From the Guidelines
HPV warts on the penis should generally be removed to prevent spread, discomfort, and potential psychological distress. Treatment options for removal include surgical excision, which can be beneficial for patients with a large number or area of genital warts, as it renders the patient wart-free, usually with a single visit 1. Other removal options include cryotherapy, laser therapy, or electrocautery. It's essential to note that treating the warts doesn't eliminate the underlying HPV infection, and warts may recur after treatment 1. Key considerations for treatment include:
- Patient preference
- Available resources
- Experience of the healthcare provider
- Potential for spontaneous resolution Regular follow-up with a healthcare provider is advisable, and using condoms can help reduce transmission risk to partners. HPV vaccination is also recommended for eligible individuals to prevent future infections with certain HPV types. In terms of specific removal techniques, surgical removal can be done through tangential excision with a pair of fine scissors or a scalpel, or by curettage, with hemostasis achieved through an electrosurgical unit or a chemical styptic 1. Ultimately, the decision to remove HPV warts on the penis should be made on a case-by-case basis, taking into account the individual patient's circumstances and the potential benefits and risks of treatment.
From the Research
Treatment Options for HPV Warts on the Penis
- The goal of treatment is clearance of visible warts, and some evidence exists that treatment reduces infectivity 2.
- Treatment options include patient-applied therapy such as imiquimod cream or podofilox, as well as clinician-administered therapies like cryotherapy, surgical excision, and laser therapy 2, 3.
- The choice of therapy is based on the number, size, site, and morphology of lesions, as well as patient preferences, cost, convenience, adverse effects, and clinician experience 2, 3.
Efficacy of Treatment Options
- Imiquimod and podophyllotoxin creams have similar efficacy for wart clearance, but with a wide confidence interval 4.
- Cryotherapy combined with interferon has been shown to be effective in treating chronic cervicitis complicated with HPV infection, with a higher HPV negative conversion ratio and total efficiency compared to cryotherapy alone 5.
- Topical imiquimod treatment has been shown to be effective in treating persistent HPV infection in patients with or without cervical/vaginal intraepithelial neoplasia, with a complete regression rate of 51.4% 6.
Considerations for Treatment
- Active treatment is preferable to watchful observation to speed up clearance of the lesions and to assuage fears of transmission and autoinoculation 3.
- The choice of treatment method should depend on the physician's comfort level with the various treatment options, the patient's preference and tolerability of treatment, and the number and severity of lesions 3.
- The comparative efficacy, ease of administration, adverse effects, cost, and availability of the treatment modality should also be taken into consideration 3.