Exam Overview

Your doctor may take a sample, or biopsy, of abnormal tissue. The majority of warts do not require a biopsy. But a biopsy may be taken if genital warts cannot be easily identified with a physical examination or during a gynecology exam with a lighted magnifying instrument (colposcopy). A microscopic exam on the biopsied tissue can help your doctor determine whether human papillomavirus (HPV) is present.

For women, abnormal cell changes on the cervix that are caused by HPV may be tested differently than genital warts. You may have a cervical biopsy to find out if you have a high-risk type of HPV that could cause precancerous or cancerous cell changes.

The biopsy can be done in your doctor's office or clinic. You may have an injection of a numbing medicine (local anesthetic). This is more likely to be used for biopsies of the outer genital area on both men and women: this includes the vulva, scrotum, or penis. The injection can be painful. But local anesthetic is necessary when the biopsy is likely to be more painful than the injection.

There usually are no complications after a biopsy.

Why It Is Done

You may have a biopsy if any of the following are true:

• Your doctor is not sure what type of abnormal tissue is present.
• Warts have not responded to treatment.
• Warts appear unusual.

Results

Findings of a biopsy may include the following:

Normal

No abnormal cells are found, which usually means that an HPV is not present.

Abnormal

Abnormal cells called koilocytes are found. Koilocytes are cells that appear hollow or concave when examined under a microscope. Koilocyte cells collected from the genital or anal areas are abnormal and indicate infection with the human papillomavirus (HPV).

Other types of skin lesions also may be found.

Abnormal cervical cell changes caused by HPV will be treated differently than genital warts.

What To Think About

Treatment for abnormal cells includes watchful waiting without treatment or removal of the abnormal tissue.

The decision to do a biopsy will be based on whether biopsy results are likely to affect treatment.

If a biopsy confirms male genital, vaginal, or perianal warts, medicine treatment is an option.

Sexual intercourse should be avoided until the biopsy area is healed.

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