[Question #4860] HPV

25 months ago
I’m hoping you can help calm my nerves a bit. I am a 38 year old male and had an anal Pap smear done. I had a scope done and they found one small wart inside the anus.  I’m going to have this removed. 

In your experience, will this likely reoccur or if completely removed will it likely not reoccur?

Also, if it is completely removed and after six months I do not have a reoccurrence would you say it’s cleared my system? 

Sorry for the long write up. Just really nervous. 
25 months ago
And one additional question. Is it true that if you have a wart it’s because your system can’t clear it and likely won’t clear it? I really hope not. 
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
 Welcome to our forum. I'll be glad to comment.

 Anal HPV infections are sometimes challenging to manage  and understanding of optimal management is still evolving. In general, following removal of a wart, if the wart has not recurred in 3-6 months it will not and you are cured of that infection. At the same time, having had one manifestation of anal HPV infection detected, most experts would recommend repeat anal Pap smears in the future. Precisely how frequently is unclear but somewhere at 6-12 months would probably be appropriate.   The topic of optimal management strategies for anal HPV infections is currently the subject of a major, multi-million-dollar study to provide more information. Results from the study will not be available for several years. In the meantime pursuit using repeat anal Pap smears is probably the way  to go. 

 I hope this reply is helpful and does not provide more information than you were looking for. EWH. 
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25 months ago
Thank you for the answer. Two last questions. 

After 6 months, if no reoccurrence it would not be needed to tell future partners of the past wart as it has likely cleared correct?

Also, is it safe to masturbate or could I spread it to the shaft?
25 months ago
And when you say challenging to manage do you mean they are likely to reoccur or more so that it is hit or miss? In your experience do these also usually clear?
25 months ago
And I apologize. Last question. Since I only had two very small warts (they were flat and only detected with vinegar) does this mean that the infection area is likely small or could it have been on its way to clearing?

Thanks again for your help. You have no idea how much this forum as put me at ease. The gal that did my scope said horrible things that freaked me out. That I couldn’t clear them or ever go a long period without them. 
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Our stance is that it is not necessary to notify partners of your HPV infection.  The reason for this is because the great majority of sexually active persons already have HPV - some of these infections are visible as warts, others are not visible and asymptomatic.

Masturbation will not spread HPV.

By "challenging" I mean that there is still much to learn about anal HPV infections.  Following treatment, the majority of specimens do stay cured.

Smaller warts are more likely to be more recent infections; more recent infections tend to respond better to therapy.

I need to say, I think that you are worrying too much.  I would suggest you follow through with your treatment, get follow-up evaluations, and not get bogged down with "what if" questions.  I hope this perspective is helpful.  EWH
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25 months ago
Dr Hook

I can’t thank you enough. I wish I was in your area for you to be my doctor. If only everyone provided reassurance. 

You have no idea how much of a service you both provide on here. 

Thank you again. 
25 months ago
Hi

My final question.  Do anal warts almost always reoccur or is it more like 30% of the cases. My doctor said they almost always reoccur. I have the small area. If he removed most of the cells is there a good chance they won’t? How soon can they usually tell within the 3 months if one will likely reoccur?
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
 Thank you for your kind words. 

 We do know that warts and other locations tend to recur about 30% of the time following treatment. The problem with anal and rectal warts is that infections may occur in several locations and may be missed on initial examination Due to the anatomy of the area (multiple folds, making visualization difficult).    It is for this reason that periodic follow-up is recommended. If the words that were treated were going to recur they would typically do so within three months.   Conversely it would be most unusual for recurrence to be a parent before the passage of three or four weeks.    (By the way recurrent warts simply mean there is a need for more treatment, there is nothing more serious to worry about regarding them.)

 As you know this is my third response to your questions as part of this thread. Therefore as per forum guidelines this thread will be closed shortly without further responses. I hope the information I have provided has been helpful to you please don't worry it sounds like you are getting very good care. Take care. EWH 
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