Penile warts: an update on their evaluation and management

Area of Science:

• Dermatology
• Infectious Diseases
• Urology

Background:

• Penile warts represent the most frequent sexually transmitted infection in males.
• Familiarity with the evaluation and management of penile warts is crucial for clinicians.

Purpose of the Study:

• To offer an updated overview of penile warts.
• To cover current understanding, evaluation, and management strategies.

Main Methods:

• A comprehensive literature search was conducted using PubMed.
• Key search terms included 'penile warts' and 'genital warts'.
• The search encompassed various study types, including reviews and clinical trials.

Main Results:

• Penile warts are caused by human papillomavirus (HPV), particularly strains HPV-6 and HPV-11.
• Lesions present diversely, often as asymptomatic papules or plaques.
• While one-third of warts may resolve spontaneously in about 9 months, active treatment is preferred for faster clearance and to mitigate transmission concerns.
• Treatment options include patient-administered therapies (e.g., podofilox, imiquimod) and clinician-administered therapies (e.g., cryotherapy, laser ablation).
• Second-line treatments are available for refractory cases, including cidofovir and 5-fluorouracil.

Conclusions:

• No single treatment for penile warts demonstrates consistent superiority over others.
• Treatment selection should be individualized, considering physician comfort, patient preference, lesion severity, and treatment characteristics like efficacy, side effects, cost, and availability.