Pan-urethral condylomata acuminata - A primary treatment recommendation based on our experience

Abstract

We present a case of a 28 year old man presenting with obstructive urinary tract symptoms and cystoscopic findings of pan-urethral, occlusive condylomata acuminata (urethral genital warts). We describe the in rooms administration process of 5-fluorouracil over an 8 week period with follow up cystoscopy results. Urine flow rates improved early in the treatment course from a maximum flow of 7ml/s to 19ml/s and a post void residual improvement from 311ml to 160ml. Significant volume reduction of the warts was achieved allowing for limited treatment with cold excision to minimise urethral stricture risk in a young man.

Keywords: Condyloma acuminatum; Condylomata acuminata; Urethral warts.

Fig. 1

Cystoscopy findings pre-treatment and post treatment with urethral 5FU and focal surgical treatment.

Fig. 2

H&E 100x magnification, features suggestive of condylomata acuminata - papillomatosis, surface hyperkeratosis and koilocytic change.

Fig. 3

Equipment set up and administration preparation by our practise nurse. NB – Importance of all plastic utensils to avoid metal ion binding and making the 5FU less effective.