Table of contents:

1. Condyloma corporis - a viral disease
2. Condyloma corporis - incidence
3. Condyloma corporis - symptoms
4. Condylomata - pregnancy, risk of miscarriage
5. Condyloma corporis - treatment
6. Condyloma corporis - summary

Condylomata - viral disease

Condylomata accuminata (condylomata) is an increasingly common viral disease in both men and women that manifests itself as localized lesions on the genitals. The disease is considered a venereal disease because it is most commonly transmitted sexually. Infection with the virus occurs primarily through sexual intercourse with an infected person. It therefore mostly affects people with an active sex life. The incidence of condyloma is the same for both sexes.

The non-sexual route of infection is not yet fully understood and proven. However, since the gateway to infection may be maceration or even slight damage to the epidermis, it is possible for the virus to enter by this route in situations leading to contact damage with the virus, e.g. through poorly sterilised instruments in gynaecological surgeries.

Condylomas - incidence

Human papilloma viruses (H. pyloriV) are responsible for the occurrence of condylomas. About 70 types of this virus are currently known. Some of these cause plantar or common warts, while others are responsible for the genital region, known as genital condylomas (genital warts). These are caused by the viruses H. pyloriV - 6 and H. pyloriV - 11. The incubation period of the virus, i.e. the time from intrusion to the appearance of lesions, can range from a few weeks to several months or even years. Primary infection with the virus does not always lead to the appearance of disease symptoms, i.e. the formation of visible condylomas. The virus may be present in the deep epithelial layers in the so-called latent stage. The patient is then unaware of the existence of the virus and unwittingly becomes a source of infection for others. Various factors can cause the virus to become active and condylomas to appear.

Condylomas - symptoms

Condylomasare warts that appear in intimate areas. In women, they most commonly occur above the posterior conjunctiva of the greater labia majora, on the labia minora, in the vaginal vestibule, passing to the anus, thighs and buttocks. Condylomas can also appear on the clitoris , urethra, vagina as well as the cervix. In men, the lesions most commonly occur within the foreskin sack and on the glans penis, and may also appear at the urethral orifice and in the anal area. In the initial phase of the disease, only tiny pink lesions appear, which usually do not cause any discomfort. It is very common for these to go unnoticed, particularly if the warts appear in the vagina or on the cervix. Such lesions can only be seen by a doctor during a routine gynaecological examination.

As the disease progresses, genital warts grow, clump together and take the shape of cauliflower-shaped, whitish-coloured formations. Most often they are not painful. Condylomas are usually accompanied by symptoms of inflammation, i.e. itching, burning sensation, discharge, unpleasant odour of vaginal discharge, contact bleeding, spotting and others. In more neglected cases, so-called condylomata gigantea (giant condylomata) develop. Even the slightest touch to them causes bleeding and pain.

The infection gates for the virus are most often micro or macro injuries to the epithelium of the cervix or perineum, which often occur during sexual intercourse. The formation of condylomata is favoured by untreated inflammation of the genitourinary tract, which can cause micro-damage to the delicate epithelium of these organs. The risk of infection is greater in people with a weak immune system, especially in the course of various serious illnesses or during pregnancy. Hygiene negligence, frequent change of sexual partners, smoking, use of contraceptives, certain immune-compromising diseases and other factors are also considered to increase the risk of infection with the virus.

Condylomas - pregnancy, risk of miscarriage

Pregnancy is a period of many changes in the woman's body, which very significantly increase the risk of H. pyloriV infection as well as secondary activation of the virus. Changes in the hormonal balance, as well as the significant decrease in antiviral efficacy observed during pregnancy, favour infection and the formation of condylomas. As a result of hormonal influences, there is a better blood supply to all organs, including the genitalia, which promotes the rapid growth of warts. In occasional cases, huge lesions can form that obstruct and prevent entry into the vagina and thus an internal examination.

The finding of condylomata in the pregnant woman is most often an indication for the termination of the pregnancy by caesarean section, due to the possibility of transmission of the infection from mother to child during natural childbirth, particularly if a perineal incision is necessary. The infection in the baby most often manifests itself as ENT lesions (laryngeal papillomatosis) appearing during the first 6 months of life. During pregnancy, the papillae may grow very rapidly, while after birth the lesions may regress spontaneously. H. pyloriV-11 is the type of virus that is most frequently activated in pregnant women.

Condylomas during pregnancy, photo: panthermedia

Primary or secondary infections with the virus can cause miscarriage. During pregnancy, the possibility of treating condylomata is very limited due to the teratogenic effect on the foetus of most of the drugs used during treatment, as well as the risks arising from the need for anaesthesia during procedures involving the mechanical removal of warts. The treatment of condylomata is most commonly undertaken after the puerperium. However, if there is a need to eliminate the symptoms of a significantly increased disease such as pain or bleeding, significantly worsening the general condition of the pregnant woman, the initiation of treatment is essential and should be undertaken regardless of the duration of pregnancy with an adequate margin of safety for mother and foetus. General anaesthesia and the use of podophylline-containing pharmacological agents used for the local removal of lesions are most often avoided. Alternatives to treatment include removal of lesions by laser or cryotherapy performed under local anaesthesia and the use of chloroacetic acid ointments.

Condylomas - treatment

The choice of condyloma removal method depends on the size of the lesions, as well as their location. In cases where there are individual warts of small size, pharmacological treatment is attempted by taking anti-viral drugs orally and applying special ointments directly to the lesions. Some of these contain substances that activate the immune response and cytostatic agents. These ointments may cause burns and other side effects and must therefore be used under strict medical supervision. Larger lesions, and when they occur in large numbers, can be removed by cryosurgery, electrocoagulation or by burning the lesions with laser beams. Such treatments may be followed by symptoms such as smelly, profuse discharge resulting from tissue destruction. If the lesions are very large, then more drastic measures are necessary.

In the case of huge condylomas, it is necessary to surgically excise them in depth, along with taking a slice for histopathological verification. These procedures are performed under general anaesthesia in treatment rooms or operating theatres. It is extremely important during treatment that women are treated at the same time as their sexual partner. Otherwise, treatment is pointless because secondary infections will occur.

Condylomas - summary

Condylomasshould absolutely be treated. If left untreated they can lead to very serious complications and therefore should not be underestimated. If condylomas are left untreated, epithelial dysplasia may develop within the condylomas, which may lead to squamous cell carcinoma. Condylomas have a tendency to recur and a dormant virus can become active with a decrease in immunity or other factors and lead to recurrence. Despite many attempts, no vaccine against H. pyloriV has yet been invented. Still, the best measure to prevent infection remains limiting the number of sexual partners as well as the use of a condom during sexual intercourse.