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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 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, however, they do not get rid of the infection once it has occurred.

Health Canada has approved 2 HPV vaccines:

  • Cervarix® (HPV2)
  • Gardasil®9 (HPV9)

To determine if you are eligible to receive the free vaccine, see HealthLinkBC File #101b Human Papillomavirus (HPV) Vaccines, visit ImmunizeBC – HPV (Human Papillomavirus), or speak with a public health nurse at your local public health unit. Those not eligible for the free HPV vaccine can purchase it at most pharmacies and travel clinics and at some sexual health clinics.

To learn more about HPV infection, see 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 SmartSexResource.

Examination 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 exam or during a gynecology exam with a lighted magnifying instrument (colposcopy). A microscopic exam 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, which usually means that an HPV is not present.

Abnormal

Abnormal cells called koilocytes are found. Koilocytes are cells that appear hollow or concave when examined under a microscope. Koilocyte cells collected from the genital or anal areas are abnormal and indicate infection with the human papillomavirus (HPV).

Other types of skin lesions also may be found.

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

What To Think About

Treatment for abnormal cells includes watchful waiting without treatment, medical treatment, or removal of the abnormal tissue.

The decision to do a biopsy will be based on whether biopsy results are likely to affect treatment.

If a biopsy confirms male genital, vaginal, or perianal warts, medical treatment is an option.

Sexual intercourse should be avoided until the biopsy area is healed.

Credits

Current as of:
February 26, 2020

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