Case Study - February 2008

This is an endoscopic view of the urethra of a 25-year-old man who presented with urethral bleeding.

  1. What abnormalities are shown?
  2. What is the cause of these abnormalities?
  3. How should they be managed?

Case presented by Mr Nigel Bullock

Reveal Answer

Open answerThere is no fixed answer to this question, however your response should be similar to the one below:

  1. These are venereal warts of the anterior urethra (condylomata acuminata)
  2. They are caused several types of human papilloma virus (HPV) and are usually sexually transmitted
  3. The warts themselves are best treated by endoscopic cauterisation. However, the patient also requires referral to a GU Medicine Clinic for contact tracing, exclusion of other STDs & advice about sexual health.

These warts have a tendency to recur until the patient has developed sufficient immunity to destroy the virus responsible. HPV has been implicated in the development of carcinoma of the cervix in sexually active women so the use of a condom during intercourse is recommended until the patient is clear of warts.

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