This article discusses an increasingly common sexually transmitted disease - condylomata. It provides basic information on the route of infection, symptoms and treatment options for the disease.
Table of contents:
- Non-sexual route of infection
- Virus incubation period
- Condyloma - incidence in women and men
- Effect of pregnancy on changes in the female body
- Methods of condyloma eradication
Condylomata accuminata (condylomata ) is an increasingly common viral disease in both women and men that manifests itself in localized lesions on the genitalia.
The disease is considered a venereal disease because it is most often 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.
Non-sexual route of infection
Has not yet been 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.
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 condylomata (genital warts). These are caused by H. pyloriV - 6 and H. pyloriV - 11 viruses.
Virus incubation period
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.
Thevirus 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 photo: ojoimages
Condyloma - incidence in men and women
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. They can also appear on the clitoris, urethra, in the vagina as well as on the cervix.
In men, lesions are most common on the preputial sac and 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 changes can only be noticed 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 gateways to infection for the virus are most often micro- and macro-injuries to the epithelium of the cervix or perineum, which often occur during sexual intercourse. The formation of condylomas 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.
Effect of pregnancy on changes in the female body
Pregnancy is a period of many changes in a 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 fitness observed during pregnancy favour infection and the formation of condylomas.
As aresult 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 the entrance to the vagina and thus the 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. Infection in the child is most often manifested by ENT lesions (laryngeal papillomatosis) appearing during the first six 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. Primary or secondary infections with the virus can cause miscarriage.
Condyloma fot. iStock
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 resulting from the need for anaesthesia during procedures involving the mechanical removal of warts. Most often, treatment is initiated after the end of the postpartum period. However, if there is a need to eradicate symptoms of 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 the pregnancy with an adequate margin of safety for mother and foetus.
Methods of condyloma removal
General anaesthesia and the use of pharmacological agents containing podophylline used for the local removal of lesions aremost commonly avoided. Treatment alternatives include laser or cryotherapy to remove the lesions under local anaesthesia and the use of chloroacetic acid ointments.
Thechoice of condyloma removal method depends on the size of the lesions as well as their location. In cases where there are isolated, small-sized warts, 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 deeply, 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.
Condyloma fot ojoimages
Condylomasabsolutely must be treated. If left untreated, they can lead to very serious complications and should therefore not be underestimated. If condylomas are left untreated, epithelial dysplasia may develop within the condylomas, which may lead to squamous cell carcinoma.
Condylomashave a tendency to recur and a dormant virus in the body, with a decrease in immunity or other factors, can become active 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.
