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Genital wart removal
Published by Bupa's health information team, May 2009.
This factsheet is for people who are planning to have genital warts removed in hospital or by their doctor, or who would like information about it.
Genital warts (also called condyloma acuminata) are fleshy growths found on or around the genitals or anus. They are caused by certain types of the human papilloma virus (HPV).Genital warts can be removed using surgery, laser, heat or extreme cold, although your doctor is more likely to suggest a home treatment.
Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your doctor's advice.
About genital warts
In the UK, genital warts are the most common viral infection diagnosed in genitourinary medicine (GUM) clinics. There are over 100 types of HPV including 40 which can cause genital warts. HPV attacks the epithelial (surface) cells in the skin causing them to grow uncontrollably, so a fleshy growth appears on or around the penis, vagina or anus. The warts are often hard on dry hairy skin or soft on moist hairless skin. You may have several warts clustered together or just one. Genital warts are usually painless but can itch and may bleed or become inflamed.
The HPV virus is very contagious and is spread by skin-to-skin contact. To reduce the risk of cross-infection and ease any discomfort, your doctor may recommend you have the warts removed.
What are the removal options?
Genital warts are treated according to their size and location. There are several hospital treatments available for removing warts, including surgery, laser, heat or extreme cold. However, treating genital warts this way is rare - most genital warts can be treated with home treatments from a sexual health clinic or hospital.
What are the alternatives?
Your doctor will probably recommend treating your genital warts with home treatments, including topical creams imiquimod and podophyllotoxin. This will depend on the type, size and location of your genital warts. You should discuss your options and alternative treatments with your doctor.
Preparing for genital wart removal
Your doctor will explain how to prepare for your treatment.
Genital warts are usually removed as a day case. This means you have the operation and go home the same day.
Genital warts are usually treated under general anaesthesia. This means you will be asleep during the procedure. Alternatively, you may prefer to have the warts treated using a local anaesthetic. This completely blocks feeling in the affected area and you stay awake. A sedative may be given with a local anaesthetic to help you relax during the procedure. Your doctor will advise which type of anaesthesia is most suitable for you.
If you're having a general anaesthetic, you will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.
At the hospital your nurse may check your heart rate and blood pressure, and test your urine.
Your doctor will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.
Your nurse will prepare you for theatre. You may also be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs.
About genital wart removal
The exact method used for removing genital warts depends on the size and location of the warts. Your doctor will explain the risks associated with each method and advise you on which treatment is most suitable for you. The procedure may take up to 40 minutes to complete.
Warts are burnt off using a low-voltage electric current through a thin wire or probe. This method immediately seals the blood vessels, so no stitches are needed.
Loop electrosurgical excision procedure (LEEP)
This is similar to electrocautery, but the wire or probe has a loop on the end to remove the warts.
Warts are cut away using a scalpel. Dissolvable stitches are used to close the wound.
A high-energy beam of light is used to destroy the warts. It seals blood vessels so you won't need stitches.
The warts may be frozen off using liquid nitrogen gas (extreme cold) or treated with chemicals that are painted on, such as trichloroacetic acid.
Samples of the removed warts are sent to a laboratory for tests to confirm HPV infection.
What to expect afterwards
If you have had a general anaesthetic, you will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.
You will usually be able to go home when you feel ready.
You may be prescribed a course of mild laxatives. Your nurse will give you some advice about caring for your healing wounds and a date for a follow-up appointment.
You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.
Recovering from genital wart treatment
If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice. You shouldn't take any medicines that contain codeine because of its constipating effect.
General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 48 hours afterwards. If you're in any doubt about driving, please contact your motor insurer so that you are aware of their recommendations, and always follow your doctor's advice.
Depending on type and extent of treatment, it may take up to three weeks to make a full recovery.
You shouldn't have sex until the warts have cleared. Removing the warts doesn't mean you are free from HPV. The virus can live in normal tissue for up to six months. There is a chance that the warts may re-occur, especially in the first six months after treatment.
When you resume sexual activity, you should practise safer sex. Using a condom will help to reduce the risk of cross-infection and protect both you and your partner.
What are the risks?
Genital wart treatment is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.
These are the unwanted but mostly temporary effects of a successful treatment, for example, feeling sick as a result of the general anaesthetic.
You will feel sore and find it difficult to sit down during the first week.
This is when problems occur during or after the operation. Most people are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
Complications of having genital warts removed are uncommon but can include:
change in skin sensation - this can happen if surface nerves are damaged, it's usually temporary
ulceration - some treatments can cause the skin to form an ulcer or scab
severe pain - surgery can cause severe pain and discomfort for a few days
repeat warts - the warts may re-occur and need further treatment
The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your doctor to explain how these risks apply to you.
- Human papilloma virus (HPV) - cervical cancer and genital warts. Health Protection Agency. www.hpa.org.uk, accessed 22 October 2008
- Genital warts statistics. Health Protection Agency. www.hpa.org.uk, accessed 22 October 2008
- Genital warts. BMJ Clinical Evidence. www.clinicalevidence.com, accessed 22 October 2008
- Preventing transmission. BMJ Clinical Evidence. www.clinicalevidence.com, accessed 22 October 2008
- United Kingdom National Guideline on the Management of Ano-genital Warts, 2007. British Association for Sexual Health and HIV (BASHH). www.bashh.org, accessed 22 October 2008
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: May 2009