Extensive condylomata acuminata of male urethra: management by ventral urethrotomy

Between 1982 and 1990, 4 males with extensive intraurethral warts presented with marked inflammation of the external genitalia. When sepsis had settled all patients underwent ventral urethrotomy, in which the urethra was divided median as far back as was necessary to expose all of the warts. Surgical and electro-excision were the preferred methods of removal. Of 3 patients who developed recurrences 2 were lost to follow-up. A third remained without treatment for 1 year and when next seen the warts had spontaneously resolved and his urethra was closed. A fourth patient was lost to follow-up for 4 years before returning with destruction of his external genitalia by a verrucous carcinoma. The human immunodeficiency virus (HIV) did not appear to be a factor in the natural history of intraurethral warts in 2 patients who were negative for serum antibodies 2 and 8 years after presentation.