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Surgical Management of Condylomata Acuminata of the Male Urethra
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  • Nicolae Bacalbasa,
  • Costin Gingu,
  • Alexandru Dick,
  • vlad olaru,
  • catalin baston,
  • mugurel crasneanu,
  • andrei andresanu,
  • stelian ianiotescu,
  • liliana domnisor,
  • ioanel sinescu
Nicolae Bacalbasa
Carol Davila University of Medicine and Pharmacy

Corresponding Author:[email protected]

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Costin Gingu
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Alexandru Dick
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vlad olaru
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catalin baston
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mugurel crasneanu
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andrei andresanu
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stelian ianiotescu
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liliana domnisor
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ioanel sinescu
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Abstract

Rationale, Aims and Objectives: Human Papilloma Virus is responsible for the disease of condylomata acuminata (CA), also known as genital warts. In men these lesions are superficial, involving the skin of the glans and prepuce, and are treated by dermatologists. When lesions involve the urethra and are not directly visible, the patients are referred to urologists for more advanced surgeries. Methods: between January 2012 – January 2017 133 cases of CA were addressed to our center; 64 non-complicated forms were further referred to the dermatologist, 45 were resected and cauterized, and 24 cases were operated in our center. Among these cases 21 patients presented warts at the levels of the urethral meatus and navicular fossa, while the other 3 had multiple urethral lesions after previous resections, up to the peno-scrotal junction. Results: surgery consisted in a limited ventral opening of the meatus and fossa navicularis till the lesions were completely exposed and was followed by electrocauterization of the tumor bed, no further urethral reconstruction being needed. In 3 cases with previous endoscopic treatment attempts (urethroscopy and resection), with the lesions progressed to the peno-scrotal junction, an extensive ventral incision of the urethra was required, in order to reveal and remove all the warts. To prevent recurrence and allow for healing, the penile urethra was kept open for 6 months, then reconstructed in a second procedure. No immediate or distant complications were encountered. The histopathological examination of the resected tissue did not reveal any signs of urethral carcinoma. After a follow-up period of 6 to 46 months no recurrence of the disease was observed. All patients have good functional and aesthetic results. Conclusions: While simple cases of genital warts can be successfully managed by dermatologist, the more severe forms that progress inside the urethra require surgical treatment.