A 33-year-old man presented with urethral bleeding accompanied by mild discomfort and pain. On examination, a condyloma (genital wart) lesion was identified at the 6 o’clock position within the urethra. Endoscopic surgery was performed. After thorough inspection of the urethral lumen, all visible lesions were completely removed using a CO₂ laser. A portion of the excised tissue was collected for histopathological analysis and multi-PCR testing. The results confirmed condyloma caused by HPV type 11, a low-risk strain. Following the procedure, the patient was able to urinate normally and was discharged after two successful voids within four hours.
Condyloma (genital warts) is a viral sexually transmitted disease caused by the human papillomavirus (HPV). It can occur not only on the genital area but also in the anus, urethra, and oral cavity—any site exposed during sexual contact. Although it resembles a wart, its size, shape, and color can vary widely. Lesions may appear as cauliflower-like growths, papules, vesicles, or flat warts, making careful examination by a specialist essential for accurate diagnosis.
Diagnosis is based on visual inspection, multi-PCR testing, and histopathological examination. After identifying lesions clinically, multi-PCR testing is used to determine the specific HPV type. Condyloma is most commonly caused by HPV types 6 and 11, while high-risk types such as HPV 16 and 18 are associated with malignancies, making precise diagnosis critically important. Biopsy is performed to differentiate from other conditions, particularly when lesions are small or atypical. In more advanced cases, lesions may extend into the urethra or anal canal, requiring endoscopic evaluation. Urethral condyloma accounts for approximately 20% of all cases. In clinical practice, flexible endoscopy combined with appropriate anesthesia can significantly reduce patient discomfort during both diagnosis and treatment.
The primary treatment for condyloma is removal of the lesions, most commonly using CO₂ laser therapy. This method offers minimal bleeding, relatively low recurrence rates, and immediate results. It is typically performed under local anesthesia, and most patients tolerate the procedure well. Cryotherapy may also be used in selected cases, offering advantages such as minimal scarring, lower cost, and safety during pregnancy. For patients who have difficulty visiting the clinic regularly, topical treatments such as imiquimod cream can be prescribed for home-based therapy.
However, the greatest challenge in condyloma treatment is its high recurrence rate. Regardless of the treatment method, approximately 40–75% of lesions can be successfully removed, but recurrence occurs in about 25–50% of patients. This is because HPV can remain in the body even after visible lesions are eliminated. As a result, many patients experience frustration during treatment. It is important not to discontinue treatment prematurely, even if symptoms improve. Adhering to the recommended treatment duration and undergoing regular follow-up evaluations are essential.
In addition to medical treatment, strengthening the immune system plays a crucial role in controlling HPV infection. Adequate sleep, regular exercise, and balanced nutrition help enhance immune function. Stress management is also important. Patients are advised to avoid sexual activity until complete recovery is confirmed. If unavoidable, consistent condom use is recommended to reduce the risk of transmission. Effective management of condyloma requires not only medical intervention but also comprehensive lifestyle modification.
According to national healthcare data from 2023, more than 61,000 patients were treated for anogenital warts (ICD code A630). HPV infection is extremely common, affecting approximately 70% of adults at some point in their lives, with an estimated transmission rate of about 50% from a single sexual encounter. In other words, condyloma is far from a rare condition. Although recurrence is common, the likelihood of recurrence decreases over time. On average, HPV is naturally cleared by the immune system within 18 to 24 months. While frequent recurrence in the early stages can cause significant stress, symptoms tend to improve over time. Therefore, overcoming the initial challenges and completing the full course of treatment is the most effective path to recovery and long-term control.
As people enter middle age, urological conditions become increasingly common. To maintain health and quality of life into older age, it is important to stay informed and proactive about urological health.