The case of a 67-year-old man illustrates both the severity and treatability of genital warts (condyloma). He initially underwent surgical removal of urethral warts at another hospital, but the condition recurred, leading him to seek further care. Examination revealed that condyloma had extensively obstructed the urethra, from the external opening to deeper structures. Using urethrocystoscopy, multiple lesions were removed from the distal urethra, external sphincter, and even the verumontanum within the prostate. By carefully following postoperative instructions, the patient achieved a favorable outcome, and after one year and four months, his HPV urine test returned negative. This case demonstrates that even advanced condyloma can be effectively treated with appropriate management.
Condyloma can develop in any area involved in direct sexual contact, including the genitals, anus, urethra, and oral cavity. It tends to occur in moist, non-keratinized regions such as the anal area, penile foreskin, vagina, and vulva. In more advanced cases, lesions can extend into the urethra or anal canal, making endoscopic evaluation essential for accurate diagnosis. Urethral condyloma accounts for approximately 20% of all cases and may present with symptoms such as hematuria or a split urinary stream. However, it can also be asymptomatic, highlighting the importance of regular screening. Lesions within the urethra should be removed endoscopically to prevent complications such as urethral stricture. In our practice, flexible endoscopy and specialized pelvic anesthesia techniques are used to minimize patient discomfort during procedures.
Anal condyloma also requires careful attention. Many patients mistakenly assume these lesions are hemorrhoids, delaying proper treatment. Because the anal region is highly vascular and sensitive, removal requires appropriate anesthesia and precise technique. This is important not only to reduce patient discomfort but also to minimize the risk of recurrence.
Immune system management plays a critical role in controlling condyloma. When immunity is weakened or fatigue accumulates, lesions may grow rapidly or recur. Maintaining a healthy lifestyle—including adequate rest, balanced nutrition, and regular exercise—is essential. Stress management also contributes to maintaining immune function.
Regular follow-up is necessary to prevent recurrence. Small lesions may be missed with self-examination alone, so periodic clinical evaluation and timely removal of recurrent lesions are recommended. In particular, urethral and anal condyloma carry a higher risk of recurrence and require closer monitoring.
Vaccination with the Gardasil vaccine is also recommended for prevention. Gardasil protects against human papillomavirus (HPV) infection and is important for both men and women. Even after infection, vaccination can still be beneficial by helping prevent infection with other HPV types and reducing the risk of recurrence. Although it is not a direct treatment, it plays a significant role in long-term prevention.
In conclusion, condyloma is a condition that can be effectively managed through early detection, appropriate treatment, continuous monitoring, and preventive vaccination. As seen in this case, although the diagnosis may initially cause concern, patients can achieve good outcomes with proper medical care. Ongoing attention to health and proactive management are key to overcoming condyloma and maintaining long-term well-being.