Anal warts, also known as condyloma acuminata, are caused by the human papilloma virus (HPV). This virus is transmitted person to person by direct contact and is considered a sexually transmitted disease (STD). Exposure to the virus may have occurred several years before the warts develop. Anal intercourse is not necessary to contract anal condyloma. If not removed, anal warts will grow larger and spread. The virus (HPV) is highly transmissible when lesions are present. Untreated anal condyloma may lead to an increased risk of anal cancer.

Symptoms

  • Tiny spots or growths inside or around the anus or genital skin
  • Can increase in size and spread if not treated
  • A lump or mass in the anal area
  • Flesh or brownish in color
  • Usually not painful
  • May cause intermittent itching, bleeding or mucous discharge

History and physical: After discussing your risk factors and sexual history, your doctor will perform a physical exam to detect any lesions in or around the anal canal, a digital exam (placement of a gloved finger into the anus), and look inside the anus with a small lighted instrument (anoscopy).

Surgical treatment: Surgical treatment usually involves some combination of excision (removal) and burning with a cautery (fulguration). These procedures are done with anesthesia in the operating room as an outpatient procedure. In advanced cases, multiple procedures may be needed to remove all of the lesions.

Pain, discomfort, spotty bleeding, clear, yellowish or blood tinged discharge are normal after excision and fulguration. Placing a gauze pad on the area will help absorb moisture and decrease itching related to moisture. Excessive bleeding is abnormal, and your physician should be notified immediately.

Follow-up: Anal warts commonly recur. Patients should follow up with their physician at frequent intervals after treatment to ensure no new warts occur. With close follow-up, in most cases, recurrent lesions can be removed much more easily than with the initial surgical treatment. Patients should refrain from sexual activity until all of their lesions are treated and they have been disease free for several months. As a precaution, sexual partners should be checked for HPV and other sexually transmitted diseases. Wearing a condom does not provide complete protection from acquiring the HPV virus.