A 26-year-old male patient visited the outpatient clinic after noticing blister-like lesions on his penis. Upon visual examination, the lesions were suspected to be genital warts (condyloma). A Multi-PCR test was performed to identify the type of human papillomavirus (HPV), and fortunately the result showed low-risk types (HPV 6 and 11). An additional biopsy was conducted to rule out other possible conditions, and no additional diseases were identified. The condyloma lesions were removed in a single session using a CO₂ laser. Because there is a risk of recurrence, the patient was advised to undergo regular follow-up examinations, during which early recurrent lesions were removed when necessary. After continuing follow-up care, no recurrence was observed for six months, and the patient was considered cured, at which point treatment was concluded.
Condyloma, also known as genital warts, is a viral sexually transmitted disease caused by human papillomavirus (HPV). These lesions can occur not only on the genital areas—such as the penile foreskin, urethral opening, scrotum, vagina, or vulva—but also in any area that may come into contact during sexual activity, including the anus or oral cavity. While condyloma lesions often resemble common warts, their size, shape, and color can vary widely. They may appear as cauliflower-like growths, papules, blister-like lesions, or flat warts.
The diagnosis of condyloma usually begins with visual identification of the lesion. A Multi-PCR test is then performed to determine whether the HPV strain is low-risk or high-risk. Genital warts are most commonly caused by HPV types 6 and 11, while high-risk HPV types such as 16, 18, 31, 33, and 35 are associated with cancers, including cervical cancer in women and penile cancer, anal cancer, head and neck cancer, or oropharyngeal cancer in men. A biopsy may also be performed to differentiate condyloma from other possible conditions such as penile intraepithelial neoplasia. Biopsy is especially recommended when lesions are small or do not have the typical appearance of genital warts.
In more severe cases, condyloma can spread inside the urethra or anal canal. For this reason, endoscopic examination may be necessary to evaluate the extent of the lesions. Approximately 20% of condyloma cases involve lesions within the urethra. Hospitals equipped with flexible endoscopy systems can perform these examinations with minimal discomfort for the patient.
Once the diagnosis has been confirmed through detailed evaluation, treatment can proceed. In most cases, CO₂ laser therapy is used to remove all visible lesions in a single session. Electrocautery or laser treatment is usually performed under local anesthesia and has several advantages, including minimal bleeding, relatively low recurrence rates, and immediate treatment effects.
In some cases, cryotherapy—freezing the lesions using liquid nitrogen—may also be used. Cryotherapy has the advantage of leaving minimal scarring, being relatively inexpensive, and being safe during pregnancy. For patients who have difficulty visiting the hospital frequently, topical medications such as imiquimod cream may also be prescribed to help reduce the risk of recurrence.
One of the main challenges in treating condyloma is the high rate of recurrence. Even if all visible lesions are removed with laser treatment, HPV itself does not immediately disappear from the body, which means that the warts can recur. For this reason, treatment should not be stopped simply because the lesions appear to improve visually. It is important for patients to continue treatment and follow-up for an appropriate period.
At Goldman Urology Clinic in Gangnam, regular follow-up evaluations are conducted to monitor for recurrence. If no recurrence occurs for six months, the condition is generally considered cured and treatment is concluded. In particular, when warts are numerous or large, they represent concentrated clusters of virus that can spread to surrounding tissues. Therefore, removing lesions at an early stage can help reduce the risk of transmission.
According to data from the Health Insurance Review and Assessment Service (HIRA), the number of patients diagnosed with anogenital warts (A630) in Korea reached 61,659 in 2022. Because of the high recurrence rate, many patients find condyloma treatment difficult and frustrating. Even if symptoms appear to improve, treatment should not be discontinued prematurely, and a period of follow-up observation is necessary.
Recurrence is more common in the early stages of the disease, which can be stressful for patients. However, recurrence tends to decrease over time. On average, the human papillomavirus (HPV) may naturally clear from the body within approximately one and a half to two years. With consistent treatment and follow-up under the guidance of a urology specialist, patients can expect significant improvement.
In addition to medical treatment, strengthening the immune system may also help recovery. Patients are encouraged to maintain adequate sleep, exercise regularly, and consume a balanced diet to support overall health.
As men reach middle age and beyond, urologic conditions become increasingly common. By providing useful information about urologic diseases that interfere with daily life, the goal is to help individuals maintain a healthier and more comfortable quality of life.