Condylomas: causes, diagnostics and treatment


Human papilloma virus is the second most spread infection in the world after herpes. There are over 100 types of the virus and only 80 of them are studied. HPV causes many diseases especially in women but men are also affected.

HPV may be responsible for the occurrence of:

  • warts;
  • papillomas;
  • pointed condylomas;
  • benign viral oncology (with time it transforms into cancer).

In some cases a person may be a virus carrier without any symptoms of the disorder. He or she infects other people but he is never sick himself.

What causes condylomas?

Sexual route of transmission is the major cause of infection. Both vaginal and oral intercourse pose a risk. Most often infection develops as a result of anal sex due to the anal mucous injuries.

Unlike other sexually transmitted diseases, condoms and other preventive methods are not effective with condylomas and papillomas as they affect not only the genitals but the area around them.

There is a high risk of infecting a baby during delivery. Transplacental route of transmission is very dangerous as the disease is manifested in the respiratory tract.

Blood transfusion and instruments of the dentist and cosmetologist are also highly responsible for transmitting infection.

This infection has the greatest risk among all the other sexually transmitted diseases. After having unprotected sex for one time only, the risk of being infected with pointed condylomatosis is 75%.

If HPV is found in the blood of a person, it is not necessarily that he or she will have the symptoms of the disease. This virus needs certain conditions to reveal itself.

Predisposing factors:

  • Age of 17-30 years old (mainly, 20-24);
  • Early beginning of sex life;
  • Frequent change of sex partners;
  • Homosexualism;
  • Unsafe sex;
  • Low immunity (the symptoms of condylomas are more typical for HIV patients).

Clinical presentation

Asymptomatic disease is typical for people with a high level of resistance to viral infections. With a sharp decrease of body protection, the virus accumulates in one skin area and cells infected by the virus begin to divide constantly, producing new formations.

Various types of HPV cause certain symptoms.

  • Warts. Small (around 1 cm) spots, asymmetrical with clearly visible but irregular edges. The color varies from yellow to black. In women the spots are found on extensor surfaces and in men in the areas where the skin is in constant contact with underwear.
  • Papillomas. From the first glance, it is not quite clear what is the difference between a papilloma and a condyloma. However, there is the difference. A delicate formation without any induration, with the color similar to the skin is a papilloma. It is round and the size may vary greatly. A papilloma is characterized by rapid growth and propagation. It can be found everywhere on the human body, but most often it is localized on male and female genitals.
  • Condylomas. Pointed condylomas in women occur more frequently.

Localization:

  • Apogenital area and male and female genitals;
  • Anal orifice and perianal area;
  • Condylomas rarely appear on the face and oral mucous (as a result of oral sex);
  • Uterine neck and urethra.

The formations are pink and have a pedicle. They are not clearly visible on the mucous and for this reason it is difficult to make a diagnosis. When palpating, condylomas are soft, without any induration. They grow very fast, sometimes in a couple of hours.

Flat condyloma. It appears in chronic HPV and is a dangerous predisposing factor for oncology development. It is localized on the uterine neck, affecting its mucous membrane and changing it radically.

There are also perianal confluent condylomas. These are the growth found on the skin. They can be easily recognized by their similarity with a cauliflower. They should be distinguished from a broad condyloma which is the sign of AIDS.

The disease is also characterized by itching which becomes more intensive with time. The formations on the genitals are surrounded by an inflammatory aureole.

Consequences and complications

  • Purulence (if condylomas left untreated in men and women).
  • Bleeding and ulceration when the formations are injured.
  • Phimosis and paraphimosis are the complication of condyloma growth on the penis. This is urethral orifice narrowing which leads to acute and chronic urine retention and causes intensive pain.
  • When a flat condyloma growth on the uterine neck, there is a high risk of cancer development.
  • Oncology also develops when condylomas appear in the anus and on the genitals. This is the predisposing condition for rectal and prostate cancer development. Usually this complication appears in homosexuals.
  • In unusual localization (in the oral cavity, respiratory tract etc.), dysfunction of affected organs is observed.

HPV diagnostics

Indications to HPV testing:

  • Infectious diseases of the urogenital system;
  • Papillomas and condylomas on the genitals;
  • HPV and other sexually transmitted infections in a sex partner;
  • Any pathologies in pregnancy and infertility (male and female).

Colposcopy

It helps to visually detect condylomas in the vagina and on other mucous membranes.

The vagina and the neck of the uterus are examined with a special instrument which consists of a binocular and lightning.

Polymerase chain reaction

This method is 100% accurate, if all the requirements are met. This method is effective even if a single cell is affected and it enables the doctors to identify a virus carriage in the absence of the symptoms. PCR helps to detect DNA fragments of condylomas in men and women, even when other tests showed negative results.

The errors, however, may also occur.





A false positive result may occur if:

  1. Incorrect sample was examined;
  2. A patient was cured but the virus was still in his or her blood.

A false negative result may occur if:

  • there are inaccuracies during examination or sample collection;
  • a patient took many medications to treat condylomas and abused douching;
  • deep infection.

Inoculation of medium

This method is used for two purposes:

  1. To detect comorbidity;
  2. To test antibiotic sensitivity.

As genital condylomas are caused by the virus, inoculation of pathological material will not give any results. However it will help to detect conditionally pathogenic flora and sexually transmitted infections.

How to treat condylomas?

Treatment of pointed condylomas in women and men is only symptomatic. At the moment, we do not have any medications to eliminate the virus from the human body. There are a lot of treatment alternatives but they are all oriented towards condyloma removal from the genitals.

 

Surgical treatment

Surgical removal of pointed condylomas is indicated when the formations are large and there is a risk of their transformation into oncology. The operation is performed under anesthesia. Usually cauterization of condyloma is used. The disadvantage of this method is that it affects surrounding healthy tissues.

Laser removal is less traumatic. Due to regulation the depth, intensity and duration of laser exposure, this method is very precise. The laser helps to remove pointed condylomas in pregnancy.

 

Cryodestruction

This type of therapy does not require any anesthesia and it virtually does not affect healthy tissues. The procedure should be repeated in two weeks. Condylomas are removed with liquid nitrogen or carbon dioxide. The duration of the procedure is 30 seconds or a minute and a half.

Conservative therapy

Treatment of condylomas in women and men may be performed with the use of a solution «Collomak» which contains salicylic acid and lactic acid. The solution is applied on affected areas two times a day. The duration of the treatment course is 5 days. This solution negatively affects healthy tissues causing dermatitis.

Solkoderm is another medication to treat condylomas which contains copper nitrate and organic acids. Several sessions are required to treat condylomas with a month interval between each session.  This medication is used to treat apogenital pointed condylomas.

Cytotoxic medications are also widely used. The most popular is podofilin. However this medication is never indicated for vaginal condylomas, in pregnancy and for condylomas in the urethra. The medication is applied on the affected areas two times a week. The duration of the treatment course is 5 weeks.

Ointments for genital condylomas contain fluorouracil and they are applied at night. This therapy is effective even if the formations are resistant to other medications. However it is strictly contraindicated in pregnancy.

Condyloma treatment with natural remedies

If you suspect to have vaginal or other condylomas, consult a venereologist to avoid complications.  However, natural remedies are also popular to treat condylomas.

The main aim of natural remedies is to dry out the formations with the help of plant extracts. These substances are good to naturally remove condylomas:

  • iodine;
  • propolis;
  • celandine.

On the initial stage of the disease such therapy is quite effective but relapse is inevitable in any case.  If no treatment gives any results, immediately visit a doctor as there is a high risk of oncology development. Be very careful with using the medications yourself as it may cause the burns of healthy tissues.

Micropapillomatosis

Another name for this disorder is vulvar condyloma. The disease is characterized by a small soft rash which appears in a line. Morphological elements of the rash are characterized by symmetry and it has a pink color. Most often it appears in puberty.

This pathology is not dangerous for health and does not require any treatment. However the rash may be removed for aesthetic purposes with radio waves or crydestruction.