Intraurethral condylomata acuminata associated with genital piercings

Topical medication as an initial therapeutic option for protruding and non-protruding condylomata acuminata of the distal urethra

Genital warts (also known as condylomata acuminata) caused by the human papillomavirus (HPV) represent one of the most common sexually transmitted infections. Although they are usually found in the outer genital region, a small proportion of men can present with (often unrecognised) intraurethral warts, generally limited to the distal urethra and urethral meatus. This poses a treatment challenge not adequately addressed by the current guidelines. Here, we present two cases of low-risk HPV-positive patients with protruding and non-protruding condylomata acuminata of the distal urethra, which were treated successfully by using two different topical regimens (ie, a combination of policresulen and imiquimod for one patient and 5-fluorouracil monotherapy for the other). Although this type of management results in lower rates of tissue destruction and complications and may be given preference as an initial therapeutic option, additional prospective comparative clinical studies are needed to elucidate its potential in similar cases.

Comparison of the risk factors and HPV types in males with anogenital warts with and without involvement of the urethral meatus in western Iran

BACKGROUND

Human papillomavirus (HPV)-induced lesions rarely develop in the urethral meatus (UM); however, their eradication can be problematic.

METHODS

A total of 22 patients with anogenital warts (AGWs) in the UM region and 22 patients with AGWs located at other anatomical sites were included in this cross-sectional study. The presence of human papillomavirus (HPV) types in biopsy samples was determined using the HPV Easy typing kit (GenID GmbH, Germany).

RESULTS

Although the patients in the AGW group with involvement of the UM had a higher incidence of reported multiple sexual partners (63.6% vs. 40.9%), larger meatus size (81.8% vs. 36.4%), and more frequent anal (36.4% vs. 18.2%) or unprotected sexual contact (68.2% vs. 36.4%) than those in the AGW group without UM involvement, only the duration of lesions (p = 0.04) and meatus size (p = 0.004) were significantly different in both groups. Low-risk HPV types were found in 75.0% and 69.2% of patients in the AGW groups with and without UM involvement, respectively.

CONCLUSION

We found that a larger UM size was more prone to the development of meatus AGWs; however, being married, delaying sexual debut, and avoidance of multiple sexual partners seemed to be associated with a decreased risk of development of AGWs, especially within the UM region.