Consult
Biopsy of genital warts (human papillomavirus)
What are genital warts?
Genital warts are a sexually transmitted infection (STI) caused by certain strains of the human papillomavirus (HPV). HPV is a very common virus with over 100 strains. Some strains can cause cancerous changes, while others cause no physical symptoms and resolve themselves.
Two strains of HPV in particular—HPV 6 and HPV 11—are responsible for about 9 out of 10 cases of genital warts.
Genital warts may also be known by other names such as genitoanal warts, anogenital warts, or condylomata acuminata.
Exam Overview
Your doctor may take a sample, or biopsy, of abnormal tissue. The majority of warts do not require a biopsy. But a biopsy may be taken if genital warts cannot be easily identified with a physical exam or during a gynecology exam with a lighted magnifying instrument ( colposcopy ). A microscopic exam on the biopsied tissue can help your doctor find out whether human papillomavirus (HPV) is present.
The biopsy can be done in your doctor's office or clinic. You may have an injection of a numbing medicine ( local anesthetic ). This is more likely to be used for biopsies of the outer genital area on both men and women: this includes the vulva , scrotum , or penis. The injection can be painful. But local anesthetic is needed when the biopsy is likely to be more painful than the injection.
There usually are no complications after a biopsy.
Why It Is Done?
You may have a biopsy if any of the following are true:
Your doctor is not sure what type of abnormal tissue is present.
Warts have not responded to treatment.
Warts appear unusual.
Results:
Findings of a biopsy may include the following:
Normal
No abnormal cells are found, which usually means that an HPV is not present.
Abnormal
Abnormal cells called koilocytes are found. Koilocytes are cells that appear hollow or concave when examined under a microscope. Koilocyte cells collected from the genital or anal areas are abnormal and indicate infection with the human papillomavirus (HPV).
Other types of skin lesions also may be found.
Abnormal cervical cell changes caused by HPV will be treated differently from how genital warts are treated.
What To Think About?
Treatment for abnormal cells includes watchful waiting without treatment, medical treatment, or removal of the abnormal tissue.
The decision to do a biopsy will be based on whether biopsy results are likely to affect treatment.
If a biopsy confirms male genital, vaginal, or perianal warts, medical treatment is an option.
Sexual intercourse should be avoided until the biopsy area is healed.
Complete the medical test information form (PDF) [PDF] (What is a PDF document?) to help you prepare for this test.
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