When a wart blocks the way: urethral condyloma presenting as acute urinary retention in pregnancy

Abstract

Urethral wart (condyloma acuminatum) is a rare cause of acute urinary retention (AUR) in pregnancy. We report a 29-year-old gravida 2 who presented at 32 weeks' gestation with AUR. Examination revealed a 2×1 cm friable, vascular growth just at the urethral meatus obstructing the lumen. There were no associated other sexually transmitted infections nor she had any pelvic pain or foul-smelling discharge and fetal surveillance was reassuring. There was immediate relief in urinary retention following excision under local anaesthesia. Histopathology confirmed condyloma acuminatum with koilocytosis. She subsequently had a spontaneous preterm vaginal delivery of a healthy 2.2 kg female infant, with no repeat episode of urinary retention. This case highlights urethral wart as a rare mechanical cause of bladder outlet obstruction in pregnancy and shows that prompt local excision safely restores voiding without adverse maternal or fetal outcome.