I'm a little confused about something that happened to me. I had an abnormal pap a 4 years ago and never really problems from it. Last year my gynecologist diagnosed me with genital warts and I was treated for them. My last pap was in July and it was normal. I saw a nurse practitioner in September because I had this weird clump of skin on the inside of my vagina, which I thought was scarring from the tca treatment, however the nurse practitioner told me it was genital warts that had gotten worse.
I told her I didn't understand because my pap was normal and wouldn't it have detected HPV which causes the warts and she said that didn't matter. I didn't have any new sexual partners after my pap so I wouldn't have been exposed to the the warts after my pap smear. Is it possible that I still have HPV and genital warts even though my pap came back normal?
Genital warts are caused by HPV types 6 and 11. HPV is a virus and once you have it, you have it for life. It may go into dormancy (remission) and show up years later. HPv 6 and 11 are considered low risk HPV while other types are considered high risk such as 16/18, 31/33/35 and many others. These high risk types of HPV can cause cancer anywhere in the genital tract, this includes the cervix, vagina, vulva, and even anal area. A PAP only tests for abnormal changes within the cells. Only if there are abnormal changes does the doctor then typically go on to do further testing to determine HPV involvement. You can have both high and low risk HPV and you can have them anywhere. Just because there was no abnormality on your PAP doesn't mean you can't have HPV lesions elsewhere whether high or low risk types. The only way to determine the type of HPV you have is through biopsy and testing for HPV DNA. Hope this helps.
wouldn't it have detected HPV which causes the warts
No, the PAP would have been looking for changes in your cervical cells. It isn't in itself an HPV test. Cervical cell changes and genital warts are caused by different strains of hpv. Warts are usually diagnosed visually, which they may not have noticed or even looked for when you had your PAP.
genital warts are caused by hpv types 6, 11, 40-45, 51... someone posted that somewhere i just cant remember. is that true? coz hvp type 45 and 51 is also high risk... im worried about that coz i also have small genital warts for 3 years now. though my pap test is always normal...
Paps are not a diagnostic tool; they are a screening tool. At the same time as a pap, a doctor can also perform an HPV/dna swab and have it tested for an active high risk infection. If a pap comes back with a problem, the lab can run an HPV test on that sample to determine if HPV is present. Neither test detects low risk HPV (ie genital warts).
Paps do not sample all tissue, either. It only samples the bit of the outer cervix that is swabbed. The doctor doesn't swab all of the outer cervix during a pap. The doctor doesn't normally swab the vagina.
Both high risk HPV and low risk HPV can cause problems on the cervix, vagina, vulva, anus/rectum, mouth/throat.