We present the case of a 55 year old patient under immunosuppressive treatment who developed multiple anogenital condylomata acuminata. Urethroscopy showed extensive condylomatous involvement of the entire penile urethra. Due to the potential morbidity of any surgical approach, we opted for an experimental treatment with Imiquimod (250 mg 5%-Imiquimod intraurethrally 3 times weekly), which was well tolerated. After a remarkable initial response and a continuous decline in the number of lesions, only minimal residual condylomata were left after 15 months. These were resected with the Holmium:YAG laser. Follow-up urethroscopy at three months showed no recurrence or signs of urethral stricture.