Endoscopic resection of extensive urethal condilomatic injury - case report and literature review
DOI:
https://doi.org/10.11606/issn.1679-9836.v101i4e-187664Keywords:
Condyloma Acuminatum, STI, Urethral, Human Papillomavirus, Urethral condylomaAbstract
Introduction: Urethral condyloma is a common sexually transmitted infection associated with the human papillomavirus (HPV). Affection in the urethra is rare, especially when dealing with an HIV-positive patient with an undetectable viral load. Objective: It aims to discuss the urethral involvement of the papillomavirus and the possible forms of treatment, as well as to review the literature. Case report: The patient in question presented suspicion of transitional cell carcinoma, being referred for treatment, but this suspicion was removed and the diagnosis of urethral condylomatous lesion was closed, with treatment by endoscopic resection of the lesions with monopolar energy. Discussion: Urethral involvement occurs in up to 5% of cases, and it has a high probability of malignancy. There are no specific guidelines on the management of intra-urethral condyloma, as it is a rare condition. The goal of treatments is to remove warts and induce injury-free periods, the conservative with cryotherapy and trichloroacetic acid not always being applicable to the urethra due to difficult access. Endoscopic resection of the lesions has been shown to be more effective. Conclusion: urologists and pathologists should be aware of this rare possibility to avoid diagnostic errors about this predominantly benign entity. Thus, we present a case of endoscopic resection of an extensive condylomatous lesion in the penile urethra of a male patient with hemophilia and HIV positive.
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References
Scheinfeld N. Condylomata acuminata (anogenital warts) in adults: epidemiology, pathogenesis, clinical features, and diagnosis. UpToDate 2017 Jan 4. Available from: https://www.uptodate.com/contents/condylomata-acuminata-anogenital-warts-in-adults-epidemiology-pathogenesis-clinical-features-and-diagnosis
Vives A, Vazquez A, Rajmil O, Cosentino M. Urethral condylomas in men: experience in 123 patients without previous treatment. Int J STD AIDS. 2016;27(1):39-43. doi: https://doi.org/10.1177/0956462415574627
Sarier M, Ozel E, Duman I, Yuksel Y, Demirbas A. HPV45-positive condyloma acuminatum of the bladder in a renal transplant recipient. Transpl Infect Dis, 2017;19(2):e12667. doi: https://doi.org/10.1111/tid.12667
Douglas J, Moreland A. Genital human papillomavirus infections. In: Morse SA, Ballard RC, Holmes K, et al., editors. Atlas of sexually transmitted diseases and AIDS. 3rd ed. Edinburgh: Mosby; 2003. p.261-278. doi: https://doi.org/10.1086/505982)
De Camargo CC, Tasca KI, Mendes MB, Miot HA, de Souza LR. Prevalence of anogenital warts in men with HIV/AIDS and associated factors. Open AIDS J. 2014;8:25-30. doi: https://doi.org/10.2174/1874613601408010025
Garland SM, Steben M, Sings HL, James M, Lu S, Railkar R, Barr E, Haupt RM, Joura EA. Natural history of genital warts: analysis of the placebo arm of 2 randomized phase III trials of a quadrivalent human papillomavirus (types 6,11,16, and 18) vaccine. J Infect Dis. 2009;199(6):805-14. doi: https://doi.org/10.1086/597071
Gormley RH, Kovarik CL. Human papillomavirus-related genital disease in the immunocompromised host: Part I. J Am Acad Dermatol. 2012;66:867.e1 doi: https://doi.org/.:10.1016/j.jaad.2010.12.050
Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:1. doi: https://doi.org/10.1093/cid/civ771
Cinar O, Suat bolat M, Akdeniz E, Sahinkaya N. A rare cause of acute urinary retention in women: meatal condyloma accuminata, a case report. Pan Afr Med J. 2016;24:87. doi: https://doi.org/10.11604/pamj.2016.24.87.9751
Kilciler M, Bedir S, Erdemir F, Coban H, Erten K, Ors O, Ozgok Y. Condylomata acuminata of external urethral meatus causing infravesical obstruction. Int Urol Nephrol. 2007;39(1):107-9. doi: https://doi.org/10.1007/s11255-005-4986-3
Vives Á, Vazquez A, Rajmil O, Cosentino M. Urethral condylomas in men: experience in 123 patients without previous treatment. Int J STD AIDS. 2016;27(1):39-43. doi: https://doi.org/10.1177/0956462415574627
Orlando G, Fasolo MM, Beretta R, Merli S, Cargnel A. Combined surgery and cidofovir is an effective treatment for genital warts in HIV-infected patients. AIDS. 2002;16:447-50. doi: https://doi.org/10.1097/00002030-200202150-00017
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