Genital warts in men and women - causes, symptoms, treatment. Why warts occur, methods for removing formations and principles of HPV treatment

Genital warts are a type of papilloma. But the favorite location of these neoplasms is the genital area, perianal fold, anus, rectum, urethra. It affects both women and men.

Itching, pain in the vagina and vulva. With sad thoughts, you run to the gynecologist and listen to the diagnosis of “genital warts”. And the thought is still gnawing that this was awarded by the beloved man. Although I did not notice signs of betrayal and any suspicious symptoms behind him. The cause of the infection seems impossible.

How are warts transmitted? What are the symptoms of the disease and is this pathology a sign of infidelity?

How long warts appear after infection in men and women will depend on general health. Virus activation can occur as a result of:

• weakening of the body's defense system;
• hormonal imbalance;
• the presence of chronic diseases;
• bad habits;
• lack of vitamins and minerals in the body;
• infection with STDs;
• congenital immunodeficiency;
• drug use;
• bad ecology.

Stressful situations, chronic fatigue can also trigger the manifestation of HPV. An irregular work schedule, lack of rest is a good help for the manifestation of human papillomavirus infection, which is much more difficult to cure than to acquire.

Is genital warts sexually transmitted?

If condylomas have arisen in the genital area, the methods of infection should be considered and differentiated precisely with sexual intercourse. In this case, you can become infected during:

1. Oral sex (often in this case, the virus will appear in the larynx, on the mucous epithelium of the oral cavity, affect the tonsils).
2. Vaginal intimate intercourse. With this route of transmission, the virus will provoke the growth of epithelial cells inside the vagina, on the cervix, clitoris in women, on the genitals, testicles in men.
3. If genital warts arose in the anus, infection in this case could occur during anal sex. Such growths can affect the epithelium of the rectum, intestines, be localized deep inside the body, or protrude from the anus with pineal formations.

How genital warts are transmitted by household

How is the virus transmitted in everyday life and is it possible? In fact, HPV does not live long in open space and quickly dies. However, in everyday life, where people closely communicate and use the same things, infection may well occur.

HPV particles that cause warts are found in biological secretions - blood, saliva, semen, vaginal mucus. They can be stored and transmitted via:

• towels;
• washcloth;
• bed sheets;
• cosmetics;
• underwear.

Genital warts: perinatal route of transmission and infection

If growths have arisen in a child, transmission and infection should be sought in an infected mother. In women during pregnancy, there is a change in hormonal levels and a decrease in the protective function of the body. These 2 factors contribute to the activation of the virus and its subsequent transmission to the fetus.

Self-healing from HPV in children can only occur if they have strong immunity and no congenital pathologies. In other cases, the virus can provoke the active growth of neoplasms in the mouth, eyes, and inside the throat. A dangerous phenomenon is the development of papillomatosis of the larynx, which is fraught with asphyxia, impaired swallowing functions and death. Women with warts in the genital area are advised to give birth by caesarean section.

transmission in a public place

If condylomas have arisen, methods of infection should be sought in the contact of a person or child with an infected person in a public place. In this case, infection can occur:

• at school;
• kindergarten;
• at work;
• in a swimming pool;
• on the beach, etc.

HPV is one of the most widespread viruses on the planet. It provokes the appearance of genital warts and papillomas on the skin. This problem worries many people, as neoplasms spoil the appearance and bring discomfort. The human papillomavirus is extremely hardy. It is able to remain active even in pools with antiseptics dissolved in water, as well as in baths and saunas. Its survivability and ease of transmission have led to a large-scale infestation of the population with this virus.

What is it

Condylomas are neoplasms of a characteristic type in the anogenital region, caused by the human papillomavirus. They come in 2 types: wide and pointed. Condylomas of the first type are considered a manifestation of secondary syphilis, have a wide base and are not very common. Formations of the second type are diagnosed much more often. They have a narrow stem and a pointed end. Condylomas are always localized in the genital area, sometimes inside them, less often in the mouth.

In the absence of adequate treatment, neoplasms can degenerate into precancer, and then into oncology. The tendency of a virus to transform depends on its type:

• HPV type 1 causes plantar warts, is safe;
• The 2nd and 4th type of HPV provokes simple warts, the level of oncogenicity is low;
• HPV types 3 and 10 cause flat warts, have a low risk of cancerous transformation;
• The 16th, 18th, 31st, 33rd, 35th HPV type provokes dysplasia of the uterine epithelium, the level of okonogenicity is high;
• HPV types 6 and 11 cause condylomatosis, a low risk of cancerous transformation.

Neoplasms have different sizes - from 2 mm to 10 cm. They tend to merge into arrays. Such groups of genital warts resemble a cockscomb. The virus is found in human skin, but does not penetrate into the blood and internal organs.

Where to look on the body

To understand that a partner is infected with condylomatosis, it is necessary to know the places of typical localization of neoplasms. The presence of outgrowths in other parts of the body and a different species does not indicate the presence of HPV.

Genital warts are transmitted through the mucous membranes of the genital organs, less often the oral cavity.

This is related to the places of their typical localization:

• On the head and crown of the penis, frenulum and inner part of the foreskin in men;
• On the clitoris and in the area of ​​its hood, external and internal labia, on the eve and on the walls of the vagina, urethra and urethra; on the hymen and cervix in women;
• In the perineum, around the anus, and inside the rectum in both sexes.

The place of appearance of genital warts is usually directly related to the form of transmission. But sometimes the virus spreads itself throughout the body, and foci occur in non-contact zones.

There are several forms of genital warts:

1. Exophytic (external) - common, formations are found in places of typical localization, as well as on the conjunctiva of the eyes, in the oral cavity, on the epithelium of the upper respiratory tract and esophagus;
2. Endophytic (internal) - less common, has several subspecies: inverting, flat and atypical. Flat ones are located in the inner layers of the mucosal epithelium, so they are difficult to see with the naked eye. Places of typical localization are the vagina, cervix. Every second flat condyloma is complicated by epithelial dysplasia of varying degrees, every twentieth - by preinvasive carcinoma.

The exophytic form is not prone to cancerous degeneration, unlike the endophytic form. But it also needs treatment, as it spoils the aesthetic appearance and creates psychological and sometimes physical discomfort.

How infection occurs

Contrary to popular belief, the virus is not transmitted through body fluids: saliva, blood, semen. The causative agent is localized only in the skin and on the mucous membranes, penetrating into the inner layers, but does not circulate throughout the body.

HPV is transmitted through injured areas of the mucous membranes and skin, as well as at the junction of two types of epithelial tissue: cylindrical and squamous multilayered. The easiest way for the pathogen to penetrate and multiply in a weakened body.

In the presence of good immunity, infection will not occur. If the virus still manages to penetrate the body, it will not be allowed to multiply by special cells - lymphocytes. They are responsible for fighting microorganisms by destroying them. To do this, immune cells produce specific antibodies.

The risk of infection increases in proportion to the number of partners. However, in most women, infection occurs with the first man. The use of a condom to protect against the virus is not always rational. This reduces the risk of infection, but does not eliminate it. The pores of the condom are too large and the virus is too small for it to pass through. Warts are often located in places not covered by the condom. In this case, getting infected with HPV is easy and with a condom.

With the disappearance of raising immunity to a normal level, the manifestations of the disease disappear on their own. This usually occurs 1-2 years after the onset of the disease. If this did not happen, there is reason to suspect the degeneration of neoplasms into precancer.

household way

It does not occur too often, since it requires the presence of several causal factors at once. This is a very low immunity, microtrauma and a virus that has survived in the external environment. Manifestations of the disease can occur from 2-3 weeks after infection to 2-3 years. In some people, the virus never becomes active. They learn about the infection after testing before planning a child, at the request of a partner or for preventive purposes.

During pregnancy, women are prescribed diagnostics for HPV with a high level of oncogenicity. This is done to prevent infection of the child from the mother during childbirth. Every second of the children from infected parents is considered a carrier of HPV. During household contacts, often one child transmits the pathogen to another on personal items that children share with each other.

The virus is able to survive in the external environment even in the conditions of a bath, sauna, swimming pool and public shower gym, despite the sanitization of these premises. Therefore, in such establishments, you should never touch anything with open areas of the body. This is especially true of public toilets and toilet bowls in them.

For HPV, autoinoculation (self-infection) is relevant. This happens during epilation or shaving when the skin is accidentally injured. If there are microtraumas in the mouth of one partner and neoplasms in the other, it is possible to transmit the pathogen through a kiss. But it is worth remembering that condylomas are contagious only in the presence of skin manifestations. In an inactive state, HPV is not transmitted through saliva and blood.

sexually transmitted infection

The most common way to get condylomatosis is to change sexual partners frequently. The probability of transmission of the pathogen during sex exceeds 50%. This is due to good conditions for its reproduction in the genital area:

• It's always warm there;
• These places are regularly moistened;
• Friction occurs due to linen, clothing and sexual contact;
• The skin and mucous membranes are often injured.

It is possible to infect a partner with condylomatosis during any type of sexual contact: oral, anal, genital. The absence of external manifestations does not indicate the safety of sex, since some types of genital warts are located inside and are not visible to the naked eye.

The place of localization of manifestations in most cases depends on which part of the body the healthy partner came into contact with the infected. If the virus is transmitted during anal sex, warts will occur in the anus and inside the rectum. During traditional sexual intercourse, the skin and mucous membranes of the penis and vagina are affected. With oral contact, condylomas are able to move to the partner's oral mucosa.

Regardless of the route of transmission, condylomatosis requires treatment. The sooner it starts, the less consequences for the body will occur in the infected. Along with the fight against neoplasms, one should increase immunity and protect oneself from the influence of provoking factors.

Condylomas are papillomatous (warty) formations with predominant localization on the genitals (skin or mucous membranes) and / or in the anus, caused by the human papillomavirus and characterized by a chronic course with relapses and a high degree of contagiousness.

Relevance of the topic

The trend towards a significant increase in morbidity due to papillomavirus infection is a cause of concern (especially about the development of warts) of clinicians of various profiles - dermatologists, obstetrician-gynecologists, urologists.

Why are warts dangerous?

The social significance and relevance of this problem are associated with the wide spread, steady increase in the number of diseases and, most importantly, the ability of these formations to transform into cancerous tumors. Almost all cases of cervical cancer and half of other malignant tumors of the anal (anus) and genital areas, as well as a number of malignant neoplasms on the skin, in the prostate and mucous membranes of the upper respiratory tract (squamous cell carcinoma of the larynx) are caused by human papillomavirus infection.

Over the past ten years, the number of infected people has increased 10 times worldwide. The results of various studies indicate that up to 82% of women are infected within two years after the onset of sexual activity, as well as about 80% of the entire sexually active population, among which there may be persons with and without obvious clinical manifestations of infection. Often, the treatment of genital warts is ineffective due to the recurrent nature of the disease and frequent cases of re-infection due to the high prevalence of this pathology.

The annual increase in HPV infection in the United States is about 5-6 million people. The prevalence here is on average 100 people per 100 thousand of the population, in Germany - about 450 people, in Russia - 30-35, and in some regions (St. Petersburg, Moscow and the Moscow Region) this figure reaches 120-165 people per 100 thousand population. However, even these figures do not fully reflect the true infection of the population with the human papillomavirus.

Due to the fact that the clinical manifestations of human papillomavirus infection tend to self-regress, its prevalence among people over the age of 25-30 years is reduced, but at the same time, the frequency of dysplasia and cervical cancer increases significantly, the maximum number of cases of which is noted among persons 45 years of age.

Etiology and pathogenesis of the disease

Causes

The causative agents are various types (at least 35) of DNA-containing viruses that are part of the papillomavirus family under the general name "human papillomavirus" (HPV). Often, one person has not one, but a combination of several types of pathogen.

The type of pathological process, its symptoms, localization, and the degree of oncological danger depend on the strain (type) of the pathogen. Human papillomavirus is divided into strains of skin and mucous membranes, with a high, medium and low risk of cancer, which can cause both malignant and benign tumors.

The most common of them are the 16th and 18th strains that cause warts on the labia with degeneration into cancer, malignant tumors of the penis, dysplasia and cancer of the mucous membrane of the vagina and cervix, rectum, larynx. The clinical manifestation of a long-term infection of types 6 and 11, related to viruses with a low oncogenic risk, are anal and genital warts.

The maximum number of diseases occurs at a young age (17-25 years), presumably due to the peak of sexual activity and the high susceptibility of the epithelial tissues of the genital organs. Condylomas in men and women occur with approximately the same frequency.

The mechanism of development of pathology

The incubation period can last from several months to several years (about eight months on average). The disease can also occur subclinically, without obvious manifestations.

The virus penetrates into the growing cells of the epithelium of the basal layer of the skin or mucous membranes through microscopic damage caused by mechanical means, bacterial infection, inflammation, etc.

Undifferentiated cells of the basal layer of the skin and mucous membranes in the process of their maturation, differentiation and movement to the overlying layers carry a persistent virus and, thus, are a source of infection with an infection that is constantly present in the epithelial cells of the upper layer.

In addition, there is a violation of the normal process of transformation of epidermal cells into cells of the surface layer of the epithelium of the skin, especially in the spinous layer, since the process of differentiation is controlled by the genes of the HPV inhabited in them. As a result, deformation zones appear, in which the skin deep layer grows and the skin area thickens due to the keratinized layer. These uneven growths, which take the form of warts, are condylomas.

Cytological examination of smears taken from the surface layer of the epithelium reveals virus-infected cells, which, in comparison with normal ones, are smaller and have a light rim surrounding the cell nucleus. Therefore, they appear empty, hence their name - "koilocytes".

Koilocytes are a specific sign of human papillomavirus infection. With a benign course of the process of koilocytes, there are few, up to single ones, an increase in nuclei in them is absent or insignificant. In the case of transformation into a tumor-like formation, these cells are determined in the upper 1/3 of the epithelial layer, and often in the form of widespread foci.

Mature viral particles do not enter the bloodstream and do not spread to other organs. They actively gather in the surface layer of the epithelium and are released when cells are destroyed on the surface of the skin or mucous membranes, as a result of which the latter become potentially dangerous in terms of infection.

How are warts transmitted?

The main risk factor for contracting papillomavirus infection for children under 12 years of age is contact with infected parents, at the age of 13-17 years, the main route of infection is sexual, and the main risk factor is early onset of sexual activity.

Infection to a healthy person is transmitted by close proximity to infected mucous membranes or skin of an infected partner. The main route of infection among adults is sexual, and protection with condoms is ineffective. The probability of infection in case of contact with an infected sexual partner is 70%. Therefore, HPV refers to infections that are predominantly transmitted sexually. Competing with genital herpes, it occurs 3 times more often than the latter.

The causative agent may also be present in the saliva and urine of an infected person. It is not excluded the possibility of its transmission during kisses and household (extremely rare!) way - in the bath, bathroom, through shared towels or underwear, etc.

The mechanism of infection and the localization of pathological elements largely depend on the type of sexual contact. During oral sex, condylomas occur in the mouth, in particular on the tongue, as well as in the esophagus, on the mucous membranes of the larynx and even the trachea. During vaginal sex, they develop on the skin of the external genitalia and on the mucous membrane of the vagina and cervix, urethra, and can spread to the skin around the anus. But initially, perianal warts occur mainly during anal sex.

An infectious agent, as a rule (but not always), causes a disease against the background of a decrease in general and local immunity and is almost always combined with other types of sexually transmitted infections, including syphilis. The main risk factors are:

• early onset of sexual activity;
• young age;
• frequent sexual intercourse with different partners;
• sexual intercourse with persons who have or had a history of diseases caused by HPV, as well as other sexual infections (herpes, trichomoniasis, chlamydia, candidiasis, etc.);
• pregnancy;
• violation of the vaginal microflora;
• endometriosis;
• autoimmune connective tissue diseases and the associated intake of glucocorticoid drugs, treatment with cytostatics, diabetes mellitus, hypothyroidism, hypovitaminosis, obesity;
• the presence of somatic pathology and frequent respiratory viral diseases.

Clinical picture

In accordance with the clinical and histological classification of human papillomavirus infection, the clinical manifestations of the latter are:

1. Skin papillomas.
2. Condylomas (must be distinguished from those in secondary syphilis and skin papillomas).
3. Papillomatosis of the larynx.

Skin papillomas

The cause of skin papillomas, or warts, is also one of the strains of HPV. The clinical difference between condyloma and papilloma is due to different types of human papillomavirus. There are simple (vulgar), subungual, mosaic, plantar, flat and other types of these formations. The most common form is vulgar papillomas, which are single or multiple dense elements with clearly defined boundaries and ranging in size from 1-2 mm to 10 mm. Often there are skin papillomas of larger sizes ("maternal"), surrounded by "daughter" elements of smaller sizes.

The surface of the warts has a yellowish-gray color and is covered with cracks formed by layers of horny epithelium plates. A characteristic feature is brownish-black dots on the surface, resulting from the formation of blood clots in their capillaries. They are especially visible when viewing warts under a magnifying glass.

warts

Conventionally, the following forms and types are distinguished:

1. Exophytic form (growing outward), represented by genital warts.
2. Endophytic, or subclinical - the elements grow mainly inside the tissue and almost do not manifest themselves.
3. Giant condyloma of Bushke-Levenshtein, or Buschke-Levenshtein tumor.

Genital warts

They have a shape corresponding to the name and are fibroepithelial formations of flesh or pink color on the skin surface or on the surface of the mucous membranes. They have a thin stem or (much less often) a wide base. On the skin, their surface is covered with stratified squamous epithelium, usually with hard (rarely soft) keratinization. In the latter case, they have an outward resemblance to papilloma.

Elements can be in the form of single or multiple dotted (up to 1 mm) nodules. Outgrowths up to 10-15 mm or more are often formed. If they are multiple, they merge and resemble a cockscomb or cauliflower inflorescences. These formations are the most characteristic clinical manifestations of HPV. Because of the specific localization, they are also called genital.

Condylomas in women occur mainly in areas with the maximum possible maceration of the surface - this is the clitoris, small and large labia, the area of ​​\u200b\u200bthe entrance to the vagina and the mucous membrane of the lower 1/3 of the vagina, the region of the anus and the external opening of the urethra. In half of the women with lesions of these departments, the formations are detected in the form of whitish elements on the cervix. Here they are especially clearly visible during colposcopy after treatment of this area with a 5% solution of acetic acid.

Genital warts in men are localized on the scrotum and in any part of the penis - on its head, body, in the region of the frenulum of the foreskin and on its inner surface, in the region of the coronal sulcus, directly at the external opening of the urethra, where they usually have a bright red color, and only 0.5-5% - on the mucous membrane of the urethra.

During anal sex with an infected partner or friction of healthy skin areas with affected condylomas, they spread to the perianal region, to the mucous membrane of the rectum close to the anus, to the perineum and inguinal folds, and even to the skin of the upper inner thighs next to the inguinal folds.

The anus and perineum are more often affected in women, and the urethra in men, which is associated with some differences in the characteristics of sexual behavior. Pathological elements, if they are single, can only be a cosmetic defect and not manifest themselves as subjective sensations. Sometimes they can be brittle and bleed.

However, large growths are able to macerate, resulting in bleeding, weeping, secondary infection, unpleasant odor, itching and burning, a feeling of soreness, irritation, especially when touched. In addition, warts can limit the entrance to the vagina, anus and the diameter of the external opening of the urethra, cause pain and burning during urination and defecation.

Unpleasant feeling and pain during intercourse in 13% are the reason for the complete rejection of sexual intercourse. They often lead not only to psychological discomfort, but also to severe neuropsychiatric disorders, the only adequate treatment for which can only be the radical removal of warts in intimate places and in the genital tract.

Differentiated diagnosis of genital warts

Of great importance is the differential diagnosis of these skin formations with the help of additional studies such as polymerase chain reaction (determination of the DNA of the pathogen), the study of smears and histological examination of tissue biopsy from the focus. In some cases, only on the basis of the results of these studies, it is possible to conduct a differential diagnosis and make a final decision on how to get rid of warts of anogenital localization.

This is due to the fact that they visually and in manifestations have much in common with skin papillomas, and, more importantly, with skin malignant neoplasms. In many ways, they are very similar even to such a manifestation of the second stage of syphilis as wide warts that occur in every 5-10 patients, and more often in women. Their localization and external resemblance to cauliflower inflorescences are identical to pointed formations caused by HPV.

The main differences between syphilitic elements:

• in addition to the anogenital region, they can be localized on the skin under the mammary glands, in the armpits, in the folds between the toes, in the navel;
• at first, small dense bluish-red rounded nodular rashes appear on a short and wide base, in contrast to genital warts, the base of which is long and thin;
• when pressing on the nodules, serous fluid is released from syphilitic elements;
• individual elements then increase and merge with each other, forming conglomerates of red color with a purple or bluish tint and an ulcerated weeping surface covered with a whitish coating;
• on the surface of individual weeping elements and "inflorescences" contains a large number of pale treponemas (the causative agent of syphilis), detected in smears or histological examination of tissue biopsy.

Endophytic warts

Elements can be:

• flat;
• inverted;
• atypical.

They are usually located in the mucous membranes.

Flat condyloma has clear contours, but, as a rule, is not visually determined, since it is located in the thickness of the epithelial layer and does not rise above its level. When analyzing a smear or histological examination, a large number of koilocytes are found on their surface.

inverted form differs from the flat one in that pathological elements are capable of false ingrowth into the underlying tissues and into the opening of the excretory ducts of the glands of the mucous membrane of the cervix. Both forms are similar and often combined. With colposcopy, their capillary network is not determined, but dilated vessels can be seen in the form of red dots.

Atypical formations often detected during colposcopy in the form of small, without clear contours, spike-like elevations above the surface of the mucous membranes of the vagina and / or cervix, which is why their surface has a speckled appearance.

Giant condyloma of Buschke-Levenshtein

It is a rare pathology that can be caused by 1, 16, 18 or 33 strains of the virus, but mainly by 6 or 11 types of HPV. The usual localization is the anogenital region, especially the areas of the glans penis, scrotum and anus, very rarely - the skin of the inguinal regions and face, mucous membranes, including the oral cavity.

The disease begins simultaneously in several areas with the appearance of nodules, similar to papillomas or genital warts, which rapidly increase in size and merge with each other. Clinically, the disease manifests itself as a giant exophytic fast-growing formation, consisting of many growths (vegetations) in the form of cauliflower. It is accompanied mainly by pelvic pain, burning, itching, bloody discharge and bleeding from the vegetation of the tumor formation and an unpleasant odor, as well as a violation of the act of defecation (with appropriate localization). Satellite elements appear around it.

The tumor continues to grow, growing into the underlying deeper tissues and causing their destruction. It is characterized by a high tendency to relapse, capable of transforming into squamous cell carcinoma without a tendency to metastasize.

1. Genital warts
2. Giant condyloma Buschke-Levenshtein

Features in pregnant women

Anogenital condylomas during pregnancy, especially in combination with genitourinary infections, pose a high risk of preterm birth (in more than half of pregnant women), the development of fetoplacental insufficiency in the fetus and its infection at birth, complications during childbirth and the postpartum period.

The causative agents of the disease in pregnant women are the 6th (on average in 35%) and 11th (in 31%) types. A frequent combination of the 6th and 11th, 16th and 18th, 31st and 33rd papilloma virus strains was revealed. In addition, HPV is most often combined with fungi (about 57%) and gardnerella (59%), less often with herpes simplex virus, ureaplasma and chlamydial infection, bacterial vaginitis and vaginal candidiasis.

In the presence of skin anogenital formations, individual foci of the disease are detected on the mucous membranes of the vagina and cervix, as well as intraepithelial dysplastic changes of the last varying severity. Moreover, characteristic of pregnant women is the progression of the process with an increase in the size and number of genital warts, as well as their frequent recurrence.

How to treat warts

The goal of treatment is:

• elimination of cosmetic defects;
• normalization of the physical and mental state of the patient;
• prevention of complications, including malignancy;
• reducing the risk of infection to others.

The choice of treatment methods depends on the nature of the process, the morphological structure of pathological elements, their size, quantity and location, and the age of the patient. Traditional methods of treatment are aimed only at eliminating the clinical manifestations of human papillomavirus infection and have a temporary effect. They are not able to stop the expression of the pathogen in the cells of the surrounding tissues and ensure its elimination from the body.

Modern methods of therapy, aimed not only at removing genital warts, but also at preventing relapses, are conditionally combined into 4 large groups:

1. Destructive techniques, the general meaning of which is that the removal or cauterization of warts is carried out by a physical or chemical method, that is, the destruction of their structure.
2. Cytotoxic agents.
3. Antiviral and immunomodulatory therapy.
4. Combined therapy.

Destructive Methods

The result of their application is only the elimination of external clinical manifestations of PVI. Physical methods include:

• Surgical removal of genital warts by excision with a scalpel. This method is currently used mainly in case of suspicion of the possibility of malignancy, sometimes for stab conization of the cervix and for the removal of single formations. Excision of their growths is associated with profuse bleeding and a long rehabilitation period in a hospital.
• Removal of genital warts by electrocoagulation- the technique is the elimination of formation by means of electrothermal destruction of tissue proteins, that is, cauterization of tissues by electric current using an electrosurgical apparatus for diathermoelectrocoagulation. This method, available in economic terms, does not require special training. However, with average efficiency, it has a number of negative properties - a high degree of trauma, a high risk of bleeding and infection, a long period of healing of the burn surface with frequent formation of rough post-burn scars.
  In addition, during electrocoagulation on the mucous membrane of the cervix or near the external opening of the urethra, there are risks of developing cicatricial narrowing of the cervical canal, cervical deformity, and cicatricial stricture of the urethra. This method excludes the possibility of subsequent histological examination. Currently, it is used mainly to remove single pathological elements.
• Removal of genital warts with liquid nitrogen, or cryodestruction - the most common method, the meaning of which is the destruction of pathological tissues as a result of exposure to very low temperatures. The procedure consists in treating genital warts with liquid nitrogen by spraying it or lubricating it with a cotton swab.
  Disadvantages of the method: the need to repeat the procedures, which takes a long time, insufficiently deep penetration and the lack of the possibility of its control, the impossibility of conducting a histological examination. In addition, it is not possible to simultaneously treat all the necessary pathological areas. Scars after cryodestruction, as a rule, do not form, but subsequent hyper- or hypopigmentation cannot be excluded.
• Removal of warts by radio waves, or radiosurgical method (radio knife) using a compact device "Surgitron". The method has a number of advantages. The main ones are the absence of trauma to the border tissues, the possibility of quick, painless excision of the pathological tissue area with high accuracy and simultaneous coagulation of the vessels. All this makes it possible to avoid bleeding, maintain a good visual overview of the surgical field, and subject the removed pathological tissue site to histological examination. In addition, the period of wound healing is quite short and usually proceeds without any complications. The main drawback of the method, which is associated with its limited use, is the high cost of the Surgitron apparatus.
• Laser removal of genital warts carried out using a neodymium carbon dioxide laser. This method, like the radio wave method, allows excising warts with high accuracy, at the required depth and, practically, without damaging the surrounding tissues, without bleeding. It can be used to eliminate both single and confluent genital warts and flat warts. If there is a large area of ​​damage or a large number of foci, the procedure can be repeated. As in the case with the use of the "radio knife", there is a rapid healing without complications and scarring. However, despite the fact that laser wart removal has been used for a long time, the use of this method is quite limited by the high cost of equipment and the need for special training of experienced medical personnel.

The method of chemical destruction is mainly used to remove genital warts in intimate places, if these formations are solitary and small in size. Their use is especially indicated in cases where it is impossible to use methods of physical destruction and drugs with a cytotoxic effect.

Chemical cauterization

Preparations for chemical cauterization cause necrosis and destruction of the pathological formation and mainly consist of a mixture of acids of organic and inorganic origin. To remove genital warts on the skin, Solcoderm is widely used, and flat formations on the mucous membranes of the vagina and cervix - Solkovagin. The components of the first drug are nitric, acetic and lactic acids, oxalic acid dihydrate and copper nitrate trihydrate. Solkovagin includes nitric, acetic and oxalic acids, but in a lower concentration, and zinc nitrate hexahydrate.

ethnoscience

Some traditional medicines also have a certain therapeutic effect. These are mainly juices, infusions and tinctures of plants, juices and pulp of fruits, spices containing natural plant acids and other components that destroy condyloma tissue during prolonged exposure, as well as phytoncides, which are supposed to suppress the reproduction of the virus. Such folk remedies are the juices of sour apples and pineapples, the pulp of garlic and kolanchoe. The juice of celandine and, somewhat less, its alcohol tincture have a particularly pronounced effect.

However, treatment with remedies recommended by traditional medicine is sometimes effective only for small formations, requires long-term use and has a very subtle effect. In addition, treatment with traditional medicine is a risk, due to the impossibility of self-timely diagnosis of malignant transformation and the difference between condylomas caused by HPV and syphilitic ones.

Cytotoxic drugs

These include a solution and ointment for genital warts (cream) "Vartek", "Kondilin", "Kondiline Nycomed". Their active ingredient is podophyllotoxin, which, in turn, is the most active component of podophyllin isolated from the roots and rhizomes of the perennial herbaceous plant podophyllum thyroid.

The drugs are produced in different concentrations, have cauterizing and mummifying effects and cause tissue necrosis. One of the advantages of podophyllin derivatives is its safety and the possibility of independent use at home.

Also, a 5-fluorouracil 5% ointment for genital warts (cream) has a cytotoxic effect, the active component of which is capable of disrupting the synthesis of cellular and viral DNA. However, despite the high efficiency and affordability of the drug, its widespread use is limited due to the frequent occurrence of side effects.

Antiviral and immunomodulatory therapy

In order to suppress HPV, antiviral and immunomodulatory therapy is used with drugs such as Oxolinic ointment, Acyclovir, Panavir, Ganciclovir, Viferon, Intron-A, Reaferon, Realdiron and others.

Most studies have shown very little or no efficacy for topical monotherapy and unpredictability for systemic use. At the same time, their introduction directly into the lesions often leads to pronounced positive results. Enough powerful and broad effect of action are immunomodulators Isoprinosine (tablets for oral administration) and Imiquimod cream.

The appointment of immunomodulatory drugs is advisable 10 days before and some time after the use of destructive removal of formations.

The disadvantages of all methods of therapy are the high frequency of recurrence of PV infection, the need for multiple repetitions of treatment procedures, as well as local negative skin reactions. The most effective is the combined treatment. The correct choice of therapy for pregnant women is especially important.

Principles of management of pregnant women

They consist in:

• the beginning of treatment from the very moment of diagnosis;
• conducting colposcopic, cytological and other studies, due to the high frequency of association of HPV with other sexually transmitted infections;
• mandatory inclusion in the plan of counseling, examination and treatment of the husband or partner.

Small and medium-sized anogenital warts in pregnant women are removed at the beginning of the first trimester by chemical destruction (Solcoderm) with a weekly interval between procedures. Preliminary it is necessary to carry out vaginal sanitation.

Large and confluent formations are excised by the radio wave method at the beginning of the second trimester in combination with antiviral and immunomodulatory therapy. For these purposes, it is possible to use the drug, for example, "Genferon Light" in vaginal suppositories - 2 times a day for 250 thousand units for 10 days. It is prescribed after the 13th, at the 24th week of pregnancy and immediately before childbirth. Before the excision of genital warts at the end of the first trimester, the vagina is sanitized and treatment (if necessary) of the urogenital infection.

Common small condylomas in the vestibule and / and in the vagina itself in pregnant women cannot be removed. All that is needed is antiviral therapy and immunomodulation, treatment of urogenital infection and vaginal sanitation.

Timely detection and combined treatment of genital warts can significantly reduce the likelihood of their recurrence and transformation into a malignant neoplasm.

Condylomas on the genitals look unpleasant. In addition, their presence indicates an increased risk of oncological diseases of the genital organs.

In the presence of HPV (papillomavirus), the risk of cervical cancer increases 300 times. Only 3% of women who are diagnosed with this cancer do not have papillomavirus. Therefore, it is not surprising that most people seek to protect themselves from this infection. But is it possible? Let's talk about whether warts are transmitted, and in what ways the papillomavirus spreads in the population.

How is HPV transmitted?

In the vast majority of cases, papillomavirus is transmitted through sexual contact. This is a highly contagious infection. The risk of infection during one sexual contact is on average 60-65%. The likelihood of a woman having this infection depends on the number of sexual partners. If he is alone, she has a 20% chance of being diagnosed with HPV.

In the presence of 5 sexual partners, the risk of human papillomavirus infection reaches 80%. This disease is one of the most common in the population. HPV is detected in 40-50% of sexually active men and women.

Are warts transmitted during anal sex?

Surely you want to know if genital warts are transmitted during rimming or anal sex. Yes, HPV is spread this way. Moreover, it can increase the risk of developing rectal cancer.

Are condylomas transmitted through a condom?

A condom does not protect against HPV 100%.

Because the virus is not always localized on the head of the penis, which is covered with latex. But the use of a condom reduces the risk of transmission of infection with a single sexual contact. In addition, it protects against many other sexually transmitted diseases, which is important if you often change partners.

Are warts transmitted by kissing?

There is currently no conclusive evidence that papillomavirus is spread through kissing. Therefore, it is impossible to say for sure whether genital warts are transmitted from a man to a woman in this way. It is very difficult to detect this. Because the incubation period of human papillomavirus infection is quite long. It lasts at least three months, and sometimes several years.

Therefore, it is extremely difficult to establish the time of infection and the source of infection. But in studies of scrapings of the epithelium of the oral mucosa, HPV is often detected.

Warts may develop in the mouth. Formations of the corresponding localization of HPV types 6, 11 and 16 are caused.

Are genital warts transmitted through oral sex?

The answer to this question is similar to the previous one. It has been established that at least three types of human papillomavirus infection can live in the oral cavity. The relationship between laryngeal cancer and papillomavirus has been proven.

Accordingly, theoretical reasoning pushes us to a positive answer. Warts can be transmitted through oral sex. Because the same types of HPV that are found in the mouth can also “take root” in the reproductive system.

Is HIV transmitted by warts?

HIV with warts is transmitted in the same way as without them. The presence of benign growths on the genitals does not affect the risk of transmission of the immunodeficiency virus.

On the other hand, the presence of genital warts often indicates either a violent sexual life or reduced immunity. Therefore, statistically, the frequency of HIV detection among people with genital warts is higher than in other patients.

Is HPV transmitted if there are no genital warts

By themselves, warts are just growths on the skin. The disease is caused by a virus. Sometimes warts remain, but HPV has already been cured. In such cases, the pathology is not transmitted. But there are also reverse situations when there are no genital warts yet or they have been removed, and the virus is present in the body.

In this case, the person is infected. You should also not forget that warts can be hidden from your view. Because they are sometimes located inside the genitals.

Are genital warts transmitted by household

HPV is transmitted by household means. And, very often. But this requires close contacts. These occur most often between spouses. But there is almost always an intimate connection between them. Therefore, in practice, HPV is most often transmitted through sex.

Are warts transmitted after treatment

Warts are transmitted if the human papillomavirus is present in the body. Accordingly, if the virus was destroyed during therapy, which is confirmed by laboratory tests, the person becomes non-infectious. If the treatment was ineffective, then the patient can still spread the infection in the population. Treatment failure is not uncommon.

Because there is no specific treatment against papillomavirus. Immunomodulatory therapy is used to reduce the viral load.

But it does not give a 100% guarantee of results. In any case, after treatment, the risk of transmission of infection is reduced. Because even if the virus is not completely eliminated from the body, its amount decreases.

Are warts transmitted in medical institutions

Often, patients are interested in whether warts are transmitted through blood transfusions or other invasive procedures. This mode of transmission for HPV is uncharacteristic. You can catch the virus in a medical facility only if you have unprotected sex in the ward. But since doctors usually do not allow this, the risk of contracting HPV in the hospital is minimal.

Are warts transmitted during pregnancy?

Another question that interests mainly women is whether warts are transmitted during childbirth or during pregnancy. The virus is spread by contact.

When passing through the birth canal, the child comes into contact with the genitals of the mother. Accordingly, he can become infected. But during pregnancy, the infection usually does not affect the fetus. It does not spread through the placenta.

Can warts be transmitted by HPV vaccination?

Condylomas are transmitted after vaccination.

There are two reasons for that:

• Vaccination does not protect against infection with a 100% guarantee for the rest of your life, but only several times reduces the risk of infection.
• Only 2 or 5 types of HPV are vaccinated, but there are dozens of other types for which there is no vaccine.

Another thing is that vaccination is carried out against the most dangerous types of papillomavirus - those that cause 97% of cases of cervical cancer. Therefore, vaccination is a good way to protect against HPV.

Are condylomas transmitted when a person has just become infected?

“For a long time” and “recently” are vague, non-specific concepts. And medicine is an inexact science. Of course, if you contracted papillomavirus three days ago, then you cannot pass the infection on to another person. At the same time, there is no exact timeline for when the infection will begin to spread. It is impossible to say that 30 days after infection, a person is not contagious, but on 31 days begins to spread HPV among sexual partners.

The risk of transmission of infection depends on many factors, including the age of infection. Because the more time has passed, the greater the viral load on the body. The chances of transmission are increasing. But even in the first weeks after infection, the risk of infection of partners may be present. It's just lower than at the stage when condylomas appear on the genitals.

When warts appear, contact competent dermatovenereologists.

Instruction

The human papillomavirus is transmitted mainly through sexual contact. You can also become infected with it when using personal hygiene products, household items of the patient. Currently, according to international medical statistics in the world, every second person can be infected with HPV. The human papillomavirus appears in the body for the following reasons: frequent change of partners, early sexual life, beriberi, decreased immunity, stress, violation of the microflora of the genital organs, sex with a partner who had previously been in contact with a woman with cervical cancer, with a woman who is a carrier papillomavirus. People with minimal stress tolerance are at risk because they have a weakened immune system. The incubation period of the disease can last from 1 month. up to several years.

Condylomas usually begin to appear in the genital area, on the mucous membranes. They look like warty formations, growths that have a flesh or pink color. Their size can vary from 1 mm to 2 cm. Condyloma can grow, in which case it will look like a cauliflower. These growths on the skin can cause itching, burning, and bleeding. Condylomas are diagnosed at a routine examination. In growths appear on the head of the penis, the crown of the head. In women, small and large labia, cervix, urethra are affected. With condyloma, it is recommended to take a test for sexually transmitted diseases (chlamydia, trichomoniasis, ureaplasmosis, etc.), because, once in the body, the virus exacerbates existing diseases and complicates their course. In men, warts can provoke the development of a precancerous condition.

Usually warts are benign formations, but in some cases they can transform into carcinoma. Warts cannot disappear on their own, they are recommended to be removed regardless of the location, shape and size. Only in these cases can doctors guarantee cancer prevention. Condylomas are removed using a laser, cryodestruction, electrocoagulation methods. Cryodestruction consists in burning out growths with liquid nitrogen, it does not require anesthesia, after the procedure there are almost no traces on the skin. Electrocoagulation is the removal of genital warts with high-frequency current. The procedure takes place under local anesthesia, scars may form on the skin. Removal of genital warts with a laser occurs quite quickly, the procedure requires anesthesia, scarring is possible.

Warts are formations on the skin that can be recognized by the characteristic shape and texture of the "cauliflower". The appearance of about 90% of warts is caused by the papillomavirus. This virus is highly contagious, and almost half of the world's sexually active population is a carrier.

You will need

• - medical specialist (gynecologist, urologist, dermatologist or andrologist).

Instruction

Condylomas are transmitted mainly through sexual contact, the condom does not protect at all from the transmission of the papillomavirus. Condylomas are located on the genitals and perianal zone. In women, neoplasms appear on the walls of the vagina, labia minora, cervix and its canal. In men, warts affect the urethra, glans penis, and foreskin.

Human papillomavirus (HPV) infection is the most common sexually transmitted disease (STD). This disease is very dangerous, since genital warts can transform into malignant neoplasms.

The papilloma virus is transmitted through the mucous membranes and skin of a person; it may not manifest itself in any way for several months, or even years. But papillomavirus infection can be activated with a decrease in immunity. As a result, viruses begin to multiply rapidly, normal division processes are disrupted, and genital warts appear.

Infection with HPV occurs not only through sexual contact, the virus can be obtained through hygiene items - a toilet lid, a comb, a towel, and so on. Children can become infected when using a common pot, and newborns - when passing through the birth canal.

3 months after the penetration of HPV into the body, warts may already appear. But if in the case of men it is not particularly difficult to detect them, then women may not notice these neoplasms for quite some time. If warts are located in the vagina, they can cause pain during intercourse and spotting. This should alert you and serve as a reason for contacting a gynecologist.