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Biopsy of Genital Warts (Human Papillomavirus)

British Columbia Specific Information

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections (STIs). HPV is transmitted through intimate skin-to-skin contact and can cause a variety of cancers as well as genital warts. HPV can cause genital warts and cancers of the anus, cervix, mouth and throat, penis, vagina and vulva.

The HPV vaccines protect against infection from certain types of HPV. The HPV vaccine is a cancer-preventing vaccine that can benefit you, no matter your sex, gender, or sexual orientation, or sexual activity status. The HPV vaccine is part of the recommended vaccination schedule for all youth in British Columbia. To be eligible for the free, publicly funded vaccine, people in B.C. need to have their first dose before they turn 19 and their last dose before they turn 26. The exception is for those that have been given the extension to June 30, 2024. 

For more information about the HPV vaccine, visit:

To learn more about HPV infection, read HealthLinkBC File #101a Human Papillomavirus (HPV) Infection and Genital Warts. For more information on STIs, sexual health information, where to get tested and other sexual health services in your area, visit Sexually Transmitted Infections.

Overview

Your doctor may take a sample, or biopsy, of abnormal tissue. The majority of warts do not require a biopsy. But a biopsy may be taken if genital warts cannot be easily identified with a physical examination or during a gynecology examination with a lighted magnifying instrument (colposcopy). A microscopic examination on the biopsied tissue can help your doctor find out whether human papillomavirus (HPV) is present.

The biopsy can be done in your doctor's office or clinic. You may have an injection of a numbing medicine (local anesthetic). This is more likely to be used for biopsies of the outer genital area on both men and women: this includes the vulva, scrotum, or penis. The injection can be painful. But local anesthetic is needed when the biopsy is likely to be more painful than the injection.

There usually are no complications after a biopsy.

Why It Is Done

You may have a biopsy if any of the following are true:

  • Your doctor is not sure what type of abnormal tissue is present.
  • Warts have not responded to treatment.
  • Warts appear unusual.

Results

Findings of a biopsy may include the following:

Normal

No abnormal cells are found. This usually means that the human papillomavirus (HPV) is not present.

Abnormal

Abnormal cells called koilocytes are found. Koilocyte cells collected from the genital or anal areas are abnormal. They are a sign of infection with HPV.

Other types of skin lesions also may be found.

Abnormal cervical cell changes caused by HPV will be treated differently than how genital warts are treated.

Credits

Current as of: August 2, 2022

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD - Family Medicine
Adam Husney MD - Family Medicine
Kevin C. Kiley MD - Obstetrics and Gynecology