Post-operative follow-up and recurrences

Is follow-up necessary after the lesions are treated?

Patients are always informed about the need for follow-up after the treatment. They are told, in particular, that no treatment eradicates HPV, and therefore the possibility for recurrence of the lesions may be small, but it does exist (it is 2%-3%).

Patients with an HSIL history must be checked in their entire lower genital tract.

After HSIL treatment, follow-up is every six months for the two first years. A greater frequency of recurrences has been observed during this period. After two years, and if no problems have been observed, check-ups are necessary once a year. It is stressed, however, to patients that they must comply with the time frames.

Will you be transmitting the HPV infection after treatment?

This depends on two things. First, on how successful the treatment was, and whether all visible lesions have been eliminated. Ssecond, on the state of your immune system and its capability of suppressing the HPV that remains after the lesions are destroyed. Usually, after the lesions are removed, a 6-12 month period passes until the HPV is suppressed by the immune system, and infectiousness is drastically reduced.

If you get treatment and the HPV lesions are gone, is there a risk of becoming reinfected by your partner?

Even if the visible HPV lesions are removed or destroyed, sometimes the virus remains in the lower genital tract area, in latent form. This is why recurrences are possible, regardless of whether we come in contact again with the person that transmitted the virus to us.

Lesions usually reappear because the immune system  is not yet capable of suppressing the virus. It is all a matter of balance between the viral action of HPV (which depends on the type of the virus) and the body’s immune system (cellular defenses against HPVs). In the case of a recent infection, since we do not know if our immune system has reached a satisfactory performance, we recommend the use of a condom for a few months. Also, after treatment, the use of a condom for six months has been proven beneficial, obviously because it stops the building of a new viral load.