Anogenital warts: causes, symptoms and treatment

1. Routes of transmission and causes of occurrence
2. Distinctive signs and symptoms in men and women
3. Diagnostics
4. How to treat anogenital warts
5. Removal
6. Prevention

Anogenital warts are benign formations that appear on the surface of the skin (genitals, anus), which resemble a nodule. These warts are also called genital warts (Condylomata acuminate). These skin papules are caused by a papillomavirus with low oncogenic risk, called HPV, belonging to types 6 and 11. Based on information provided by statistical databases of medicine in the USA, then the number of patients affected by anogenital warts reaches 20 million people and at the same time Up to 6 million newly infected people are registered annually.

Which doctor should I see for an anogenital wart? These formations are examined by a dermatologist, proctologist, and urologist.

According to the classification carried out at the international level of the 10th revision, which is called the International Statistical Classification of Diseases and Related Health Problems 10th Revision Version for 2006, it was decided to classify this type of skin papillomas as infectious diseases, the transmission of which can mainly be sexually transmitted. Anogenital warts are also called venereal warts.

Like any warts, genital papillomas have been known to healers for a long time. The healers of Ancient Hellas called such skin nodules “figs”, since their outlines were similar to the fruits of fig trees. And if such papules were found in men on the genital organ, then, according to ancient treatises, they were recognized as retribution for a homosexual relationship.

Routes of transmission and causes of anogenital warts

Although warts can be contracted through the belongings of a person suffering from HPV, genital papules are predominantly of intimate origin - sexual contact, anal-genital penetration. If we talk about the possibility of transmission of this type of virus through oral-genital exposure, it is also being considered at this time, and for patients infected with HIV, this fact is proven. There is a possibility of infection with genital warts from a pregnant woman to a newborn during labor. There are assumptions about the contact and household route of acquiring such an infection, but this fact has not yet been documented.

Advice!!! If anogenital warts are detected, you should not blame the partner who is currently with you, since the infection could have occurred much earlier. The incubation period, when symptoms are not yet observed, can take from 14 days to several months or even a year, but on average it takes 90 days. Since this virus is one of the variations of HPV, it can remain in a “dormant” state for quite a long time in the human body until favorable conditions are created for its manifestation.

Patients affected by this type of virus do not always develop condylomas. The aggressiveness of the infection depends on the following factors:

1. too much sexual activity;
2. the sexual partner has had contact in the past with women suffering from anogenital warts or cervical cancer;
3. decreased background immunity;
4. presence of sexually transmitted diseases;
5. smoking tobacco or various herbs;
6. drinking alcohol in abnormal doses;
7. pregnancy;
8. endometriotic disease of the uterus;
9. avitaminosis.

Distinctive signs and symptoms of anogenital warts in men and women

Pictured are anogenital warts

Anogenital papillomas have a dough-like consistency and have a structure in the form of lobules; their outlines are similar to a cockscomb or cauliflower rosettes. Such skin nodules are characterized by the presence of a narrow base (also called “legs”). Genital warts are also distinguished by their ability to self-heal. It is observed that papillomas can disappear without any therapy or outside intervention over a period of several months to two years. Only rare cases of degeneration of genital warts into a malignant formation have been recorded.

If we talk about papules on the genitals, then in men they form on the head of the genital organ, namely the leaf of the foreskin, its internal part, the body of the penis and its frenulum, the coronary groove, the perineum, the inguinal and perianal areas, and the scrotum. Or condylomas can be formed in the area of ​​the urethra, that is, near the urethra on the outside of the opening.

In women, the main localization is the labia minora, the surface of the vagina, the cervical mucosa, and papillomas can also be found at the mouth of the urethra, in the skin folds and the area near the anus.

Based on the localization of formation, genital warts are divided into:

1. External Genital Warts - places of formation include the foreskin on the penis, the coronary groove on its head, the labia minora and majora, that is, external genital warts are formed.
2. Vaginal Warts are located almost at the vestibule of the vagina and are called vaginal anogetital warts.
3. Anal wars. Anal warts are localized in the anus.
4. Urethral Meatus Warts. Skin formations formed in the urethra are endourethral condylomas.
5. Cervical Warts. Anogenital warts that appear on the surface of the cervix.
6. Warts Mouth. Condylomas that form in the oral cavity and their localization includes the area of ​​the mucous membrane of the cheeks, on the tongue and lips.

According to their appearance, anogenital warts are divided into:

1. Keratotic nodulesHorny appearance, often resembling cauliflower or seborrheic keratomas, the usual sites of their formation are the dry skin found on the shaft of the penis, the scrotum and the labia.
2. Papular formations, having the outline of a dome, with a diameter varying between 1-4 mm. Their surface is smooth, characterized by less keratinization than that of keratic warts, their color has the shade of raw meat, and are usually located on a layer of epithelium that is completely keratinized.
3. Giant Buschke-Levenshtein condyloma – a very large condyloma, which forms in patients with a reduced level of immunity, or in a woman who is pregnant.

The main symptoms of venereal warts that patients may experience are itching and burning in the genital area. Also, as they grow, such skin tumors can interfere not only with sexual intercourse, but also make it difficult to urinate. If such warts appear in the anus, they can not only itch and itch very much, but also create problems during bowel movements. Any such manifestations occur due to friction of the underwear against the skin nodules, they are injured and can bleed, and then a burning sensation occurs as they heal.

Diagnosis of anogenital warts

It is usually possible to diagnose genital warts by visual examination not only by a dermatologist, but also by the patient himself. As a rule, such papillomas have the appearance of nodules, are pointed or in the form of spots. When venereal warts are still very small, they are not even noticed by the patient, since they are perceived as skin roughness.

It is important to remember that there are no specific sensations inherent in this disease. Patients may present with complaints that are considered common, such as itching in the genital area, a burning sensation, or spotting, but these manifestations may correspond to the symptoms of various diseases. Such, for example, as genital condylomatosis will require differential diagnosis, since dermatitis and hypertrophy of the sebaceous glands, molluscum contagiosum and syphilic condylomas lata have similar symptoms, and anogenital warts resemble polyps or can degenerate into malignant neoplasms.

It is clear that the presence of such skin formations is an unpleasant issue, but can be eliminated after therapy, however, genital warts pose a particular danger to pregnant women. Since there is a possibility of ruptures of warts formed on the cervix or in the genital area during labor. Then heavy bleeding will be provoked and the baby will be infected when passing through the birth canal. Then, in newborns, anogenital warts can form in the larynx and this will complicate access to air and breathing.

Important!!! When diagnosing anogenital warts, it is not recommended to use HPV DNA testing (PCR - non-amplification). This widely used test detects oncogenic HPV types. The material is a smear taken from the mucous membrane, occasionally urine, amniotic fluid, or blood sampling. Based on the result of this method, a decision will be made about whether the patient has HPV or not. However, if the technology is not followed or the specialist is insufficiently qualified, the result may be false, both negatively and positively.

But still, many specialists tend to send patients to perform such tests, as well as perform cytology and biopsy of skin tumors, an extended version of calposcopy and urethroscopy, histological and immunological studies.

How to treat anogenital warts?

If we talk about radical methods of getting rid of venereal warts, they are at the development stage. Moreover, all therapy refers to the elimination of manifestations - papillomas formed on the genitals. Today we can talk about the following methods by which the destruction of condylomas occurs:

1. The skin lesion is treated with Podofilin a large number of times. This drug is prescribed in 10-25% of cases of condylomas. The substance is made from the rhizome of podophilus thyroid and has the activity of damaging wart cells and inhibiting the development of papules. The cost of the drug varies between 500-800 rubles.
2. Applying ointments to the wart, such as Bonafton (price 90-110 rubles), Viferon (price 151-198 rubles), Condyloma ointment (from 100 rubles), Oxolinic ointment (from 53 rubles) in the form of applications.
3. Interferon injections (price starts from 92 rubles).

Important!!! You should not try to remove anogenital warts on your own, as you may end up with quite unpleasant consequences in the form of burns, scars, or repeated manifestations (relapse). It is necessary to follow the instructions of a dermatologist until the anogenital warts completely disappear. In this case, both sexual partners are treated to prevent re-infection.

Often, experts prescribe the use of trichloroacetic acid or bichloroacetic acid, which suggest a cure for venereal warts in 80-90% of cases. It is important to use such drugs with extreme caution, as there is a possibility of the formation of deep scars or ulcers.

Currently, it is recommended to use vaccination with the drug "Gardasil", which will serve as protection against damage by the papilloma virus, which causes the formation of genital warts. The price of the drug starts from 6695 rubles.

If we talk about the effectiveness of using drugs that will help increase immunity (immunomodulators) or antiviral drugs that are used to treat warts that occur in the genital area, this method has not yet been fully studied in the CIS. Although self-healing from genital warts is possible with a course of taking such drugs. But in world medical practice they are not mentioned as therapeutic measures to cure anogenital warts.

If you believe the forecasts presented by medical institutions, then despite the fact that the duration of treatment can be extended from a month to six months and a high percentage of relapses, a complete cure for anogenital warts is ultimately achieved.

Anogenital warts: removal

The need to remove anogenital warts arises when there is a danger, for example, during pregnancy or an increase in the number of venereal warts, their pain, change in size, color or bleeding. In this case, the following removal methods are recommended:

1. Cryotherapy - cauterization with liquid nitrogen. The doctor uses the end of a small clamp, which he dips into liquid nitrogen and then squeezes the papilloma for 10-15 seconds, freezing it. The procedure is repeated twice more for 1 condyloma, so the removal time reaches one minute. A whitish mark forms at the site of the wart, and after a few days the crust falls off. The price of the procedure for one skin nodule is 300 rubles. This method can also remove papilloma on the neck or other parts of the body.
2. Using a radio wave “knife”. This method has minimal contraindications and is less traumatic. When using the Surgitron device, electric current is converted into radio waves with a frequency of 3.8-4.0 MHz (high frequency). The surface of the wart is dissected due to the fact that heat is generated, as the skin tissue resists the penetration of such waves. The price of the procedure starts from 600 rubles.
3. Surgical intervention necessary for the development of genital warts when they take on large sizes. Local anesthesia is used. With such an excision, there is always a small capture of parts of healthy skin. After removing the wart, a cosmetic suture is placed on the wound, which is removed after a week. The price of surgical intervention starts from 350 rubles. This method is also used when it is necessary to remove age-related keratoma.

Prevention of venereal warts

In order to protect yourself from infection with an oncogenic virus, it is recommended to use intimate hygiene products specially designed for this purpose, which, for example, can be sprays. Such products have a whole range of capabilities: the ability to create a barrier to viruses, and also have an immunomodulatory effect, and have the ability to regenerate tissue. They will not only be an obstacle to the penetration of the human papillomavirus into the body, but will also be able to block the spread of endemicity into the vaginal cavity and the cervix. It is recommended to use such drugs intravaginally both before and after sexual intercourse. The spray is considered convenient, since it is sprayed by pressing the valve once or twice.

As for the use of protective equipment (condoms), they cannot in any way protect against HPV during intimate relationships, so it is important to have a regular sexual partner and in any case not be subject to casual relationships.

It is also possible to use special quadrivalent vaccines, which were mentioned above. Such drugs are produced on the basis of a protein that is part of the shell that characterizes the most common oncogenic papilloma viruses (types 6 and 11, 16 and 18). The immune system will perceive such a protein as a foreign body and trigger the production of antibodies that resist infection. However, this procedure will have an effect when it is performed on a girl in adolescence, before her sexual life begins.

In any case, both women and men must observe the rules of personal hygiene, promptly carry out adequate therapy for infectious and inflammatory diseases of the pelvic organs, it is recommended to give up smoking (including hookah) and excessive alcohol consumption, and eliminate factors that lead to is a decrease in immunity.

Video about methods of diagnosis and treatment of anogenital warts: