Condyloma in women causes, symptoms and treatment

Genital warts ( viral warts, genital warts, genital warts ) – focal or multiple tumor-like papillary or mucocutaneous growths, often localized in the genital area, less often in the mouth and perianal region.

In HIV-infected patients, genital warts may occur in atypical locations, such as on the face, eyelids, and ears.

The time between infection and clinical manifestations ranges from 3 weeks to 6 months and on average lasts about 2.7 months. Susceptibility to this disease is the same in both males and females. The average age of those infected varies from 22 to 25 years.

Causes of growths, from what they appear?

The main cause of genital warts is the human papillomavirus (HPV). It is a DNA-containing virus that multiplies in the nuclei of epithelial (surface) cells of the skin and mucous membranes of the genitals, the oral cavity.

Currently, science knows about a hundred varieties of this pathogen. According to clinical manifestations, they are divided into cutaneous and anogenital types. In the affected cell, the virus can exist in two forms:

• Free (episomal) – do not integrate into the genetic apparatus of the cell, are of a benign nature;
• Integrated (intrasomal) – affects the genome, determine the malignant course of the process.

Types 6 and 11 are most often responsible for genital warts. Scientists believe that these types do not cause cancer (they do not undergo malignancy) and precancerous diseases, that is, they are included in the group of low oncogenic risk.

There are also other, more dangerous types of HPV . The most common are 16, 18, HPV 31 , 33 , 35 , 39 , 45, 52 , 58 , 59 , 67 types, which are much less likely to cause genital warts, but more often cause oncopathology (cancer) and precancerous conditions. This group of papillomaviruses is a group of high oncogenic risk.

The first signs of genital warts, the initial stage

At the initial stage, women complain about:

• pain of a pulling, aching nature;
• burning and itching, which are localized depending on the location of the future condyloma of the vulva (the entrance to the vagina, urethra, cervix, clitoris);
• the presence of bloody spotting.

Further, outgrowths, accumulations of papillary formations of soft consistency appear in these areas of the skin. Upon initial examination, one can notice a resemblance to cauliflower inflorescences. The size of the formations is variable – from very tiny to several millimeters in diameter. The quantity may also vary.

In some cases, the elements of viral warts can be smooth papules, the size of which does not exceed the size of a pinhead. Warts usually do not differ in color from normal skin, but can range in color from pale pink to dark brown.

The surface of the warts is easily macerated (the fabric is saturated with moisture and swells), the result is that the surface becomes white. In the future, it erodes, changes color to bright pink, bleeds easily. The resulting microtraumas are the entrance gate for infection, as a result of which the penetration of microorganisms occurs. The result is suppuration of warts with offensive discharge.

Risk factors

Factors that predispose to the occurrence of genital warts include:

• non-compliance with the rules of personal hygiene;
• smoking, alcohol;
• increased skin moisture, its maceration;
• pathological discharge from the genitals;
• frequent traumatization of the skin;
• immunodeficiency states (both congenital and acquired – beriberi, taking cytostatics, excessive insolation, atopic dermatitis);
• metabolic pathology (for example, diabetes mellitus);
• hormonal imbalance (during pregnancy, menopause);
• both acute and chronic diseases of internal organs;
• the presence of HIV infection in the body;
• association of HPV with other sexually transmitted infections (gonorrhea, trichomoniasis, bacterial vaginosis, syphilis, chlamydia, cytomegalovirus infection);
• diseases of the urinary tract.

Ways of development of HPV infection

The main routes of infection are:

• sexual ;
• contact-household (through personal hygiene items).

It is almost impossible to prevent infection with the virus using available methods, including barrier contraceptives. Through microtraumas on the genitals, the pathogen is transmitted from one sexual partner to another.

When infected, papillomavirus enters the body, where it is met by immunocompetent cells. In most cases, these cells destroy the pathogen.

But if the immune response is insufficient, then the virus infects the epithelial cells of the basal layer of the skin or mucous membranes, integrates into the genetic apparatus with a further change in the work of these structures. Cells begin to actively divide, grow in a limited area, outwardly turning into warts.

Virus diagnosis

The diagnostic algorithm is built according to the following plan:

• When a patient first contacts a local general practitioner or general practitioner, the latter is obliged to issue a referral to specialized specialists – an obstetrician-gynecologist, urologist, dermatovenereologist, oncologist;
• Inspection of growths on a gynecological chair in good light in most cases allows you to correctly make a diagnosis;
• Inspection in mirrors is obligatory. This procedure will assess the condition of the vaginal wall and cervix;
• A swab is taken from the cervix to identify pathological cells or to conduct a polymerase chain reaction (PCR), which helps in establishing the species of the pathogen.

At the preclinical stage, a diagnostic sample with 5% acetic acid is used. A gauze napkin moistened with a solution of acetic acid is applied to the areas under study for 5-10 minutes. When viewed under a magnifying glass or colposcopy (examination of the entrance to the vagina, the walls of the vagina, the vaginal wall of the uterus through a colposcope), condylomas are visualized as small white nodules.

Colposcopy gives the most complete picture of the condition of the walls of the vagina and cervix. During this procedure, it is possible to conduct a biopsy (taking a fragment of organ tissue for microscopic examination). A piece of tissue is taken if a malignancy of the process is suspected, then annually – a cytological examination of smears from the cervix.

If it is necessary to examine the urethra, they resort to ureteroscopy, which is performed by a urologist. If an anoscopy is required – an examination of the anus – then they resort to the help of specialists such as a surgeon or a proctologist. A blood test for sexually transmitted infections is also done.

HPV Treatment Methods

It is impossible to completely eliminate the human papillomavirus from the body – you can only remove viral warts. This will alleviate the patient’s condition, as well as reduce the risk of infection of the sexual partner. There are a number of treatments for genital warts, but they all have specific disadvantages.

The most common method in treatment is cryodestruction. Liquid nitrogen is applied to the surface of the growths using a cotton swab or sprayer. This procedure is repeated every 2 weeks until the complete destruction of all genital warts. The procedure rarely leads to scarring, it is low cost. In some cases, after this manipulation, the development of either hyper- or hypopigmentation is possible.

Diathermocoagulation is a painful method of therapy that leaves behind persistent scars. It is used only for the removal of single condylomas.

Laser destruction is performed using carbon dioxide and neodymium YAG lasers (yttrium aluminum garnet lasers). After removal, scars may remain.

Medical methods include:

• Kondilin . The main active ingredient of Kondilin – podophyllotoxin – when used locally, the result is necrosis and destruction of genital warts. The advantage of this method is the possibility of self-treatment of the affected areas of the skin in accessible places. The first treatment is carried out by a doctor or nurse, thereby teaching the patient how to use the drug correctly. Apply 2 times a day for 3 days, after a 4-day break is made. The duration of therapy is up to 5 weeks. Contraindications: pregnancy, lactation, children’s age, the use of other medicines containing podophyllin.
• Solcoderm . When applied, the skin turns yellow, after which the treated tissues are mummified. The treatment of affected surfaces is handled by medical personnel. If necessary, the manipulation is repeated after 4 weeks. The use of this drug may be accompanied by a strong burning sensation and pain reaction, in some cases, hyperpigmentation with scarring may occur.
• Trichloroacetic acid . It is used at a concentration of 80-90%, applied directly to warts. Its residues are removed with talc or sodium bicarbonate. If necessary, the treatment is repeated at intervals of 1 week. If, after 6-fold treatment, genital warts remain, then it is necessary to change the method of treatment.

Treatment of growths with folk remedies at home

Human papilloma virus is a virus that can lead to malignancy (degeneration into cancer) in the human body. The basis of this are malignant (oncological) cells. The destruction or decrease in the activity of these cells is achieved by exposure to hormone preparations, chemotherapy drugs and other treatments. In this regard, treatment must have a precise focus.

Alternative methods of treatment can not only have the desired effect, but also provide the proper expected result. Therefore, therapy with folk remedies is impractical and can be dangerous due to the late start of treatment, which is highly effective.

If you find symptoms that may indicate the occurrence of genital warts, it is recommended to consult a specialist.

Features of treatment in pregnant women

During pregnancy, immunodeficiency is observed, which is a trigger for the recurrence of genital warts. Carry out symptomatic therapy aimed at maintaining the immune status of women. In the presence of growths, their destruction is carried out only in the third trimester.

For the unborn baby, there is a risk of infection with the virus when passing through the birth canal. The risk of condylamosis of the larynx increases at the first breath, passing through the affected vagina. With such localization of genital warts, a woman  is delivered by caesarean section.

After the destruction of genital warts, a woman needs to undergo antiviral therapy and endure the period before a new pregnancy.

Infection prevention

Prevention of genital warts includes:

• compliance with the rules of personal hygiene;
• having one sexual partner;
• obligatory visit to the doctor in case of any changes in health;
• physiotherapy, hardening, massage;
• complete rest;
• Spa treatment;
• reduce the amount of stress;
• complete nutrition;
• avoid hypothermia and overheating;
• adequate sleep (8 hours).

Genital warts – this is the pathology that can be treated. But HPV infection remains forever persistent in the human body. Its recurrence directly depends on the observance of all preventive measures.