Clinical Significance of Vulvar Condyloma as a Marker of Concurrent High-Risk Cervical HPV Infection and Abnormal Cervical Cytology

Background/Objectives: Human papillomavirus (HPV) infection is the principal etiological factor in cervical cancer and its precursor lesions. Although vulvar condyloma is typically associated with low-risk HPV types, high-risk HPV genotypes may coexist. This study evaluated the association between vulvar condyloma, cervical cytological abnormalities, high-risk HPV positivity, and cervical histopathological outcomes. Methods: This retrospective observational study included 407 women evaluated at the Department of Obstetrics and Gynecology, Izmir City Hospital, between January 2025 and January 2026. Patients underwent cervical cytology, HPV testing, vulvar examination, and colposcopic biopsy when clinically indicated. Patients were categorized according to the presence or absence of histopathologically confirmed vulvar condyloma. Logistic regression analyses were performed to identify factors associated with vulvar condyloma. Results: Vulvar condyloma was identified in 180 patients (44.2%). Abnormal cervical cytology was recorded in 66/180 patients (36.7%) with vulvar condyloma and 41/227 patients (18.1%) without condyloma (p < 0.001). High-risk HPV positivity was observed in 104/180 (57.8%) and 86/227 (37.9%) patients, respectively (p < 0.001). In multivariate analysis, adjusted ORs were 2.30 for HPV16 positivity (95% CI 1.36–3.89, p = 0.002), 3.29 for HPV18 positivity (95% CI 1.40–7.73, p = 0.006), and 2.01 for abnormal cervical cytology (95% CI 1.24–3.25, p = 0.005). Recorded CIN2+ was 15/180 (8.3%) in the condyloma-positive group and 7/227 (3.1%) in the condyloma-negative group in the overall cohort; in the biopsy-restricted analysis, CIN2+ was 15/82 (18.3%) and 7/41 (17.1%), respectively. Conclusions: Vulvar condyloma was independently associated with abnormal cervical cytology and high-risk HPV infection, particularly HPV16/18 positivity. These robust associations suggest that vulvar condyloma may represent a clinically visible marker of concurrent cervical HPV-related disease. Careful cervical evaluation is warranted in women presenting with vulvar condyloma, whereas CIN2+ findings should be interpreted cautiously until confirmed in larger prospective cohorts with standardized histopathological verification.