HPV & Genital Warts Treatment

What is HPV?
Many of you may have heard of the HPV virus via the internet, papers and television, but not everyone is aware of what the HPV virus actually is.
The human papillomavirus (HPV) is a virus that can be sexually transmitted. There are currently over one hundred known sub types of HPV and about thirty of these sub types affect both male and female genitalia. People can be infected with conditions such as genital warts and in more serious cases cancer.
HPV can be spread through sexual skin-to-skin contact. This means that penetration is not required to be infected by the virus. Vaginal and anal intercourse are also methods of HPV transmission. You can contract HPV from having oral sex, however it is less common.

Symptoms and detecting HPV
Detecting HPV can be difficult as in many cases there aren’t any symptoms. In some cases a person may show symptoms by developing genital warts. This may not occur in all people who are carrying the HPV virus as genital warts are just one strand of the infection. Some people may be affected by this strand of HPV for many years before displaying genital warts and some may never contract them at all. Detecting HPV can therefore be very difficult as symptoms are few and far between.

Women who are infected with the strand of the HPV virus which is connected to cervical cancer do not usually experience symptoms at all. A cervical smear is a very useful way to detect abnormal cervical changes caused by HPV.

Genital warts, Condyloma Acuminata
Genital warts are one of the most common types of sexually transmitted diseases and also referred to as venereal warts or condylomata acuminate.Anogenital warts are caused by human papillomaviruses (HPVs) which are transmitted through oral, anal, and genital sexual contact with rare cases of autoinoculation and vertical transmission have been reported.
 HPV types are classified into high-, intermediate-, and low-risk group. Genital HPV infection is closely linked to cancer of the cervix, glans penis, anus, vulvovaginal area, and periungual skin. Cancer occurs when there is an integration of the HPV genome into the host DNA.
In most persons, genital HPV infection appears to be transient, lasting about 1–2 years and results in no sequelae. In a small proportion, about 2% of immunocompetent persons, the infection persists, and in a small proportion of those with persistent HPV infection, cancer may develop. Genital warts are sexually transmitted and therefore other sexually transmitted diseases  may be found in patients with genital warts. A complete history should be taken and the patient screened for other STDs. The whole genital area should be carefully examined because external genital wart  infection is often multifocal. Women with EGWs should have a routine cervical cytological screening to detect cervical dysplasia, but the presence of EGWs alone does not require more frequent  Pap smear More Detailss or gynecologic evaluation. Risk factors included: early age of starting sexual relation, number of sexual partners, unprotected sex, infection by other STD at the same time,and immunosuppression, especially in a patient infected with HIV.
Genital warts are often asymptomatic but may cause discomfort, discharge, or bleeding. The typical lesion is soft, pink, elongated, and sometimes filiform or pedunculated. The lesions are usually multiple, especially on moist surface and their growth can be accelerated with pregnancy.

Genital warts Treatment
 Large malodorous masses may form on vulvar and perianal skin. This classical acuminate (sometimes called papillomatous or hyperplastic) form constitutes about two-thirds of anogenital warts. The most common sites of the posterior fourchette correspond to the likely site of greater coital friction. Most other lesions are flat and some of these generally on nonmucosal surfaces such as the pubic skin, perianal skin, and groin, may be sufficiently pigmented. The primary goal of treatment of genital warts is to eradicate or reduce the symptom.

How Genital Warts Are Treated
Warts may recur after treatment because of the activation of latent virus present in healthy skin adjacent to the lesion. Several treatment options are developed for eradication of genital warts. Pharmacological therapy includes topical application of podophyllin, podofilox, 5-fluorouracil, and trichloroacetic acid (TCA) have had unsatisfactory results.Local skin reaction and pain are common adverse effects. None of these drugs have been shown uniformly effective or directly antiviral.

Surgical techniques with the exception of cryosurgery, these modalities usually have the common advantage of complete treatment following one application. By electrosurgery removal of a very large mass of warts is a painful procedure, best performed with the patient under either general or spinal anesthesia. Pain after surgery is common. Carbon dioxide laser vaporization is typically used for treatment of refractory HPV disease or extensive warts of the anogenital mucosal category and is particularly useful in the treatment of periurethral and vaginal warts. It is the treatment of choice for pregnant women with extensive lesions or lesions that do not respond to TCA. Carbon dioxide laser therapy is an efficient therapeutic modality because of its precision and rapid healing without scarring.

Treating HPV-Related Cancers in Other Parts of the Body
In addition to causing cervical cancer, HPV can cause several other types of cancer:

•      Anal cancer

•      Oropharyngeal cancer

•      Penile cancer

•      Vaginal cancer

•      Vulvar cancer

At present, there are no established screening guidelines for HPV-related cancers other than cervical cancer, so typically these cancers are found only when they cause symptoms, and treatment is based on the stage of the cancer when it is detected.

Treatment for Precancerous Cervical Changes
In women, some types of HPV can cause the growth of precancerous cells on the surface of the cervix — known as cervical dysplasia — which can lead to cervical cancer.
Nearly all cases of cervical cancer are caused by HPV, with 70 percent of cervical cancer cases resulting from HPV types 16 and 18, according to the CDC.
Getting regular Pap or HPV tests raises the likelihood of catching cervical dysplasia early, and removing precancerous growths can help prevent cervical cancer from developing.

Severe cervical dysplasia is treated with one of several types of surgical procedures, including:

•      Cryosurgery

•      Laser therapy

•      Cold knife conization (or cold knife cone biopsy), in which a cone-shaped piece of abnormal cervical tissue is removed with a scalpel or laser knife

•      Electrosurgery

If cervical dysplasia has progressed to cervical cancer, a woman may be advised to have a hysterectomy (removal of the uterus), or to undergo radiation therapy, chemotherapy, or both.

HPV Vaccination
Safe effective vaccinations against HPV should ideally be performed before a girl is sexually active. There is a nationwide screening program that should be offered through schools however if you or your daughter would like to discuss this further please do not hesitate to contact us.

Types of vaccinations available include Gardisil & Cervarex

How to Prevent Common Skin Warts
HPV is ubiquitous, meaning it’s found everywhere, so it may be impossible to prevent all warts.
But you can lower your risk by following these common-sense suggestions:

•      Don’t bite your nails or pick at hangnails.

•      Don’t scratch or pick at existing warts.

•      Don’t touch other people’s warts.

•      Don’t share razors, towels, socks, or shoes with other people.

•      Wear flip-flops or shower sandals in public showers, locker rooms, and around swimming pools to avoid getting plantar warts.

•      If you have a plantar wart, wear slippers or shoes around the house to avoid spreading them to others.

•      Keep any warts on your feet dry, as moisture encourages them to spread.

Full Sexual health screening
We offers a full sexual health screening and this includes:

•      Chlamydia

•      HPV

•      HSV Type2

•      Gonorrhea

•      HIV

•      Hepatitis B

•      Hepatitis C

•      Syphilis.

“Our practice is built on single premise: the highest quality care.”  Op.Dr.Nevra / Gynecologist

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