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 exam or during a gynecology exam with a lighted magnifying instrument (colposcopy). A microscopic exam on the biopsied tissue can help your doctor find out whether human papillomavirus (HPV) is present.

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 needed 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. This usually means that the human papillomavirus (HPV) is not present.

Abnormal

Abnormal cells called koilocytes are found. Koilocyte cells collected from the genital or anal areas are abnormal. They are a sign of infection with HPV.

Other types of skin lesions also may be found.

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