[Question #4771] Mysterious GW

27 months ago
Hello DRs,

Thank you for you time. I have read many of the forums and understand you views on most this subject but things are not lining up. I am a 32 year old male married faithfully for 7 years besides 1 event. 

In November 2017 I received a normal handjob from a massage parlor. No genital to genital contact at all. Fast forward to today I was diagnosed with a wart on the bottom/back/left not facing the front of the scrotum and one on my thumb(I believe I have had the thumb one many many years). I was very upset and confused. The Dermatologists that diagnosed it said it did not look like a wart that is transmitted by sexual activity because of it being a single wart not cauliflower and was in a very odd location for that to be the case. She proposed I self infected as both warts look very similar. I agree that location doesn't make sense but from what I read hard warts never travel to the genitals (Maybe scrotum is different?)

My questions are as follows
1) what are the chances I got the wart in that location from a handjob in November 2017?
2) what are the chances the DR. assessment was right that it was self infection. Note I have a bad nervous habit about picking and scratching the thumb wart daily. I also very often find myself scratching my scrotum when nervous when laying in bed. 
3) I have had sex with my wife 4 times since the event in November 2017. All unprotected vaginal with her on top or missionary. Both positions would not allow the location of my scrotum to touch her genitals. What are the chances I got it from her?
4) Given the above what are the chances that she has gotten the wart from me? She has a pap smear in 3 weeks. This is the real problem as I have put the event behind me and don't want to have this jeopardize my marriage and ability to see my children. 
5) Any other ideas how I got it?
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
Welcome to the Forum.  I'll do my best to help.   Let me start with the caveat that when we talk about HPV infections there are all too often exceptions to generalizations.  The likelihood that the lesion/probable wart diagnosed to day was acquired from your receipt of masturbation well over a year ago is almost zero.  While non-genital warts are almost never transmitted to the genitals through casual contact, it does occur.  The most likely explanation for the wart discovered today is that it was acquired from your hand or some other, incidental contact.  The probability that it was sexually acquired is very low.  Likewise, the likelihood that the HPV discovered in your rear end was transmitted to your wife is also very low.  Thus, in answer to your questions:

1) what are the chances I got the wart in that location from a handjob in November 2017?
Very low.

2) what are the chances the DR. assessment was right that it was self infection. Note I have a bad nervous habit about picking and scratching the thumb wart daily. I also very often find myself scratching my scrotum when nervous when laying in bed. 
I suspect that this is the most likely route of infection.  Transmission of HPV is facilitated through friction and inoculation of scratches or abrasions - your tendency to scratch may have facilitated transmission..

3) I have had sex with my wife 4 times since the event in November 2017. All unprotected vaginal with her on top or missionary. Both positions would not allow the location of my scrotum to touch her genitals. What are the chances I got it from her?
Very low.

4) Given the above what are the chances that she has gotten the wart from me? She has a pap smear in 3 weeks. This is the real problem as I have put the event behind me and don't want to have this jeopardize my marriage and ability to see my children. 
Also very low

5) Any other ideas how I got it?
Please see above.

I wish I could be definitive for you but that is not going to happen.  I think the best thing I can suggest is to try to move on from this difficult to explain coincidence.  I doubt that there will be further problems related to the lesions found today.  EWH

---
27 months ago
Just to clarify the wart was on the back of the scrotum still on the scrotum and away from the anus. Does that change your findings at all? Also both warts have been frozen. When would it be safe to continue intercourse with my wife?
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
I understood the location of your warts.  No change in my thoughts.

As for sex with your wife, I would not worry.  EWH
---
27 months ago
Assuming that I did get the wart from my thumb how likely is it that I will reinfect myself in other genital areas. I had the wart froze off Friday but I know that I have scratched the area several times before and after the wart showed. I am terrified I might have moved it infection to my penis. Is this just as unlikely as normal hand to genital reinfections or is it more likely now that we know the virus can live in that region? How long do I have to wait to see if I have indeed re-infected myself. 
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
The infection you acquired is a rare event.  The likelihood that you would spread the infection is rarer still and quite unlikely.  While I understand your fear, I urge you not to let this get to you.  The likelihood of recurrence or transmission to your wife is very, very low.  As far as the "what if" it should occur, typically it takes about three months for a new HPV infection to lead to a visible wart.  Please don't let yourself get crazy with  repeated aggressive self examination.  EWH---