anogenital warts or genital warts

The appearance of cone-shaped flesh-colored growths in the genital area is a cause for concern, which is fully justified, since the health of the genital area is an important point for the overall physical and moral well-being of a person.

These wart growths cause discomfort, interfere with normal sex life, and can also cause more serious health problems. If the integrity of the condyloma is damaged, infection can occur and transition into a malignant formation. Therefore, the desire to get rid of such manifestations is understandable and quite natural.

due to presence

The cause of papilloma warts is the Human Papilloma Virus. This virus has a certain DNA set that successfully integrates into the cells of the human body and causes them to change their growth cycle, shape and structure.

According to the international classification of diseases ICD-10, human papillomavirus is classified as B97. Coded 7. Anogenital warts of sexual nature are coded A63. 0 is given.

There are several different types of this virus, each of which causes a specific warty papilloma. The type of virus determines the course of the disease process, symptoms, place of manifestation, and the severity of complications.

The strains are divided into two main types:

• cutaneous, with predominant presence on the dermal layer;
• Mucous membrane, which appears on the mucous epithelium of the genital organs, oral cavity, etc.

In addition, the types of papillomaviruses differ depending on the risk of degeneration into an oncogenic process into oncogenic, moderately oncogenic, and non-oncogenic.

Often, several different types are present in an infected person's body at the same time.

Routes of infection and risk factors

There are several ways for the pathogen to enter the body:

• "Vertical" transmission, This is the name given to the transfer of the infectious agent from mother to child during pregnancy. It is currently unknown whether the infection occurs in the prenatal period or directly during childbirth, but it is undesirable to perform a cesarean section on a mother suffering from papillomavirus. CesareanSection is performed only in case of bleeding from papilloma inside the birth canal.
• sexual path.The infectious agent can enter the body during vaginal, oral or anal sex. The pathogen is also spread through saliva during kissing. The use of a condom during intercourse does not guarantee protection from the virus, but it does reduce the possibility of its transmission. Decreases.
• Home method.This mechanism of disease transmission is quite rare. Infection can occur through contact with the patient's personal items. Since the virus is contained in saliva and urine, contact with someone else's utensils, shared towels, personal hygiene items, toilet bowl or bathroomIt is possible to get infected by using.

The mode of infection is determined primarily by the age of the person: in infants, with a high degree of confidence, it can be established that the infection came from the mother, and in older children, through contact and household contact. From the age of 17, in most cases, sexual transmission occurs.

According to statistics, human papillomavirus is present in the body of more than half of the sexually mature population, but in most cases it does not manifest itself in any way and exists as a carrier.

The peak of this disease occurs at an early age of 17 to 25 years. This is due to maximum sexual activity and high sensitivity of the epithelium on the organs of the genitourinary system.

Predisposing factors that increase the likelihood of the disease are:

• early onset of sexual activity;
• Frequent change of sexual partners;
• Age up to 25 years;
• sexual contact with people who previously had human papillomavirus or other sexually transmitted diseases;
• pregnancy;
• imbalance of intrauterine flora;
• any chronic disease;
• endometriosis;
• Therapy with cytostatic or glucocorticosteroid drugs;
• excess weight;
• Disruption of the thyroid gland and disruption of insulin production;
• Hypovitaminosis.

Frequent stress and non-observance of the principles of personal hygiene significantly increase the likelihood that, after entering the body, the infection will enter the active phase.

After introduction, the virus spreads throughout the body via the bloodstream, attaching to cells, penetrating their structure and integrating its DNA into the cell's DNA. The affected cells then begin to actively grow and divide. Due to which condyloma appears.

development methods

After entering the human body, the virus does not cause any symptoms for a certain period.

The course of the disease occurs according to the following algorithm:

• Hidden period. During this stage, the carrier is not aware of the presence of the infectious pathogen, as there are no clinical manifestations. However, a person at this stage is already infectious and can infect his partner through sexual contact. This latent period can last from 2-3 months to several years.
• The disease begins when the virus multiplies sufficiently in the body or when the immune system's protective mechanisms wane. During this period, the first symptoms appear.
• Active growth with increasing symptoms.

The further sequence of events is developing in one direction:

• Self-healing with complete disappearance of papilloma warts (often observed after termination of pregnancy);
• sluggish course and lack of skin growth;
• Active mobility of papillomas with an increase in size, shape, number and merger of closely located groups;
• Degeneration of benign growth into malignant.

Types of Condyloma

There are several traditional types of condyloma papilloma:

• exophytic- protruding above the surface of the skin or mucous membrane with preferential growth outward;
• endophytic- with a strong increase in depth of skin structures, therefore little noticeable during visual inspection;
• Buschke-Levenshtein education- characterized by rapid growth rate, large size and frequent recurrence after a course of treatment. With this form, there is both external growth and damage to the deep internal layers of tissue.

The shape of genital warts can be thin or wide. If the stem is thin, the tip may be pointed or club-like. Papillomas with a wide base are quite rare. The color of all such growths is close to the color of the skin: from fleshto pink. The surface may be soft or covered with a layer of keratin.

Warts may appear singly or in groups similar to lumps. Sometimes several such groups reach a size of 1. 5 cm. When several clusters merge, structures appear that resemble cauliflower inflorescences or a chicken's comb. These growths make it easy to identify the disease upon examination.

Single growths usually do not cause as much discomfort as larger elements. In rare cases, they rupture and bleed slightly.

Larger formations are more problematic: they can become wet, bleed, and deteriorate due to secondary infection taking root in the affected areas.

symptoms

The first symptoms appear after the completion of the latent period, which in the least cases lasts several weeks.

The occurrence of condyloma is as follows:

• Slight redness appears on the skin, which begins to itch;
• The rash appears as blisters or small bumps on the skin or mucosal surface;
• Tubercles gradually 1-1 in length. grow up to 5 centimeters;
• New rashes appear nearby, which also turn into condyloma papules.

Localization depends on the specific strain and the place of entry of the pathogen into the body:

• external genitalia;
• anal area (anogenital papilloma);
• Inside the urethra;
• on the cervix;
• On the epithelium in the mouth (on the oral surfaces, tongue and inside of the lips).

The clinical picture may vary in each specific case depending on the health status of the individual. For small warts, no other symptoms may be observed.

With a more severe course, the following concomitant symptoms are observed:

• Itching or burning at the rash site;
• Sensation of a foreign object in the perineal area;
• moisture in the area of the neoplasm;
• Unpleasant odor from the area where the condylomas are located.

All the above symptoms are intensified by physical activity, prolonged walking or running.

In severe cases, fatigue, weakness, symptoms of intoxication, prolonged headache, fever and high temperature are observed.

There is some difference in symptoms in men and women. This is due to physical differences and characteristics of sexual behavior.

manifestations in men

Condyloma in men often affects the scrotum, groin, pubis and various anatomical parts of the penis: head, body, frenulum and foreskin, coronary groove. When localized near the urethra, papillomas acquire a pronounced red color, And this spot often causes splitting or spraying of the stream while urinating.

If the rash is located outside the anus, there may be severe pain during bowel movements, and blood may be present in the stool. Because of this, a reflex fear of defecation often appears, which may lead to periodic constipation and sometimesSometimes causes piles.

There are often vague pains in the lower abdomen, burning and pain during sex, as well as pain when urinating.

Prolonged infection reduces a person's immunity, making him more susceptible to respiratory diseases, which are more difficult to treat than usual.

manifestations in women

The most common places for papillomas to occur in women are the perianal area, where humidity and temperature constantly increase: the clitoris, the labia, the vaginal outlet, and the epithelium of the urethra. If an infection occurs during anal sex, a ring of growths may form around the anus. Can be concentrated.

Large growths often become secondarily infected, causing a strong odor, bleeding, ulcers, and severe pain when touched. Burning sensation and severe discomfort are observed while walking.

In 50% of women, white elements form on the cervix of the uterus, which are detected during routine colposcopy, before which they are treated with an acidic disinfectant that can enhance the white color of the condyloma.

In some cases, all the growths are located on the mucous membranes of the woman's internal genital organs, so she does not pay attention to them until the scheduled visit to the gynecologist. This is often the reason for starting treatment later than in men. Is.

Often women experience embarrassment due to the presence of formations in intimate places, which forces them to refuse sex.

Rarely, papillomas occur in the mouth, and in extremely rare cases – on the pubis, thighs, neck or face.

Features of condylomatosis during pregnancy

If condylomatosis has been treated, pregnancy should not be planned earlier than a few months. The period of abstinence from pregnancy is increased if the woman took antiviral drugs during treatment. After successful treatment and regular intervals, you can safelyCould potentially get pregnant.

If the disease is detected during pregnancy, it is advisable to wait for treatment until all the baby's organs are already formed. Treatment after 28 weeks will not cause any developmental abnormalities in the fetus. Are there.

The reasons for the appearance of condylomatous warts in pregnant women include the standard decrease in immunity with increased stress on the body and significant hormonal fluctuations.

If papillomas are located on the external parts of the genital organs or in the perianal area and do not cause discomfort, the question of treatment can be postponed until childbirth. But rapid growth, increase in size and severe pain in growthIn case, you should immediately consult a doctor. Sometimes, with a high rate of progression of the structures, their loosening is observed, which can lead to rupture of the vagina.

This disease, as a rule, does not affect the formation of the fetus, but its influence extends to the mother's condition and the process of childbirth. If other infections are present, there is often a risk of premature birth. .

When the condyloma is damaged during the passage of the fetus through the birth canal, this often leads to infection of the infant and laryngeal condylomatosis in the neonatal or thoracic period. Therefore, the presence of significant papilloma in the birth canal is a direct indication for cesarean section. There is a signal.

If necessary, the growth is removed during pregnancy, after which the tissue is sent for histology to verify its benign nature.

The use of traditional medicine methods to get rid of condyloma during pregnancy is unacceptable, as it may not only not have a positive result, but can lead to the degeneration of benign cells into malignant cells.

Formations that do not cause discomfort during pregnancy often disappear on their own without treatment within several months after childbirth as the woman's hormonal balance returns to normal.

diagnosis

If a patient shows symptoms similar to human papillomavirus, he needs to contact a gynecologist, urologist or venereologist.

First of all, the specialist conducts a survey to clarify the following points:

• Time to detection of first symptoms by the patient;
• Possible causes of infection;
• Dynamics and development of the disease until you go to the doctor.

Next, a clinical examination is performed, during which the specialist determines the location, intensity, size and condition of the growth. For women, an additional colposcopy (examination of individual genital organs with magnification) or extended colposcopy (examination with acetic acidA similar procedure) is performed using solution.

For more accurate diagnosis, doctors prescribe the following additional tests:

• PCR diagnostics, allows you to detect the pathogen in scrapings from the epithelium of affected areas and determine its quantity (also allows you to determine the strain of the virus);
• anoscopy- visual inspection of the area near the anus with magnification;
• cytology and histologyslices of structures to identify abnormal cells or tissues;
• biopsy of growthFrom epithelial tissues for microscopic study of tissue structure;
• Antibody titer detectionTo this virus;
• smearFrom the cervical canal and cervix for microscopic oncocytology.

If necessary, consultation with a dermatologist or proctologist is scheduled. If the diagnosis is made on a pregnant woman, it is necessary to contact an obstetrician-gynecologist.

After receiving all the necessary data, the specialist can select individual tactics for treatment and complete relief from the disease.

Treatment

Often, with condylomatosis, people avoid going to medical institutions and choose self-therapy, preferring local drugs that can remove visible manifestations, but do not cure the body of the infection, transferring it to a latentThis type of treatment almost always results in relapse. Therefore, final cure requires an integrated approach, which can only be determined by a specialist.

Treatment is carried out in the following areas:

• removal of growths;
• fight against viruses;
• Strengthening the immunity of the patient.

All methods used to combat genital warts are divided into radical and medicinal.

radical methods

Such methods are chosen if it is necessary to urgently eliminate external manifestations or when condyloma in women is localized on the cervix.

The following methods are used for removal:

• surgical excisionFormations using a scalpel under local or general anesthesia. The cut place is stitched with surgical threads. Despite the fact that this method is considered classic, it often causes postoperative bleeding and long-term rehabilitation in the hospitalTherefore, surgical removal has been used less and less recently.
• Cryodestruction with liquid nitrogen.This method is relatively inexpensive and safe, and does not require anesthesia or anesthesia. After solidification, the protein of the structures is destroyed, the nodules dry up and fall off. After a few weeks, there will be no scar at the treatment site. Or no trace remains.
• Laser Removal.Despite safety and high efficiency, the method requires anesthesia and has a high cost, so it is prescribed if other methods cannot be used. When exposed to the laser beam, the growth stalkThe structure is destroyed. After cauterization, the condyloma is deprived of nutrition, which leads to necrosis and the scab disappears within a few days. After laser removal, scars often remain.
• Electrocoagulation.This method is inexpensive, but very painful, so it requires local anesthesia. The genital growth is exposed to high temperatures, during which the papilloma is cauterized. After a few days the scabs fall off on their own and fall off on their own. Leave a mark behind.
• Radiosurgery.At the moment, this is the most high-tech, fast and effective method, which determines its high cost. Using high-frequency radio waves, genital warts are removed painlessly in 15-30 minutes. This wayThere is no bleeding after removal, healing occurs within a day, after which no scars remain on the skin.
• Destruction by chemicals.This technique is suitable only for small structures, without multiple fusion. Special strong substances are used, causing the death of growth cells. These products are based on high concentration acids or alkalis that cause local chemical irritation. Reasons arise.

If we limit ourselves only to radical methods of dealing with condylomatosis, recurrence of condyloma occurs in every third case.

drug therapy

An integrated approach includes eliminating benign formations, getting rid of viruses in the body, and increasing the immune status. Therefore, drug treatment includes the use of such drugs:

• pharmacy productsFor necrosis of warts, acceptable for home use. This product should be applied pointwise to the condyloma for several days. If the drug gets on healthy tissues near the growth, deep chemical burns will occur, so you should apply the drug very carefully. Requires application. After daily applications, take a short break of several days. If the sprout does not fall off, the course is repeated. Pharmaceutical products that cause necrosis of growths include solutions and ointments.
• Antiviral agents.They may be for local or systemic use.
• immunomodulatorTo improve immunity.

In addition, to improve the body's defenses, systematic intake of multivitamin complexes, a special diet and a healthy lifestyle are prescribed.

Immunity to condylomatosis does not develop after treatment, so re-infection from a previous sexual partner is possible.

Possible complications

If left untreated for a long time, condylomatosis causes the following complications:

• The addition of a bacterial infection to the damaged condylomatous papilloma, which leads to purulent formations, balanoposthitis and ulceration in the perianal area.
• When growths in the urethra increase, viral-bacterial urethritis may develop, causing urination problems, urinary retention in the body, and urinary tract infections.
• When large formations are localized in the anus, hemorrhoidal bleeding and paraproctitis occur.
• Genital warts can affect a person's sex life, causing him to refuse sexual intercourse. All this often leads to depression and psychological problems.
• Women may develop cervical erosion and dysplasia.
• The greatest danger is the risk of benign tumors turning into cancer (cancer of the head of the penis or cervix).

Preventive Measures

Prevention of condylomatosis is divided into specific and general.

Typical preventive measures include vaccination with a new quadrivalent vaccine. These vaccines do not work against all types of human papillomaviruses, but they successfully fight the most dangerous of them, the ones that cause cervical cancer. VaccinationDone from the age of 11 and repeated three times.

Non-specific prevention is similar to the measures inherent in many sexually transmitted diseases:

• use of barrier contraceptives;
• Personal hygiene at the proper level;
• regular sexual partner;
• Regular checkups by a gynecologist or andrologist;
• Timely treatment of diseases of the pelvic organs;
• Quitting alcohol and smoking.

In addition, it is necessary to avoid stress, physical fatigue, hypothermia and any factors that weaken the immune system. Healthy diet, better health and proper sleep pattern will help prevent the appearance of genital warts.