Sexually Transmitted Diseases/Growth inside tip of penis

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Question
I am a 40 year old male and I had unprotected sex with a woman about one year ago who had formerly been in a relationship that may have been high-risk for STDs.  About four months ago, I was inspecting my penis for genital warts, which I contracted 4 years ago (three years prior to the experience mentioned above).  In the last four years, I have had two occasions where the genital warts were frozen off.  

During my inspection, I spread apart the tip of my penis.  As I spread apart the urethra, I noticed that there were several very small pieces of pink flesh that protruded from the urethra like a tiny pink sunflower.  These pieces of flesh were about 1-2 mm deep inside the urethra.  I would estimate that there are about 10-20 of these pieces of flesh that looked like the "pedals" of the tiny sunflower.  These pedals are only visible when I spread apart the tip of my penis.  It does not cause any pain, though on occasion, it itches a little bit, which is what prompted me to inspect this area in the first place.  There is also no pain upon urination.  

Upon first examination four months ago, the very tips of two of the fleshy "pedals" were dark.  These dark spots were very small, about 1/4 mm or less.  The dark spots are no longer present.

I do not have the means to go to a doctor for inspection or treatment.  Could this be genital warts inside the urethra?  Or something else?

Answer
Hello Mike,
Yes, these fleshy little growths just on the inside of your penile tip do indeed sound like warts caused by HPV. Unfortunately, there are no good methods for removing or treating them, without applying freezing or topical medications correctly.  It's not a do-it-yourself project because of the potential for damage that might cause either or both chronic pain or scarring which would not be good. As long as these little annoyances continue to exist and grow, they may be shedding virus to anyone you have unprotected sex with (oral, vaginal, anal).  And if they continue to grow larger, they may interfere with the outflow of both urine and semen. Perhaps it is time to plan on a trip to a nearby city you'd like to visit, around a doctor's appointment. You didn't say where you are or where you are near, or where you'd like to visit!

Good luck!
--mark  

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience

Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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