Female Urethral Condyloma Causing Bladder Outlet Obstruction
A 39-year-old woman presented to our hospital complaining of frequency, urgency, and sensation of incomplete bladder emptying. Urinalysis revealed no microscopic hematuria or pyuria, and her urine culture remained sterile. An uroflowmetry was performed, and the free maximum flow rate (Qmax) was low at 14 mL/sec, with voided volume at 218 mL, and postvoid residual urine volume (PVR) at 25 mL. She was administered an alpha blocker for two weeks, but there was no symptom improvement. A follow-up uroflowmetry showed an even lower Qmax at 8 mL/sec, with voided volume at 206 mL, and PVR at 45 mL. To rule out any anatomical obstructing lesions, a physical examination was performed, and multiple small papillary masses were noted around the external urethral meatus ().\nThe rapid plasma reagin card test and Treponema pallidum hemagglutination test results were negative. Cystourethroscopy demonstrated nonspecific findings in the urethra and bladder. An urodynamic study revealed a detrusor pressure at maximum flow rate (PdetQmax) at 25 cm H2O with Qmax at 14 mL/sec, indicating BOO. The masses were surgically excised, and primary repair was performed. Histopathological examination indicated condyloma acuminata with papillomatosis, acanthosis, parakeratosis, and hyperkeratosis ().\nExcision of the masses resulted in near complete resolution of her symptoms. No obvious recurrence of condyloma acuminata has been observed for 6 months after the surgery. One month after the surgical excision, a follow-up uroflowmetry showed an improved Qmax, voided volume, and PVR at 17 mL/sec, 229 mL, and 10 mL, respectively.