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. 

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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.