{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T04:36:47Z","timestamp":1763959007667,"version":"3.44.0"},"reference-count":27,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,7,25]]},"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>Genital warts (also known as condylomata acuminata) caused by the human papillomavirus (HPV) represent one of the most common sexually transmitted infections. Although they are usually found in the outer genital region, a small proportion of men can present with (often unrecognised) intraurethral warts, generally limited to the distal urethra and urethral meatus. This poses a treatment challenge not adequately addressed by the current guidelines. Here, we present two cases of low-risk HPV-positive patients with protruding and non-protruding condylomata acuminata of the distal urethra, which were treated successfully by using two different topical regimens (ie, a combination of policresulen and imiquimod for one patient and 5-fluorouracil monotherapy for the other). Although this type of management results in lower rates of tissue destruction and complications and may be given preference as an initial therapeutic option, additional prospective comparative clinical studies are needed to elucidate its potential in similar cases.<\/jats:p>","DOI":"10.1136\/bcr-2021-243618","type":"journal-article","created":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T13:09:04Z","timestamp":1632229744000},"page":"e243618","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Topical medication as an initial therapeutic option for protruding and non-protruding condylomata acuminata of the distal urethra"],"prefix":"10.1136","volume":"14","author":[{"given":"Tomislav","family":"Mestrovic","sequence":"first","affiliation":[{"name":"Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia"},{"name":"University Centre Varazdin, University North, Varazdin, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Sviben","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, School of Medicine, University of Zagreb, Zagreb, Croatia"},{"name":"Microbiology Service, Croatian National Institute of Public Health, Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanja","family":"Zember","sequence":"additional","affiliation":[{"name":"Department for Urogenital Infections, University Hospital for Infectious Diseases 'Dr. Fran Mihaljevi\u0107', Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domagoj","family":"Drenjancevic","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Department, University Hospital Centre Osijek, Osijek, Croatia"},{"name":"Department of Microbiology and Parasitology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,9,21]]},"reference":[{"key":"2025082711401388000_14.9.e243618.1","doi-asserted-by":"crossref","first-page":"552028","DOI":"10.3389\/fpubh.2020.552028","article-title":"Epidemiology and burden of human papillomavirus and related diseases, molecular pathogenesis, and vaccine evaluation","volume":"8","author":"Kombe Kombe","year":"2020","journal-title":"Front Public Health"},{"key":"2025082711401388000_14.9.e243618.2","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1128\/jcm.33.8.2058-2063.1995","article-title":"Human papillomavirus (HPV) type distribution and serological response to HPV type 6 virus-like particles in patients with genital warts","volume":"33","author":"Greer","year":"1995","journal-title":"J Clin Microbiol"},{"key":"2025082711401388000_14.9.e243618.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-023897","article-title":"Prevalence and distribution of HPV types in genital warts in Xi'an, China: a prospective study","volume":"9","author":"Zhu","year":"2019","journal-title":"BMJ Open"},{"key":"2025082711401388000_14.9.e243618.4","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.puhe.2011.01.016","article-title":"Appraisal of the burden of genital warts from a healthcare and individual patient perspective","volume":"125","author":"Scarbrough Lefebvre","year":"2011","journal-title":"Public Health"},{"key":"2025082711401388000_14.9.e243618.5","doi-asserted-by":"publisher","DOI":"10.21101\/cejph.a4378"},{"key":"2025082711401388000_14.9.e243618.6","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp070504"},{"key":"2025082711401388000_14.9.e243618.7","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1007\/s00120-014-3619-9","article-title":"Urethral condylomata acuminata","volume":"54","author":"Brummeisl","year":"2015","journal-title":"Urologe A"},{"key":"2025082711401388000_14.9.e243618.8","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.4.4.273"},{"key":"2025082711401388000_14.9.e243618.9","first-page":"150-159","article-title":"Consensus on HPV of the Portuguese society of andrology, sexual medicine and reproduction: treatment","volume":"19","author":"Jorge Pereira","year":"2021","journal-title":"Rev Int Androl"},{"key":"2025082711401388000_14.9.e243618.10","doi-asserted-by":"crossref","DOI":"10.1016\/j.pdpdt.2021.102204","article-title":"The place of 5-aminolaevulinic acid-photodynamic therapy in the treatment landscape of urethral warts: a systematic review","volume":"33","author":"Kechichian","year":"2021","journal-title":"Photodiagnosis Photodyn Ther"},{"key":"2025082711401388000_14.9.e243618.11","first-page":"51","article-title":"Urethral condylomata, due to human papilloma virus (HPV) type 6\/11., associated with transitional cell tumors in the bladder and ureter. 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