Intraurethral condylomata acuminata associated with genital piercings

Abstract

A 33-year-old man was referred to our institution with papillary masses at the urethral meatus and difficulty urinating. Genital examination showed two piercings on the frenulum, which were penetrating the external urethra. Endoscopic examination revealed papillary tumours over the entire circumference of the penile urethra and the piercing site. The tumours were resected transurethrally. Microscopic examination revealed condylomata acuminata. Human papillomavirus types 6 and 66 were detected in the lesions. Retrograde urethral viral infection is rare because of the protection provided by the mucosal immune system. Genital piercing may have facilitated spread of the human papillomavirus into the urethra.

Complications of Genital Piercings

“…Another study that surveyed 84 men and women with genital piercings found that 52% reported at least one health-related problem following their piercings [6]. These complications may be related to the piercing process itself, or the persistence of a foreign body in the tissue [19][20][21]. In general, complications of genital piercings can be broadly divided into three categories: structural, infectious, and partner related.…”

“…Most infections caused by body piercing are mild, localized and easily treated with topical antibacterial ointment, frequent cleansing and warm compresses with no need to remove the piercing [5,19]. However, the risk of cellulitis, carbuncles, impetigo, abscesses, post -streptococcal glomerulonephritis, endocarditis, as well as bacteremia and toxic shock syndrome still remains [1][2][3]19,20].…”

“…The data that have been collected challenge the assumption that individuals with genital piercings have an increased incidence of STIs [4,6]. However, an association between genital piercing and molluscum contagiosum has been reported, as well as an association between genital piercing and recurrent condyloma accuminatum caused by Human Papilloma Virus [2,6,19,20]. Penile edema (suspected to be caused by N. gonorrhoeae or C. trachomatis ), prostatitis, testicular infection, and Fournier's gangrene have all been reported in association with genital piercing, and squamous cell carcinoma has been diagnosed at the site of a Prince Albert's ring piercing [3,5,25].…”

“…Complications of genital piercings as pertaining to the sexual partner include condoms being damaged by protruding jewelry during intercourse, swallowed piercings causing choking and aspiration, trapping of piercings between the partner's teeth, teeth-chipping, postcoital bleeding, and loss of jewelry [2,5,8,19,20].…”

Comparison of the risk factors and HPV types in males with anogenital warts with and without involvement of the urethral meatus in western Iran

“…There are few reports regarding susceptibility to the development of AGWs in the UM, in which most of the patients are in their third decade and usually have a previous history of STIs. Urethral instrumentation is also a risk factor, especially in older men, while AGWs with UM involvement are rarely associated with urethral malformations such as hypospadias (6)(7)(8)(9).…”