage you to seek a second opinion from a specialist who can provide a more definitive diagnosis and discuss your treatment options. Regular check-ups and open communication with your healthcare provider are key to managing your health and alleviating your concerns.

In summary, while the electrosurgery may have left some marks, the best course of action is to have a thorough evaluation of the current lesions. This will help clarify their nature and determine if any further treatment is necessary. Remember, early detection and treatment are crucial in managing any potential issues related to HPV and genital warts.