Ano-genital warts in consecutive male heterosexual patients referred to a CO2-laser clinic in Copenhagen

The relation between sexual practices and location of anogenital warts is discussed. Results were derived from clinical examination and interview of 56 consecutive male patients referred to CO2-laser treatment of therapy-resistant genital warts, at a clinic at the Department of Dermatovenereology, Gentofte Hospital, located in the northern area of Copenhagen. Twenty (100%) patients with anal warts and 36 (100%) patients with penile warts all claimed to be strictly heterosexuals. None of the patients interviewed had had anoreceptive coitus or been engaged in sexual practices with oro-anal contact. The study population otherwise had a heterosexual profile with approximately one fifth of the patients having had other sexually transmitted diseases, mainly chlamydia. The group of patients with anal warts had significantly fewer known sex partners with genital warts (25% versus 58%, p < 0.05) compared to the patients with penile warts. All patients received one or more CO2-laser treatments using local anesthesia, resulting in cure rates of 80% (16/20) and 89% (32/36) in men with anal warts and penile warts, respectively. Anal warts seem to be much more common in a heterosexual male population. There is a need to elucidate the nature and epidemiology of anal human papillomavirus infection in heterosexual males.