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Most human papillomavirus (HPV) infections of the genitals cause no symptoms and are suppressed by the immune system within two years. There are many different strains of the virus, though just a few can cause genital warts or lead to more serious complications, such as cancer.

Though there’s no cure for HPV infection, your healthcare team at �����о��� Langone can create treatment plans for the conditions it can cause, such as genital warts; changes in the cells of the cervix or anus, called dysplasia, that are sometimes precancerous; and HPV-related cancer. A person can have multiple strains of HPV at once, and our clinicians can quickly and accurately diagnose HPV and determine appropriate treatment.

About 1 percent of Americans have the strain of HPV in their mouth that is found in oropharyngeal cancers—cancers of the throat, tongue, and tonsils. Having oral sex may transmit the virus that can cause these cancers, which affect more men than women.

Genital Warts

Each year, about 360,000 Americans with low-risk HPV develop genital warts. These warts can be small or large and flat or raised; they may appear alone or in a cluster. They’re most often noticed on the outer part of the female genitalia known as the vulva, as well as the anus and penis but can also be found in the cervix, vagina, scrotum, urethra, mouth, or throat.

Although most warts don’t cause symptoms, some people experience itching, bleeding, and discomfort, and sometimes excess vaginal discharge. If you notice any of these symptoms, or bumps or lesions on your genitals, see your �����о��� Langone specialist.

A gynecologist performs a pelvic exam and checks the cervix, vagina, vulva, anus, and, if symptoms warrant, the mouth for warts. A urologist examines the penis, scrotum, anus, and, if symptoms warrant, the mouth, for warts. Colorectal surgeons examine the anus for warts.

Some genital warts are too small to be seen during a physical exam. If you’re experiencing itching, bleeding, or mild discomfort and your provider suspects that you have genital warts, they may take a sample of tissue from the affected area and send it to a laboratory for analysis.

Cervical Abnormalities and Cancer

High-risk strains of HPV can lead to cancer of the cervix—the lower part of the uterus, or womb. The cervical canal is the passageway that connects the uterus to the vagina. The early stages of cervical cancer often don’t cause symptoms, and so it’s important to get screened regularly.

Keep in mind, if you test positive for high-risk HPV but don’t have any symptoms, your provider may decide to monitor your health without treatment; most of the time, HPV is naturally suppressed by the immune system. Even precancerous cell changes can vanish if the immune system builds up resistance to the virus.

Colposcopy

If your cervical Pap test results show abnormal cells on the cervix, or if screening test results indicate infection with a high-risk strain of HPV, your provider may perform a colposcopy. This procedure helps diagnose cervical dysplasia, which is a precancerous condition, or cervical cancer. During the test, a magnifying instrument called a colposcope is used to view the surface of the cervix and vagina and a sample of tissue called a biopsy may be taken for analysis in a laboratory.

Cone Biopsy

A cone biopsy may be performed if a cervical Pap test or biopsy from a colposcopy shows precancerous changes in the cells of the cervix. In this procedure, a cone-shaped wedge of tissue is removed from the cervix, including the cervical canal, and examined for abnormalities under a microscope. Performed under general or spinal anesthesia, this procedure is done in the hospital.

Loop Electrosurgical Excision Procedure

The loop electrosurgical excision procedure, also known as LEEP, is used to diagnose and treat abnormal cervical tissue. In this procedure, which is performed in the medical office with local anesthesia or in the hospital with general anesthesia, a wire loop heated by an electrical current removes tissue, which is sent to a laboratory for analysis. You may feel some discomfort during this procedure, but it is not painful.

If any of these tests shows that you have cervical cancer, your ������� Langone gynecologist refers you to a gynecologic cancer specialist, who oversees your treatment.

Anal Abnormalities and Cancer

High-risk strains of HPV can lead to cancer of the anus—the skin at the very end of the intestines. The early stages of anal cancer often don’t cause symptoms, and so it’s important to get screened.

Keep in mind, if you test positive for high-risk HPV but don’t have any symptoms, your provider may decide to monitor your health without treatment; most of the time, HPV is naturally suppressed by your immune system. Even precancerous cell changes can vanish if the immune system builds up resistance to the virus.

High Resolution Anoscopy (HRA)

If results of your anal cytology—commonly called an anal Pap test—show abnormal cells of the anus or screening test results indicate high-risk strain of HPV, a high resolution anoscopy (HRA) procedure may be indicated. This procedure diagnoses a precancerous condition called anal dysplasia or anal cancer. During the test, a magnifying camera is used to view the surface of the anus through a small plastic scope called an anoscope. A sample of tissue called a biopsy may be taken for analysis in a laboratory. This test is typically done in an outpatient setting and does not require special preparation. If HRA finds genital warts or precancer, your provider will discuss treatment options such as medications, outpatient procedures, and surgery.

Electrocautery

Electrocautery involves the removal of dysplasia by destroying them with a low-voltage electrical probe. This procedure is performed in the office, and a local anesthetic is applied to the area surrounding the warts. Swelling and pain can occur after the procedure. It can take two to four weeks to heal and even longer if the treated area is large. Scarring rarely occurs and the sphincter muscle is not impacted.

Excision

This procedure can be used to remove small areas of abnormal anal tissue. Local anesthetic is used to numb the skin then the abnormal tissue is excised using a small tool. Stitches are not necessary. Sexual activity should be avoided during the healing process, which can take about two to four weeks.