What are anal warts?

Anal warts (also called “condyloma acuminata”) are a condition that affects the area around and inside the anus. They may also affect the skin of the genital area. They first appear as tiny spots or growths, perhaps as small as the head of a pin, and may grow larger than the size of a pea. Usually, they do not cause pain or discomfort to afflicted individuals. As a result, patients may be unaware that the warts are present. Some patients will experience symptoms such as itching, bleeding, mucus discharge and/or a feeling of a lump or mass in the anal area.

Anal warts, thought to be caused by the human papilloma virus, can grow larger and spread if not removed.

It is important to know that Anal warts can be found both heterosexuals and in men who have sex with men.  Either way, it is nothing to be ashamed of – and it is something that you SHOULD SEEK TREATMENT FOR.

What causes these warts?

They are thought to be caused by the human papilloma virus (HPV) which is transmitted from person to person by direct contact. HPV is considered a sexually transmitted disease. You do not have to have anal intercourse to develop anal condyloma.

Do these warts always need to be removed?

Yes. If they are not removed, the warts usually grow larger and multiply. If left untreated, the warts may lead to an increased risk of cancer in the affected area.  This is similar to the risks of cervical cancer in women.

What treatments are available?

If warts are very small and are located only on the skin around the anus, they may be treated with a topical medication. They may also be treated by a physician by freezing the warts with liquid nitrogen. Warts may also be removed surgically. Surgery provides immediate results but must be performed using either a local anesthetic – such as novocaine – or a general or spinal anesthetic, depending on the number and exact location of warts being treated. Warts inside the anal canal usually are not suitable for treatment by medications, and in most cases need to be treated surgically.

Must I be hospitalized for surgical treatment?

No. Surgical treatment of anal warts is usually performed as outpatient surgery.

How much time will I lose from work after surgical treatment?

Most people are moderately uncomfortable for a few days after treatment, and pain medication may be prescribed. Depending on the extent of the disease, most people return to work the next day.

How long is treatment usually continued?

Follow-up visits are necessary at frequent intervals for several months after the last wart is observed to be certain that no new warts occur.

What can be done to avoid getting these warts again?

In some cases, warts may recur repeatedly after successful removal, since the virus that causes the warts often persists in a dormant state in body tissues. Discuss with you physician how often you should be evaluated for recurrent warts. Abstain from sexual contact with individuals who have anal (or genital) warts. Since many individuals may be unaware that they suffer from this condition, sexual abstinence, condom protection or limiting sexual contact to single partner will reduce your potential exposure to the contagious virus that causes these warts. As a precaution, sexual partners ought to be checked, even if they have no symptoms.

as a urologist i see a lot of patient with growths or bumps on the penis

some patients ask do I have cancer? do I need a biopsy? 

Most patients with a classic wart or HPV do not need a biopsy, patient who are uncircumcised or recurrent growths may consider a biopsy.

Freezing a wart with liquid nitrogen, cauterization, or topical treatments like aldara (imiquimod topical cream)

if you have a wart get to a doctor and have it treated.  A biopsy is not a  bad idea but no always necessary

thanks for all of stories and questions I hope this site can help you fight your personal war on warts. 

the wow team is committed to helping you with the most sensitive topics!

click find a physician for a team member physician in your area!

Treating penile warts presents several problems to the patient and to the treating physician.  The ideal treatment would be non-invasive, non disfiguring, quick, painless and it would eliminate the risk of any wart recurrence.

The ideal treatment does not exist.

Most treatments offer some sort of balance between expedience, invasiveness, and recurrence.  The correct treatment really depends on patient preferences, patient medical history, and the doctor’s experience.

Treatment options include:

• Imiquimod: This is a form of immunotherapy.  Is not invasive and non-disfiguring but requires 16 weeks of therapy.  Dermatologists seem to like to use it, but urologists like Dr Schoor, who have had extensive experience with imiquimod, have not found it useful for his male wart patients.
• Podophylin: This is another form of immunotherapy.  Like imiquimod, it is non-invasive and non-scar producing.  Podophylin takes approximately 4 weeks to work and is very effective on penile condylomas.  Recurrence rates are low with this approach.
• Cryo therapy: This means freezing off the warts, usually with liquid nitrogen.  This is a great treatment that effectively gets rid of the lesions without scar formation or marks and has very low recurrence rates.  It is painful and requires at least 3 to 4 applications over a 6 to 8 week period.  Dermatologists like this form of treatment for their patients.  Urologists don’t too so much of it, however.
• Cautery: Effective though invasive and scar producing.  It does require that the doctor give a local aneshtetic prior to the procedure.  Recurrence rates are higher than for the other treatments, but the results are immediate.  Perhaps the worst aspect of this approach is that the cautery smoke may contain vaprized though live viral particles that can be inhaled by patient and staff alike.  To prevent this occurrence, special masks may be worn.
• Excision: 100% effective but 50% or greater recurrence risks when used alone.  It does leave a scar but the result is immediate, which most men want.  Another advantage is that it allows for pathologic confirmation of the lesion, which on rare occasion can be a penile veru
  

  Using crythherapy to treat disease

  cous cancer.  Recurrence risks can be minimized by cauterizing or freezing the base after the excision or by having the patient apply podophylin or imiquimod after the wart has been removed.

• Laser therapy: This procedure is done in the OR with a CO2 laser.  It is very effective over the short and long term, non-scar forming, and immediate.  It is very expensive and best reserved for patients with extensive disease, such as in the immunoscompromised population.

We hope readers find this useful.