Laser Surgery for Genital Warts
British Columbia Specific Information
Genital warts are a sexually transmitted infection (STI) caused by infection from the human papillomavirus (HPV). Genital warts can be treated using topical medication or freezing. These treatments do not get rid of the HPV infection; a person who has been treated may still pass it on, even if the warts are no longer visible. For information about genital warts and HPV, see HealthLinkBC File #101a Human Papillomavirus (HPV) Infection and Genital Warts. Please speak with your health care provider to discuss the best treatment option for you.
You may also be interested in exploring HPV vaccination. Health Canada approves the HPV vaccines Cervarix® (HPV2) and Gardasil® (HPV4) for use in women up to the age of 45, and Gardasil® for men ages 9 and older. Both vaccines protect against infection by HPV types that cause most cases of cervical cancer and several less common cancers. Gardasil® also protects against infection by the HPV types that cause most cases of genital warts. The vaccines prevent HPV infection but do not get rid of the infection once it has occurred. For more information on the HPV vaccines, see HealthLinkBC File #101b Human Papillomavirus (HPV) Vaccines.
For more information on STIs, sexual health information, where to get tested and other sexual health services in your area, visit SmartSexResource.
Laser surgery may be done in a doctor's office or clinic, a hospital, or an outpatient surgery centre. Local or general anesthetic may be used depending on the number of warts to be removed or the size of the area to be treated.
For women, abnormal cervical cell changes caused by HPV will be managed differently than genital warts caused by HPV. Your doctor may recommend certain types of surgery, such as laser surgery. To learn more about surgical methods to treat abnormal cell changes, see the topic Abnormal Pap Test.
What To Expect After Surgery
Recovery time depends on the location and number of warts removed. Healing usually occurs in 2 to 4 weeks.
For men and women who have had laser surgery, call your doctor if you have any of the following:
- Bleeding that lasts longer than 1 week
- A fever
- Severe pain
- Bad-smelling or yellowish discharge, which may point to an infection
Avoid sexual intercourse until the treated area heals and the soreness is gone (usually 1 to 3 weeks, depending on the size of the area treated).
Why It Is Done
Laser surgery may be done when:
- Medicine has failed, and the warts need to be removed.
- Warts are widespread.
- Warts need to be treated during pregnancy. Your doctor will recommend when treatment should be done during pregnancy.
How Well It Works
In studies, laser surgery removed warts in about 20 to 40 out of 100 people. But warts may return after surgery.footnote 1
Laser surgery is a safe treatment for pregnant women.
Laser surgery may cause any of the following:
- Pain, swelling, or itching
- Discharge from the vagina or penis
- Sores in the area treated
- Tissue that sticks together
- Shedding of dead tissue
- Urination that occurs in a wide, spraying stream, for treatment done in the urethra. Scarring of the penis is a possible side effect that can result in problems with urination or erection.
What To Think About
Doctors usually use laser surgery for genital warts after other treatments have failed.
There are concerns that laser treatment may increase the risk of having warts return by destroying the local immune system, which allows inactive viruses to become active.
Laser surgery requires specialized training and equipment. Some experts believe that the skill of the doctor doing the laser surgery affects surgical success. People thinking about laser surgery for genital warts should ask the doctor how many times he or she has done this procedure and what his or her success rate is.
Warts that are difficult to treat may be managed by adding other treatments, such as fluorouracil. Genital warts may be treated with fluorouracil before or after laser surgery.
- If used before surgery, fluorouracil reduces the size and number of warts that need laser treatment.
- If used after surgery, fluorouracil may prevent genital warts from coming back.
An advantage of laser surgery is that adjacent and deep tissue is not damaged during laser treatment.
Treating genital warts does not cure a human papillomavirus (HPV) infection. The virus may remain in the body in an inactive state after warts are removed. A person treated for genital warts may still be able to spread the infection. Condoms may help reduce the risk of HPV infection, but they do not protect the entire genital area against skin-to-skin contact.
The benefits and effectiveness of each type of treatment need to be compared with the side effects and cost. Discuss this with your doctor.
Current as of: May 22, 2015
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