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Surgery for Human Papillomavirus

NYU Langone doctors may recommend surgery for genital warts if medication doesn’t work or the warts are widespread. Surgically treating genital warts doesn’t cure a human papillomavirus (HPV) infection, however, and warts can return after surgery if the immune system does not eliminate the infection.

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Surgery may be used to treat moderate to severe cervical dysplasia by removing abnormal cells on the cervix. This can reduce the risk of cervical cancer. Surgery is not used to treat mild cervical dysplasia, which often goes away on its own and typically does not lead to cancer. Your doctor continues to monitor mild cervical dysplasia to make sure that it does not progress.

Electrocautery

Electrocautery involves the removal of warts by destroying them with a low-voltage electrical probe. This procedure is performed in the doctor’s office, and a local anesthetic is applied to the area surrounding the warts. 

Electrocautery is typically used when the warts are small and not widespread. Swelling and pain can occur after surgery. It can take two to four weeks to heal and even longer if the doctor cauterizes large areas. Scarring may occur.

Excision

This procedure can be used to remove small, hardened warts and those that have joined together, as well as abnormal cervical tissue. The doctor uses a local anesthetic to numb the skin or the cervix and then excises the wart or abnormal tissue using a scalpel. Stitches are typically necessary, which dissolve on their own in two to three weeks. 

Sexual activity should be avoided during the healing process, which can take about two to four weeks.

Laser Surgery

In this procedure, a laser destroys warts or abnormal cervical or vaginal cells. Laser surgery for warts is typically used when the warts are inside the vagina or other treatments to remove them have failed. Laser surgery can destroy moderate to severe cell changes. Your doctor may recommend a follow-up Pap test to check for cell abnormalities four to six months after the procedure.

This procedure can be performed at the hospital under general anesthesia. You can go home the same day. Full healing may take one to three weeks, so it’s best to avoid sexual activity during that time.

Loop Electrical Excision Procedure

With a loop electrosurgical excision procedure, or LEEP, your doctor uses a wire loop heated by an electrical current to remove large genital warts or abnormal cervical tissue. It can be performed in the doctor’s office with sedation and local anesthesia or in the hospital with general anesthesia. While there may be some discomfort during the procedure, it is not painful. 

Recovery can take one to three days, depending on the number of warts removed or the size of the area treated for abnormal cells. Sexual activity should be avoided for one to three weeks after the procedure.

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