[Question #984] Next steps for Condyloma

50 months ago
30 y/o male. I noticed warts. I went to an Urologist. The biopsy confirmed Condyolma. I was prescribed Zyclara and the topical cream made no improvement. I recently had laser ablation. The MD said there is a good chance the warts will come back. I'm  wondering what steps I can take to minimize the odds of the warts coming back. I understand protective sex and minimizing sex partners is good practice, and I will comply. What else can I do to prevent recurrence of genital warts? Also, going forward, while receiving oral sex (without a condom & no visible warts) am I compromising my partner? Next step, married life. Would I compromise my wife if no warts are present? Can't have kids with a condom on?

Thank you for your time and effort. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
50 months ago
Welcome to the forum. Thanks for your question.

I'm not sure what your urologist means by "a good chance":  most of the time, warts do not recur after successful treatment. I would estimate it happens about 10% of the time, but usually the immune system controls HPV to the point that symptoms do not recur and the infection cannot be transmitted. How quickly the virus clears isn't certain, but I tell my patients that if warts do not recur within 6 months, they can consider themselves cured.

HPV certainly can be transmitted to the oral cavity, and for the next few months you should tell your partners about your recently treated warts so they can decide whether to proceed with oral sex or any other kind of contact with your genital area.

You may not be aware that the large majority of all people get genital HPV (90% or more), and 20-25% experience genital warts. So your situation is extemely common!

There will be no reason for you to use condoms when you have a wife or other long term, committed partner, assuming you have not had high risk sex recently (when the relationship starts) and she hasn't done so either. She should be vaccinated against HPV, if she is under age 26 and not previously vaccinated; it will protect her against your wart virus, if you are still carrying it at the time (which is unlikely, as discussed above); or against any other HPV strains you may be carrying. And like all women, she should follow standard advice about pap smears to protect her against cervical cancer due to HPV. And of course you can have children:  90% of the world has had HPV, and the world continues to be populated by healthy kids! It will be the same for you.

I think you would benefit from getting additional information about HPV. Excellent information is available from the American Sexual Health Association (sponsor of this forum, www.ashasexualhealth.org -- where you can even find videos by me about HPV); and the US Centers for Disease Control and Prevention (www.cdc.gov/std).

I hope this has been helpful. Best wishes--  HHH, MD

---
50 months ago
HHH, MD:

Thank you very much for your time. I reviewed  www.ashasexualhealth.org and I found the information helpful. My follow up questions have been answered.

I greatly appreciate the assurance. 

Have a great weekend. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
50 months ago
The only thing I would add is that if or when you discuss your recent warts with partners, you can also remind them that oral warts or other symptoms of oral HPV are rare, and serious outcomes extremely uncommon -- so even in the chance you still have active infection, the likelihood they will develop any problem from it is very low.

Thanks for the thanks. I'm glad to have helped. Have a good weekend yourself.

---