Genital warts are the outward expression of human papillomavirus (HPV) infection. Infection with the virus is carried out mainly through contact and sexual contact, and each person at some point in his life is a carrier. The manifestation of the infection is observed in immunocompromised patients, and despite the therapy, the infection often recurs.
What are genital warts?
The human papillomavirus is a DNA virus of the Papovaviridiae family. There are low-risk and high-risk strains of the virus. The cause of genital warts is low-risk strains HPV-6 and HPV-11. High-risk strains of the virus (16, 18, 31, 33, 35, etc.) are cited as causes of precancerous and cancerous diseases, the most common of which is cervical cancer.
Entering the body, the human papillomavirus attacks the epithelial cells in the mucous and submucosal layers of the urogenital system. Once in the skin cells, the virus changes them morphologically and turns keratinocytes into koilocytes. The incubation period varies from 3 weeks to 9 months, and symptoms usually appear about 2-3 months after contact with the virus.
Risk factors for HPV infection are sexual intercourse with multiple sexual partners, lack of barrier methods of contraception, sexual intercourse from an early age, frequent change of sexual partners. The use of oral contraceptives and smoking, as well as the presence of underlying sexually transmitted disease, also increase the risk of HPV contamination.
Genital warts are different in shape and size, smooth or with an uneven surface and the shape of cauliflower, formations. Their color is usually whitish but can be hyperpigmented, colorless, or pink in color. In most cases, genital warts are multiple, forming groups – clusters. In women, they most often develop in the cervix, vagina, vulva, perianal. Warts may appear in and around the mouth if the infection occurred as a result of oral sex.
In a large percentage of cases, human papillomavirus infection is asymptomatic. With the development of genital warts, burning, itching, increased sensitivity in the area, vaginal discharge is possible. In larger formations located at or at the entrance to the vagina, bleeding may occur after intercourse.
The presence of genital warts in pregnant women can create difficulties during childbirth. Large formations in the vagina may make it difficult for the fetus to pass. In some cases, bleeding may occur. When passing through the mother’s vagina, the fetus can become infected with HPV, causing warts to form in and around the newborn’s mouth.
Genital warts diagnosis
The diagnosis is made on the basis of the clinical picture and external manifestations of the disease. The detection of genital warts on external examination in a pelvic examination usually guides the gynecologist to the patient’s condition. During the gynecological examination, a smear and DNA analysis material is taken. The PCR method is used to diagnose HPV. The cytological examination provides information about the histological structure of the cells in the female genital tract, the presence of precancerous or cancerous conditions.
Genital warts in Women
The various forms of genital warts that affect women can occur in or around the vagina, vulva, anus, or near the entrance to the uterus. Often the warts are too small to see or notice. Warts in the vagina or anus can cause discomfort, but not any symptoms.
- Two out of three cases of genital warts are near the vulva
- One in three cases of genital warts is in the vagina
- In every three cases, it is between the vagina and the anus
- Two of the four cases are around the anus
- One in ten cases is on the cervix
Genital warts in men
Genital warts are less common in men than in women. They often appear on the tip of the penis, but can also appear around the anus, especially when the virus is transmitted during anal sex. Most types of warts will appear between one and three months after infection.
If you think you are infected, you should be tested to avoid complications and prevent the transmission of the infection to future partners. In about half of all cases, genital warts appear on the shaft of the penis, usually just below the foreskin.
- In one in three cases, the genital warts are around the anus
- At ten, one case is with genital warts on the head of the penis
- In one in ten cases, the genital warts are in the urethra
- The same is the statistic of genital warts under the foreskin
- In about one in thirty cases, genital warts appear between the anus and the scrotum
- In one in a hundred cases, genital warts are on the scrotum
Complications of genital warts
Cancer – HPV infection has been linked to cervical cancer, as well as cancer of the vulva, anus, and penis. Of course, not all HPV infections lead to cervical cancer, but it is crucial for a woman’s long-term health that she conducts regular tests.
Pregnancy problems – there is a small risk because the mother with genital warts can get warts in their throat (laryngeal papillomatosis). Also, hormonal changes that occur during pregnancy can cause genital warts, bleeding, or an increase in their number.
Methods for treating genital warts
There are many methods for treating genital warts. Despite the wide variety of therapies, HPV infection often recurs, and controls and a complete cure are quite difficult. The following medications can be used as a topical therapy for necrotization and removal of genital warts:
1. Podoxyphylline – in the form of a solution, cream, or gel. It is applied twice a day, three consecutive days a week. The maximum treatment period is 4 weeks.
2. Imiquimod – an immunomodulatory product that binds to Toll-like receptors and stimulates the production of cytokines that stimulate the removal of genital warts. It is applied three times a week for a period of up to 16 weeks.
3. Synecatechin – a preparation for topical application. It consists of green tea extract containing synecatechins, which have antiviral and antitumor properties.
4. Trichloroacetic acid (TCA) – due to the low systemic absorption of the acid can be used in pregnant women.
5. Aldara – The active substance in the medicine Aldara is imiquimod. This has immune-stimulating properties. The substance activates immune cells and promotes the formation of cytokines. It supports increased cell production. Aldara is a cream for external use.
How to prevent genital warts?
An HPV vaccine called Gardasil can protect men and women from the most common HPV strains that cause genital warts, which are linked to cervical cancer. A vaccine called Cervarix is also available. This vaccine protects against cervical cancer, but not against genital warts.
Men and women up to the age of 26 can get the HPV vaccine. It can also be given at the age of 9 and is held in three rounds. These vaccines should be given before they become sexually active, as they are most effective before a person is exposed to HPV. Using a condom every time you have sex can also reduce the risk of genital wart inflammation.