Anogenital warts or genital warts

According to statistics, the human papillomavirus is present in the body of more than half of the adult population, but in most cases it does not manifest itself in any way and is present in the form of migration.

The peak of the disease occurs at a young age from 17 to 25 years. This is due to the maximum sexual activity and the high sensitivity of the epithelium of the organs of the genital system.

Predisposing factors that increase the likelihood of the disease are:

• early sex;
• frequent change of roommates;
• age up to 25 years;
• sexual contact with people who have previously had human papillomavirus or other sexually transmitted diseases;
• Pregnancy;
• vaginal flora imbalance;
• any chronic disease;
• endometriosis;
• treatment with cytotoxic or glucocorticoid drugs;
• excess weight;
• dysfunction of the thyroid gland and dysfunction of insulin production;
• hypovitaminosis.

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

After introduction, the virus spreads throughout the body through the bloodstream, attaches to cells, penetrates their structure and integrates its DNA into the cell's DNA. Infected cells then begin to actively grow and divide, as a result of which nucleation bodies appear.

Ways of development

After the virus enters the human body, it does not cause any symptoms for a certain period of time.

The course of the disease takes place according to the following algorithm:

• Hidden period. At this stage, the carrier is unaware of the presence of infectious pathogens, as there are no clinical symptoms. However, a person is already contagious at this stage and can infect their partner through sexual contact. This latent period can last from 2-3 months to several years.
• The onset of the disease occurs when the virus multiplies sufficiently in the body or when the protective mechanism of the immune system decreases. During this period, the first symptoms appear.
• Active development with increasing symptoms.

The further course of events is developing in one of the following directions:

• self-healing with the complete disappearance of papilloma warts (most often after the end of pregnancy);
• slow pace and lack of growth of skin growths;
• active dynamics of papillomas with an increase in shape, size, number and fusion of neighboring groups;
• the degeneration of a benign growth into a malignant one.

Types of condyloma

There are several traditional types of conjunctivitis:

• exophytic- protruding beyond the surface of the skin or mucous membrane with preferential growth outwards;
• endophytic- with predominant growth deep in the skin structure, therefore not noticeable during visual inspection;
• Buschke-Levenshtein education- characterized by rapid growth rate, large size and frequent relapses after treatment. With this form, there will be both external growth and damage to the deep inner layers of tissue.

Genital warts can have a thin base or a wide base in shape. If the stem is thin, the tip may be sharp or club-like. Papillomas with a broad base are quite rare. The color of all such outgrowths is close to the color of the skin: from flesh to pink. The surface can be soft or covered with a layer of keratin.

Warts can appear singly or in groups that look like lumps. Sometimes so many groups reach sizes of 1. 5 cm. When several groups merge, formations similar to cauliflower florets or rooster combs appear. These growths make it easy to identify the disease upon examination.

Single rates usually do not cause as much inconvenience as large factors. In rare cases, they break and bleed slightly.

Large formations are more difficult: they can become wet, bleed and worsen due to a secondary infection that takes root in the affected areas.

Symptoms

The first symptoms appear after the latent period is over, which lasts a few weeks in the shortest case.

The occurrence of conjunctivitis occurs as follows:

• a little redness appears on the skin, which begins to itch;
• rashes appear on the skin or mucous membranes in the form of blisters or small bumps;
• tubercles gradually grow to 1-1. 5 centimeters in length;
• New rashes appear nearby, which also turn into varicose veins.

Location depends on the specific strain and the place where the pathogen enters the body:

• external genitalia;
• anal area (anogenital papillomas);
• inside the urethra;
• on the cervix;
• on epithelial tissue in the mouth (on the surfaces of the mouth, tongue and inside of the lips).

The clinical picture may differ in each individual case depending on the individual's state of health. For small warts, no other symptoms may occur.

With severe treatment, the following symptoms appear:

• itching or burning where the rash occurs;
• sensation of a foreign object in the perineal area;
• moisture in the area of the tumor;
• an unpleasant odor from the area where conjunctiva is located.

With exercise, long walks or runs, all the above symptoms intensify.

In severe cases, fatigue, weakness, signs of poisoning, chronic headache, fever and high fever appear.

In men and women, the symptoms are somewhat different. This is due to anatomical differences and characteristics of sexual behavior.

Manifestations in men

Condylomas in men most often affect the groin, groin, pubic and various structural parts of the penis: head, body, frenulum and foreskin, coronal groove. When localized near the urethra, papillomas take on a distinct red color, and this location often causes splitting or splashing in the stream during urination.

If the rash is located at the exit of the anus, severe pain may occur during bowel movements and blood may be present in the stool. Because of this, a reflex fear of defecation often occurs, causing periodic constipation and sometimes hemorrhoids.

There is often a vague pain in the lower abdomen, during sex there is a burning sensation and pain, as well as during urination.

The prolonged presence of infection lowers a man's immunity, making him more vulnerable to respiratory diseases, which are more difficult to treat than usual.

Manifestations in women

The most common places where papillomas appear in women are the perianal areas, where humidity and temperature constantly rise: the epithelium of the clitoris, labia, vaginal outlet and urethral opening. If an infection occurs during anal intercourse, a ring of growths may collect around the anus.

Large growths often become secondary infections, causing a strong odor, bleeding, sores and severe pain to the touch. When walking there is irritation and great discomfort.

In 50% of women, a whitish substance forms on the cervix of the uterus, which is detected during a routine colonoscopy, before they are treated with an acid antiseptic that can increase the white color of cancerous growths.

In some cases, all growths are located on the mucous membrane of the woman's internal genitals, so she does not notice them until a scheduled visit to the gynecologist. This is often the reason for starting treatment later compared to men.

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

Rarely, papillomas appear in the mouth, and in rare cases - on the pubis, thighs, neck or face.

Features of condylomatosis during pregnancy

If treatment has been carried out, pregnancy should not be planned until several months later. The period of abstinence from pregnancy is prolonged if the woman took antiviral drugs during treatment. After successful treatment and maintained intervals, you can definitely get pregnant.

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

The reasons for the appearance of varicose veins in pregnant women are a standard decrease in immunity with increased stress on the body and significant hormonal fluctuations.

If papillomas are located on the external parts of the genitals or in the abdominal area and do not cause discomfort, then the question of treatment can be postponed until the child is born. But in the case of rapid growth, increase in size and severe pain in the growth, you should immediately contact a doctor. Sometimes, with a strong progression of the formations, it is noted that they come off, which can lead to rupture of the vagina.

This disease does not normally affect the formation of the fetus, but its effects extend to the condition of the mother and the birth process. If other infections are present, there is often a risk of prematurity.

When conjunctiva is damaged while the fetus is passing through the birth canal, it often leads to infection in the baby and larynx on the newborn's chest or chest. Therefore, the presence of significant papillomas in the birth canal is a direct indication of cesarean section.

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 medical methods to get rid of conjunctivitis during pregnancy is unacceptable, as this can not only have a positive result, but can lead to the degeneration of benign cells into malignant ones.

Formations that did not cause discomfort during pregnancy often disappear on their own without treatment within a few months after delivery, as the woman's hormonal balance returns to normal.

Analysis

If a patient notices symptoms reminiscent of human papillomavirus, they need to contact a gynecologist, urologist or venereologist.

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

• time when the patient detects the first symptoms;
• probable causes of infection;
• dynamics and development of the disease until you see a doctor.

After this, a clinical examination is carried out, where the specialist determines the location, strength, size and condition of the growths. For women, there is an additional colposcopy (examination of the individual genitals with magnification) or a longer colonoscopy (a similar procedure with an acetic acid solution).

For a more accurate diagnosis, the doctor prescribes the following additional tests:

• PCR analysis, allows you to detect the infection in scrapings from the epithelium of the affected areas and determine its amount (also allows you to determine the strain of the virus);
• perspective- visual inspection of the area near the anus with magnification;
• cytology and histologyexcerpts from the images to identify atypical cells or tissues;
• biopsy of interestfrom epithelium to microscopic examination of tissue structure;
• detection of antibody titerswith this virus;
• lubricatefrom cervix and cervix for microscopic cancer diagnosis.

If necessary, a 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 choose individual methods of treatment and complete relief from the disease.

Treatment

Often, with condylomatosis, people avoid going to medical institutions and choose treatment themselves, choosing local drugs that can remove visible symptoms, but do not cure the body of infection, moving it to a hidden level. Such treatment almost always leads to relapse. Therefore, for a final cure, an integrated approach is required, which can only be determined by a specialist.

Treatment is carried out in the following areas:

• remove interest;
• fight the virus;
• strengthen the patient's immunity.

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

Radical methods

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

The following methods are used for removal:

• Surgeryformations using a scalpel under local or general anesthesia. The incision site is sutured with sutures. Although this method is considered a classic, it often causes postoperative bleeding and long rehabilitation in the hospital, so recently surgery has been used less and less.
• Cryoablation with liquid nitrogen.This procedure is relatively cheap and safe and does not require anesthesia or sedation. After freezing, the protein of the images is destroyed, the nodules dry and fall off. After a few weeks, no scars or scars remain at the treatment site.
• Laser removal.Despite its safety and high efficiency, the method requires anesthesia and is characterized by high costs, so it is prescribed if other methods cannot be used. When exposed to laser light, the structure of the growth stem is destroyed. After vascularization, the conjunctivitis is deprived of nutrients, which within a few days leads to its necrosis and the scab disappears. Scars often remain after laser removal.
• Electrocoagulation.The procedure is affordable but is very painful so it requires local anesthesia. Genital growths are exposed to high heat, as papillomas are cauterized. The scab falls off on its own after a few days, leaving a scar.
• Radiosurgery. At the moment, this is the most high-tech, fast and effective method that determines the high cost. Using high frequency radio waves, genital warts are painlessly removed in 15-30 minutes. After such removal, there is no bleeding, healing occurs within a day, after which no marks remain on the skin.
• Destruction by chemicals.This technique is only suitable for small formations, without multiple fusions. Special strong substances are used which lead to the death of growth cells. These products are based on high concentrations of acids or bases that cause localized chemical burns.

If we limit ourselves only to radical methods of combating condylomatosis, then the recurrence of condylomas occurs in every third case.

Medical treatment

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

• Pharmacy productsfor wart necrosis, acceptable for home use. For several days, this product should be applied systematically to the condylomas. If the drug gets on healthy tissue near the growth, a deep chemical burn will occur, so you need to use the drug very carefully. After daily use, take a break for a few days. If the shot does not fall off, the course is repeated. Medicinal products that cause necrosis of growths include solutions and ointments.
• Antiviral drugs.They can be for local or general use.
• Immunosuppressive drugsto improve privacy.

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

Immunity to atherosclerosis does not develop after treatment, so re-infection from previous partners is possible.

Possible complications

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

• Attachment of bacterial infection to damaged chain-shaped papillomas, which leads to purulent formations, balanoposthitis and ulceration in the abdominal region.
• When a growth grows in the urethra, bacterial urethritis can develop, leading to problems urinating, urinary retention in the body, and urinary tract infection.
• When large formations are localized in the anus, bleeding occurs from hemorrhoids and paraproctitis.
• Genital warts can affect a person's sexuality and cause them to refuse intercourse. All this often leads to depression and psychological problems.
• Women can have cervical erosion and dysplasia.
• The greatest risk is the risk of degeneration of benign tumors into cancer (penile or cervical cancer).

Preventive measures

Prevention of condylomatosis is divided into specific and general.

Specific preventive measures include vaccination with the new tetravalent vaccine. These vaccines do not work against all strains of human papillomavirus, but they successfully fight the most dangerous ones, which cause cervical cancer. Vaccination is carried out from the age of 11 and is repeated three times.

Non-specific prevention is similar to the measures involved in many STDs:

• use of barrier contraceptives;
• personal hygiene at the right level;
• regular bollmate;
• regular examination by a gynecologist or psychologist;
• timely treatment of pelvic diseases;
• stop smoking and alcohol.

In addition, it is necessary to avoid stress, physical fatigue, hypothermia and all those factors that weaken the immune system. A healthy diet, improved health and proper sleep patterns will help prevent the appearance of genital warts.