Genital Warts (condylomatosis) In Women And Men - Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Genital warts in women and men

Causes condylomatosis HPV (human papillomavirus). Infected with this virus, according to various sources, from 40 to 80% of the population, but only in 3% of women, it provokes the appearance of genital warts. These growths are not only a cosmetic defect, they are able to degenerate and provoke the development of cervical cancer.

Content:

• Condyloma - what is it?
• Causes of genital warts
• Types of genital warts
• Symptoms of genital warts
• Diagnosis of genital warts
• Warts treatment

Condyloma - what is it?

Condyloma (it is often called a genital wart) is an overgrowth of the papillary layer of the skin epithelium, which leads to the formation of unaesthetic outgrowths. They are flesh-colored or pinkish in color and are located mainly on the genitals or in the anus. Condylomas can appear in clusters, occupying a large area in the genital or anal area.

When condyloma is just starting to grow, it is not a source of infection. Once it appears above the surface of the skin, the risk of HPV transmission increases significantly.

Genital warts are most commonly sexually transmitted and highly contagious. It is noteworthy that infection occurs during vaginal, oral or anal intercourse with an infected partner. Unfortunately, the use of a condom does not guarantee protection against genital warts, since infection is possible through any contact with the mucous membrane and skin of a sick person.

Causes of genital warts

Warts are caused by human papillomavirus. This virus has a large number of strains (more than 100), but genital warts cause the 6th, 11th, 30th, 42nd, 43rd, 44th, 45th, 51st, 52nd and 54th types. An active virus is not always found on the genital mucosa. It may also be present in urine or saliva. Thus, infection does not always occur through sexual contact: it is possible to become infected through kissing or by household means.

Infection occurs through microtrauma on the mucous membranes or skin.

After infection, warts may appear after a few weeks, but sometimes the human papillomavirus can activate after a couple of years. The main factor responsible for the appearance of genital warts is the state of immunity of the infected person. In some cases, human papillomavirus infection can pass asymptomatically or heal on its own some time after activation.

It is important to understand that the presence of HPV in the body does not always lead to the development of visible symptoms of infection. For many years, the virus may not manifest itself in anything. It is activated only when favorable conditions are created for its reproduction. As a result, warts form on the genitals.

Risk factors that increase the likelihood of genital warts:

• Drop in immunity. This can happen due to long-term antibiotic therapy, with poor nutrition, with dieting. Also, the body's defenses weaken against the background of hypovitaminosis, HIV infection and other chronic diseases. Do not exclude such a factor influencing immunity as stress.
• Pregnancy in which the body's own defenses are naturally reduced.
• Postpartum period. A woman at this time often has not only physical, but also emotional exhaustion. The situation is aggravated by a deficiency of vitamins and hormonal imbalance.
• Refusal to use condoms during intimacy.
• Sexual contact with people with condylomatosis.
• Failure to comply with the rules of intimate hygiene.
• Infection with sexually transmitted infections.
• Promiscuous sex.

Possible routes of transmission of human papillomavirus:

• The virus is transmitted primarily sexually. In this regard, oral, genital and anal contacts are dangerous. The virus is extremely contagious, the probability of infection even after a single contact is equal to 75%.
• Sometimes the infection is transmitted by using shared towels, underwear, etc. That is, it is impossible to exclude the possibility of transmitting the virus through the household route, but this does not happen often. Therefore, many scientists are still questioning this path of HPV transmission.
• The infection can be transmitted during childbirth, when the baby passes through the mother's birth canal. In this case, indicate the vertical path of spread of the disease.

Types of genital warts

Condylomas can be:

• Pointed (exophytic)
• Flat (endophytic).

Genital warts stretch with their tip up, but form on the skin. These growths cause HPV, which rarely cause cancer.

Flat condylomas grow deep into the epithelium, causing pathological changes in it. They quickly malign, that is, they are reborn into cancerous tumors.

The cervix is a favorite place for the localization of genital warts in women. Therefore, all patients who have been diagnosed with HPV with a high risk of malignancy should be closely monitored, as they are more likely to develop cervical cancer.

Symptoms of genital warts

The symptoms of the human papillomavirus are the appearance of genital warts and their proliferation on the genitals and in the anal area. Condylomas can appear singly or in groups. In appearance, they sometimes look like flesh-colored warts, and sometimes they grow, becoming like "cauliflower" (confluent warts). The sizes of genital warts can reach from a couple of millimeters to several centimeters.

In men, condylomas appear most often on the glans penis, the crown of the glans, and the frenum of the foreskin.

In women, they appear on the frenulum of the labia, labia, clitoris, external opening of the urethra, in the vagina and on the cervix.

The appearance of genital warts around the anus is typical for both sexes.

Depending on the state of the immune system, condylomas can grow, do not change for a long time, or disappear on their own. Warts are an extremely dangerous and unpleasant symptom, since they not only interfere with a full sexual life and cause discomfort, but can bleed and interfere with normal childbirth.

Flat condyloma of the cervix is a sign of an acute or chronic infection.

Diagnosis of genital warts

Diagnosis of genital warts is not difficult. The doctor examines the affected area, after which the woman prescribes colposcopy. The cervix and the vessel that feeds the warts are treated with vinegar. This leads to his spasm, after which the affected area becomes white.

The blood is examined by PCR, which allows you to determine the type of virus and its amount in the body. The woman will have to donate blood for HIV, syphilis and other STDs. The sexual partner is examined.

A smear from the surface of the condyloma, cervix and from the cervical canal is sent for cytology. This eliminates the likelihood of malignancy of the tumor. If the doctor immediately suspects a cancerous process, then he performs a tissue biopsy.

When warts appear in the urethra, urocystoscopy is performed, and when they form in the rectum, anoscopy is performed.

It is important to distinguish warts from molluscum contagiosum, from syphilitic warts and from cancerous tumors.

Warts treatment

To date, it will not be possible to completely get rid of HPV. Therapy boils down to removing growths and taking antiviral drugs that reduce the activity of the virus in the blood. The final stage of treatment is the intake of immunostimulants, which can increase the body's defenses.

• Coagulation with chemicals. To destroy tumor cells, you can act on it with various chemical components. This will cause the growths to dry out and fall off. Coagulation with chemicals is a safe and effective treatment. To cope with genital warts, such drugs as Solkoderm, Bonafton, Kondilin allow.
• Diathermocoagulation. In this case, condyloma is cauterized with current. This method of treatment is notable for its low cost, but high painfulness. After such exposure, scars may remain on the skin.
• Liquid nitrogen treatment. Liquid nitrogen is applied to the build-up, which has a low temperature. The tumor is frozen, its cells are destroyed. This treatment does not carry the risk of scarring.
• Radio wave treatment. Treatment is carried out using the Surgitron apparatus. The tumor is influenced by high frequency waves. The method is not associated with painful sensations and is highly effective. The skin regenerates quickly, leaving no marks on it. However, this therapy is more expensive than all other treatments.
• Removal by laser. This method is very effective but painful and therefore requires local anesthesia. Sometimes, after such treatment, scars remain on the skin.

Having removed the genital warts once, you cannot count on the fact that she will never appear again. Typically, relapse occurs in 40-80% of cases.

Clinical case: A woman came to the appointment with her daughter (child 8 years old). The girl developed 4 condylomas in the perineal area. The largest of them was 1 cm in size. The rest did not exceed 5 mm. The girl was referred to a pediatric gynecologist. The doctor, due to inexperience or some other factor, cut off the largest warts with scissors. This is a very painful process that is dangerous for the patient. The doctor advised not to touch small neoplasms at all. Mother and child again turned to me for help. I had to persuade the little girl to undergo repeated treatment for a long time, since the past experience was accompanied by severe pain. As a result, I anesthetized the growth and removed it by electrocoagulation. The woman did not come to see me again, from which I conclude that the therapy was successful. Probably,the infection happened in a household way, since similar neoplasms were also found in the mother 6 months ago.

Using antiviral ointments

Imiquimod can be used to treat genital warts (Aldara - 4000 rubles, Keravort - 2000 rubles). The drug is available by prescription. It is used for topical application to persons over 12 years old. Treatment is long, there is a possibility of side effects in the form of erosion, tissue swelling, burning, itching, and scab formation. The drug is used every other day. It is kept on the skin for 10 hours, after which it is washed off with water.

Condilin solution (700 rubles), Condilox, Condiline, Podofillotoxin, Podofilox, Podophyllin. This is a toxic agent that prevents skin cells from dividing, which contributes to the death of condyloma tissue. The drug is applied to the affected area 2 times a day. The therapy lasts 3 days without interruption. Then for 4 days the skin is not treated with anything, after which the course is repeated (there should be four in total). It is important to ensure that the drug does not get onto healthy tissues.

Warts vaccines

There are 2 HPV vaccines - Cervarix and Gardasil. However, experts differ on the advisability of vaccination, since there are no compelling arguments for its effectiveness. Vaccines work for about 8 years, so they cannot protect against cancer 100%. In addition, such vaccinations allow you to prevent infection only with viruses of type 16 and 18. While in 30% of cases, cervical cancer is provoked by other HPVs.

Read more: HPV vaccination - why is it needed?

In addition, there is no data on how these vaccines affect a woman's reproductive function. There is evidence that they adversely affect the work of the ovaries, can provoke inflammation of the uterus, lead to hormonal disruption and irregularities in the menstrual cycle. All this can lead to future infertility.

Therefore, before giving the vaccine to your child, you need to carefully consider this decision. You cannot protect yourself from all types of cancer with a vaccine. Is it worth putting the girl's health at unnecessary risk, because many sources compare these vaccines with sterilization.

The author of the article: Bykov Evgeny Pavlovich | Oncologist, surgeon

Education: graduated from residency at the Russian Scientific Oncological Center. N. N. Blokhin "and received a diploma in the specialty" Oncologist"