Genital warts is a sexually transmitted disease, though it is not as popular as herpes and AIDS.
AETIOLOGY
The real name of genital warts is condyloma acuminate. Genital warts appear near the genitals and they look like a cauliflower. They are caused by one of the 80 types of the human papilloma virus (HPV).
Unfortunately, most of infections caused by HPV are not recognized yet as they show no symptoms. Of all types of HPV, types 6 or 11 are considered to be the leading causes of visible genital warts.
The infection can be caught by sexual contact due to the occurrence of active virus on the genitals. It has been discovered that sexual partners of people with genital warts have 60%-90% of chances of having warts within 3 months.
In most cases people have HPV but they are not aware of it.
It sometimes happens that warts do not appear for several years even though there is the active virus in the body for years. Research discovered that when women go for their routine Pap smears reception, in most of them HPV is revealed. It is possible that the virus had been acquired in the past.
Genital wart may appear in various places: internally- in the upper vagina or cervix, or in the male urethra; externally- on the genitalia, in the anal area.
Due to the location of a wart and its transmission through sexual mode many emotional problems may arise. Patients suffer from psychological disorders- the feeling of guilt, embarrassment and anger.
RISK FACTORS:
Everybody who have ever had sexual contact can be infected with HPV. If immune system of an individual is suppressed, he/she is likely to have visible lesions caused by that virus.
The virus doesn’t have to flare up with an obvious trigger. HPV infection may also appear if a person is taking cancer medications or other drugs used for the prevention of rejection of the transplantation of an organ.
This infection may also occur together with other diseases transmitted sexually.
SYMPTOMS:
* Genital warts are more common in the young and sexually active people, but they may affect any age group.
* The warts are fleshy pink, may be pointed, papular or macular, may occur singly or in clusters.
* Warts are normally painless, only sometimes itchy or tender.
* They may bleed after intercourse.
* The areas that are most commonly affected are: the vulva, penis, cervix, vagina, perineum and perianal region. But lesions may occur also on the face and mouth.
* Genital warts in children raise concerns about the possibility of sexual abuse.
INVESTIGATIONS:
* Genital warts are frequently connected with other STIs, so referral for full screening is advisable.
* Colposcopy, proctoscopy or histology may be necessary.
* Laboratory tests may identify HPV DNA in latent cases.
* A cervical smear may pick up changes in cervical intraepithelial neoplasia that require follow-up.
TREATMENT:
* Untreated warts normally grow and spread, but sometimes resolve spontaneously.
* In any new sexual relationship condoms should be used.
* Although treatment aims at destroying the warts, recurrence rates are high.
* Podophyllotoxin or podophyllin paint must be applied weekly by a physician or nurse.
* Men can apply podophyllotoxin to penile warts with instruction.
* A good alternative can be freezing with liquid nitrogen or nitrous oxide every 3 weeks.
* If the warts are extensive surgical removal under general anesthetic may be necessary.
