Genital Warts
Definition of Genital Warts
Genital warts (condyloma acuminata or venereal warts) are caused by a group of viruses called human papilloma viruses (HPV).
Description of Genital Warts
Genital warts are one or more painless, soft and fleshy growths that usually appear one or two months after exposure, but can take as long as nine months to incubate. Some warts are so small that they can be only identified with a colposcopic exam of the cervix and vagina or a Pap smear.
Causes and Risk Factors of Genital Warts
Genital warts are spread by sexual contact with an infected partner and are very contagious. Approximately two-thirds of all persons who have sexual contact with an infected partner will develop this sexually transmitted disease (STD).Although much remains to be learned about how the papilloma virus progresses, doctors have observed that the warm, moist environment in the genital area seems to favor wart growth. Outbreaks appear to be exacerbated during pregnancy and in patients with defective immune systems.
Patients with a history of genital warts may be at increased risk for certain types of cancer. The human papilloma virus is associated with up to 90 percent of all cervical malignancies and may play a role in cancers of the vagina, anus, vulva and penis.
Cervical warts may be transmitted to the newborn via passage through the infected birth canal.
Symptoms of Genital Warts
Like many other STDs, HPV infection often does not cause symptoms. One study sponsored by the National Institute of Allergy and Infectious Diseases (NIAID) reported that almost half of the all women with HPV had no visible symptoms. However, in many cases, small, hard spots (easily visible to the eye) can develop within three weeks to three months after exposure. In women, the warts occur on the lips of the vagina, inside the vagina or around the anus. Anogenital warts may be itchy. Women also develop cervical warts, which are flat lesions invisible in their early stages. HPV infection is one of the most common causes of abnormal Pap smear tests.
Diagnosis of Genital Warts
It is important for a person who may have genital warts to see a doctor so other types of similar-looking infections or conditions can be ruled out or treated. Genital warts are usually diagnosed by direct visual examination. When acetic acid (vinegar) is swabbed on the cervix or penis, HPV lesions appear whitish.
Colposcopy, a painless examination during which a lighted magnifying instrument is used to view the internal reproductive organs in women, can be performed in the doctor's office.
In some cases, it is necessary to do a biopsy of cervical tissue. This involves taking a small sample of tissue from the cervix and examining it under the microscope. Sampling cells with a biopsy and testing for HPV genetic material may be necessary to confirm a diagnosis.
Treatment of Genital Warts
Genital warts often occur in groups and can accumulate into large masses on genital tissues. They often reappear after treatment. Depending on factors, such as their size and location, genital warts are treated in several ways. A doctor may recommend treatment with a chemical, such as a 25 percent podophyllin solution, which is applied to the affected area and washed off after several hours. Podophyllin should not be used during pregnancy, because it is absorbed by the skin and may cause birth defects.
Small warts can be removed by freezing (liquid nitrogen) or burning (electrodesiccation).
Imiquimod, a 5 percent cream that is an interferon inducer, has produced moderate activity in clearing external genital warts.
Surgery is occasionally needed to remove large warts that have not responded to other treatment.
Doctors at some medical centers also use laser surgery to remove genital warts.
Prevention of Genital Warts
The use of condoms may reduce transmission of anogenital warts.
Questions To Ask Your Doctor About Genital Warts
How are genital warts contracted?
Could the warts be transmitted to another person if there are no symptoms?
How will you treat this condition?
How will we know if all are removed?
Will I have pain after the treatment?
Will medication be given for pain?
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