Human papillomavirus HPV

 

Diagnosis of human papillomavirus HPV

Diagnosis

If HPV presents as genital warts, it is relatively easy to diagnose. Chances are, you will feel the warts and go to your doctor for a diagnosis. Or your doctor might see or feel them during a physical exam. Your doctor will recognize genital warts by their location on the body and their appearance, which may be:

  • Flat lesions
  • Thin, stem-like protrusions
  • Cauliflower-shaped bumps

If genital warts are suspected but they aren’t visible or easily seen, your doctor will use a vinegar solution on the genital area. If there are warts, the vinegar will cause them to turn white.

For strains of HPV that do not cause the appearance of symptoms, a Pap test is used to detect the virus and any cervical changes it may cause. This is the reason it is recommended that women get a Pap test done once every three years. The earlier abnormal cells are detected, the better the chances that the condition can be treated before it progresses to cervical cancer.

If the presence of HPV is suspected, your doctor can also do a DNA test on the cells from your cervix. This will tell them which, if any, of the high-risk strains of HPV you have. This DNA test is particularly recommended for women over the age of 30, who have a higher risk of getting a high-risk strain of HPV.

Treatment

Many HPV infections clear up in time, without treatment. When it comes to genital warts, there are a number of treatment options. Your doctor is likely to start with a topical medication, such as one of the following:

  • Imiquimod
  • Podofilox
  • Trichloroacetic acid
  • Sinecatechins

If the topical medication doesn’t work, your doctor will consider other options. These include:

  • Liquid nitrogen freezing
  • Using an electrical current to burn the warts off
  • Removal via surgery
  • Removal via laser surgery

The removal option chosen for genital warts will depend on the size, shape, location, and extent of the warts.

If HPV is found in the cervix, you will have a procedure called a colposcopy. Your doctor will use a colposcope to get a magnified view of your cervix, and will also take samples of cervical tissue from areas that look abnormal to do a biopsy.

If precancerous lesions are present, they will be removed using one of the following methods:

  • Liquid nitrogen freezing
  • Laser surgery
  • Surgery
  • Loop electrosurgical excision procedure (LEEP) – a thin loop of electrically charged wire that removes a thin layer of the cervix
  • Cold knife conization – a procedure that removes a cone-shaped piece of cervical tissue

Preparation

When preparing for your appointment, be sure to know or write down your symptoms. Be prepared to discuss your sexual history, as well as any recent changes in your life and any stress you’ve been experiencing. Your doctor will also want to know what medications and supplements you are taking. Finally, prepare a list of questions you have.

You may have genital wart treatment done right in your doctor’s office, or in a clinic or hospital. To prepare, do the following:

  • Do not schedule appointments during your period.
  • Be prepared for a local or general anesthetic, depending on the number of warts to be removed and the procedure being used.

When preparing for a colposcopy, do the following:

  • Do not schedule the appointment during your period.
  • Do not have sexual intercourse within two days prior to your procedure.
  • Do not wear tampons within two days prior to your procedure.
  • Do not use vaginal medications within two days prior to your procedure.
  • Take an over-the-counter pain medication before your appointment.

Recovery

In most cases, HPV will be resolved by the immune system within a year or two. If you have surgical removal of genital warts, the amount of healing time will depend on the type of removal and severity of the warts. With LEEP, recovery takes up to three days. With laser surgery, recovery can take one to two weeks. If you have a colposcopy, it will take four to six weeks for your cervix to heal.

Complications

In many cases, your body’s immune system will fight off an HPV infection. In rare cases, there are two complications that can result from an infection:

  • Lesions in the upper respiratory system, and oral lesions in the throat or mouth or on the tongue
  • Cervical cancer (and genital, anal, oral, and respiratory cancers) caused by certain strains of HPV

Rely on the skilled Dignity Health women’s services team for comprehensive care of HPV. From screening to treatment, our doctors offer expertise and a philosophy of care, dignity, and respect.

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.