[Question #1201] HPV oral transmission

50 months ago
I had unprotected reciprocal sex with an unknown status partner 10 weeks ago and developed a few bumps on the abdomen two weeks ago that were sight diagnosed as genital warts by a dermatologist. They froze those off, and i wasn't convinced they were warts, but now it appears a fleshy colored wart is growing on the tip on my penis. I am going in to treat that, and the doctors gave me Aldara creme to apply but i want to get rid of it as it is growing close to the urethra. Will that wart infiltrate the urethra eventually? i wouldn't want that. I am in a sticky situation as my marital status doesn't welcome this unwelcome case. I can't believe oral only has put myself in this HPV bind, if that's what it is. But it sure looks like it. If the warts were not from this recent exposure, could they have been laying dormant from a past experience for many years? Thanks.
Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago

Welcome back to the Forum.  I will try to help.  I have read over your earlier interactions with both Dr. Handsfield and Teri and agree with all that they have said.  My synthesis that your back pain and jock-itch-type rash are coincidental to the exposure you mentioned and unrelated. 

Your current question about the possibility of having acquired HPV and genital warts from the encounter in question suggests to me that you have greave concerns about this partner or the encounter and that you are on the "lookout" for STI-related consequences of it.  I will not challenge that you have genital warts but whether you got them from the exposure you describe is questionable.  Oral HPV infection if only about 1/4th as common as genital infection and transmission through oral sex, while it probably occurs, is likewise thought to be uncommon.  when HPV is transmitted and causes warts, for visible warts to develop in less than 6-8 weeks would be unusual and the typical time between acquisition and detection of warts is about three months..  From what you have told us over your posts, if these lesions are warts, my suspicion is that the HPV infection causing them was acquired long ago and simply took till now to manifest themselves (or be noticed since it does seem that you are now looking hard for any evidence of your indiscretion than you may have in the past.

Intraurethral warts are unusual. 

I hope this perspective is helpful.  EWH

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50 months ago
Thanks Dr. Hook. These supposed warts developed seven weeks post potential exposure. I am afraid of the suspected tear drop shaped wart on the tip of my penis infiltrating the urethra tube. That one developed about 8 weeks post exposure. Would it be painful to have a wart in that location frozen off? I think that would be an uncomfortable place to perform a biopsy. I have applied Imiquimod Cream to the area for a few weeks, and no change, if anything it's gotten slightly bigger. I am thinking she gave it to me on my genitals while she performed oral on me. As for looking harder at everything since this incident, you are correct, I am uber-analyzing everything, but I know what I see, and the tip of the penis 'wart' was definitely not there before. The dermatologist passed over it without a thought, but this guy also though skin pigmentation on the top of the penis was a wart, when i have had it for over seven years and other dermatologists never gave it a second thought. So I am not believing him much. If these warts and HPV has been dormant in my system, could it have been for 15 years? I never noticed anything before, but wasn't really looking. Is there also a chance, in its dormant state, if it was an old infection, that i couldn't have passed it on to my wife over that time period of 14-15 years? i am not sure, but pretty positive she never had HPV. Is sex possible if these are genital warts with my long-time partner? Thanks Dr. Hook!
Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago
Larry, as I said above, my sense is that you are far more worried and fixated on these lesions than is warranted, either from a medical or relationship perspective.  IF this lesions you are worried about are warts (you do not know this) anyone who tells you that they can be sure they were recently acquired is fooling themselves (and you).  Personally, I remain skeptical that they reflect something acquired relatively recently.  

Warts rarely go into the urethra and when they do, they still more rarely cause problems.  The fact that there has been little response to Aldara makes it less likely that this is a typical wart.  Freezing is uncomportable.  A biopsy by an expert would likely be less uncomfortable (because local anesthic would be used) and would provide tissue which could be analyzed.

There is no medical reason for you to abstain from sex with your long time sex partner at this time.  If she were going to be infected it most likely would have happened by now.

EWH
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50 months ago
Thanks for the reply. I have not had sex with my long time partner since this dalliance. If the supposed warts were acquired in fact a long time ago (15 years or so) is it at all possible that transmission never occurred to my wife as this supposed virus has been well dormant and latent for so long, or is that an impossibility? Also, I have read that in menopausal women there is a chance for reinfection with the same strain later in life. Could that be true as well, or again is that impossible? I will await your final reply, that is until the next serious of questions, which (hopefully) won't be necessary!
Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago

Nothing is impossible (some people win the lottery) but it would be highly unlikely if any of the lesions you have detected are warts as you fear (remember however, you do not know this).

I am unaware of any data on susceptibility of post menopausal women to HPV- this sounds like something you might have read on the internet which I would discount.

As you know, we provide three responses.  Thus this thread will be closed later today.  EWH

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