Condyloma - a benign formation that occurs when infected with the human papillomavirus, most often appears on the mucous membranes of the genital organs. Such formations give a person considerable discomfort and multiply rapidly, increasing in number. Removal of genital warts with a laser is one of the possible methods of struggle, quite safe and painless, and therefore popular.

The nature of education and its features

Condyloma is a type of benign tumor. Small in size, it resembles a flesh-colored or pinkish growth and appears not only on the superficial areas of the skin, but also on the mucous membranes. Condylomas rarely occur alone, they are mostly observed in groups.

The cause of their occurrence is the papilloma virus. It is transmitted from person to person through close everyday contact, including sexual contact. It is also present in urine and saliva, but does not enter the bloodstream and does not affect internal organs.

After infection, warts do not appear immediately, the incubation period of the disease can range from several weeks to several years. The disease makes itself known when sharp decline immunity, against the background of other viral and bacterial diseases, hypothermia or overheating.

The most dangerous genital warts, sexually transmitted. Some strains of the virus can cause the transformation of a benign tumor into a malignant one. That is why any condyloma cannot be ignored, it is imperative to ensure its professional removal.

Genital warts in intimate areas can be accompanied by itching, burning, provoke a feeling of moisture, when injured, they bleed and an inflammatory process may occur. As for flat condylomas, they are rarely accompanied by any unpleasant sensations, therefore they are diagnosed less often.

There are cases when warts disappear on their own and do not require treatment, as a rule, this happens within 3-4 months after they appear on the surface of the skin or mucous membranes. The "older" the condyloma, the less likely it will disappear without treatment.

It is better to entrust the treatment of genital warts to a specialist. This will avoid unnecessary complications and unpleasant consequences. In most cases, the removal of such tumors is carried out using a laser. It is generally accepted that such a technique is the most effective, safe and fairly affordable from a financial point of view.

Deletion algorithm

Removal of genital warts with a laser, as a rule, does not take more than 30 minutes (the time is given relative to the elimination of several formations and taking into account anesthesia). The procedure is quite simple and is carried out according to the following algorithm:

• Anesthesia. Prevents discomfort during the removal process. An anesthetic cream or injection is used, depending on the size of the warts.
• Removal. Before performing manipulations, a specialist needs to set individual equipment settings for working with each specific patient (beam diameter and power). The laser vaporizes the tumor tissue and seals the blood vessels, preventing bleeding.

It should be noted that the laser technique contributes only to the superficial elimination of the disease, that is, it removes the tumors themselves, but not their cause. To prevent recurrence of genital warts, you should drink a course of antiviral drugs that the doctor selects.

Recovery period

Healing of the skin or mucous membrane at the site of the removed tumor occurs within 10-15 days. The rehabilitation period takes place at home and does not require the patient to stay in the hospital. In addition, in the absence of severe complications, regular visits to the doctor after the procedure are also not mandatory.

Immediately after the elimination of genital warts, it is necessary to start taking antiviral drugs, as well as vitamins designed to strengthen the immune system. Such measures will help reduce the risk of recurrence of tumors. Among other things, the patient will have to adhere to the basic recommendations to speed up the healing of the wound at the site of condyloma. Immediately after the procedure, a crust forms on it, which is prohibited:

• Subject to mechanical stress (friction, pressure).
• To expose under direct sunshine, ultra-violet radiation.
• Seal and prevent access to fresh air.
• Rip off.

If itching, redness, discomfort occurs, you should immediately consult a doctor.

Contraindications

Elimination of genital warts with a laser has a number of contraindications. The impact of this kind is not customary to carry out when:

• Oncology.
• diabetes mellitus.
• Pathologies of the circulatory system.
• Pregnancy.
• Individual intolerance to light radiation.
• Allergy to local anesthesia.

If necessary, the list of restrictions can be expanded. In order to find out if this method of fighting tumors is right for you, you should visit a preliminary consultation with a surgeon, and maybe even pass additional tests.

Hygiene in condylomas is a set of measures aimed at getting rid of and eliminating the infection of people around with the disease. It will help eliminate the development of neoplasms and contribute to a speedy recovery.

When a patient finds out during a medical examination or discovers genital warts on his own, he is overcome by mixed feelings: frustration, surprise, worries about a sexual partner and not knowing what hygiene should be for condylomas.

What to do if warts appear on intimate places? It is necessary to begin immediate treatment of neoplasms. Why is it so important?

Genital warts without timely diagnosis and treatment can spread and affect the internal genital organs in a woman and the urethra and rectum in both sexes.

Often, the lack of treatment leads to serious complications. Dangerous with condylomatosis is the likelihood of degeneration of formations into oncological disease.

With condylomas in intimate places, you should not use flavored personal care products. To care for skin affected by HPV, it is better to use ordinary baby soap. As for washing underwear, it is not recommended to use washing powder. For this purpose, laundry soap is suitable.

What to do after removal

The postoperative period for the removal of warts on the skin is often accompanied by swelling of the tissues, pain, discharge from the formed wounds (ichorus, lymph) and other unpleasant sensations. What to process? Any pain reliever can be taken to relieve pain. Often use Ketorol, which will help to cope with this. bad feeling and relieve puffiness. Take 1 tablet 2-3 times a day. The maximum daily dose is 40 mg of the drug (4 tablets).

Panavir gel is used after removal of genital warts for prophylactic purposes. Liniment is applied to the area where the procedure was performed, a thin layer 3-4 times a day for a week.

Spray Panavir-intim will help wound healing, relieve inflammation and prevent the appearance of new formations. Also, the doctor often prescribes long-term washing with Epigen-gel. The mandatory course of using the gel after removal can be from 10 to 20 days.

Also, the first few days after the destruction of the neoplasms, the wounds should be treated with a solution of manganese or furacilin and baths should be made from chamomile decoctions. In a warm, steep broth, you need to sit for 10-15 minutes, and then dry the genitals with a clean towel. After the procedure, do not immediately put on underwear, but allow the place to dry in the air. Women should definitely use panty liners, which are changed every 2 hours.

Features of care after removal in various ways

Therapy for HPV consists of two areas: removal of growths and internal administration of antiviral and immunomodulatory drugs.

For external disposal of neoplasms, there are a number of methods. The period of recovery of the skin and the care of the affected area after the procedure will depend on the method of removing genital warts.

Consider a table that shows the options for the treatment and treatment of the skin or mucous membrane:

Removal method	Skin care after the procedure.
Cryodestruction	After removal with liquid nitrogen, wounds remain in place of the genital warts, which heal after about 2 weeks. Immediately after the procedure, there is swelling of the tissues and pain at the sites of removal. To get rid of such symptoms, the doctor prescribes an analgesic and anti-inflammatory agent: Nimesil, Miramistin, Panavir Intim, Ibuprofen, Ketorol, Solpadein. Isoprinosine may also be prescribed to prevent the development of new growths. It is recommended to wash after cauterization with nitrogen with a solution of potassium permanganate and steeply brewed medicinal herbs (chamomile, calendula).
laser therapy	Laser excision refers to methods with a short period of recovery of damage to the surface of the skin. After cauterization of genital warts with a laser, a crust remains on the skin, which disappears on its own after 4-6 days. After removal, gynecologists prescribe washing with Epigen gel twice a day. It is also necessary to take baths with medicinal herbs that have anti-inflammatory and disinfecting effects. To prevent relapse, Panavir is prescribed in tablets.
Electrocoagulation	After cauterization of genital warts with current, crusts form in their place, which cannot be removed until they are completely detached. The first few days, the wound and the skin around it must be treated with a solution of furacilin, chlorhexidine or potassium permanganate. Immediately after the procedure, swelling of the tissues may be observed. To alleviate the condition, you can take the anti-inflammatory and analgesic Ketorol.
Chemical degradation	After exposure to neoplasms with chemicals containing concentrated acid, damage remains on the skin. Wounds heal for a long time, and this process is accompanied by pain. The condition will be facilitated by Baneocin ointment or Levomekol, Ketorol.
Drug treatment	This method is characterized by a very long period of therapy. Treatment can take from 2 weeks to a month or more. The drugs used to remove growths already have anti-inflammatory, analgesic, and antiviral effects. Additional measures are not necessary.
radio wave removal	After the procedure, it is necessary to wash with a cool solution of potassium permanganate (potassium permanganate) or a decoction of chamomile. The doctor may prescribe the use of drugs that prevent relapse (Panavir, Isoprinosine, Imiquimod).

How long does it live? After the end of the recovery period, regardless of the method of removing genital warts, you should continue to increase immunity and lead a healthy lifestyle in order to avoid the appearance of new formations.

Hygiene rules and prevention of occurrence

An important recommendation regarding hygiene in condylomas is the refusal to go to saunas, baths, swimming pools, jacuzzis and similar places. Do not swim in open water until the end of the rehabilitation period after removal. Taking a bath can contribute to self-infection with condylomatosis. To avoid this risk, personal hygiene should be limited to showering.

The next point in the patient's behavior in the event of manifestations of HPV on the skin is abstinence from sexual intercourse during the period of therapy and for some time after treatment. Everything will depend on the selected method of dealing with the pathogen and the method of removing growths. If this rule is neglected, then there is a possibility of damage to the neoplasms on the penis, lips or vagina, which will entail:

• inflammation;
• accession of a secondary infection;
• spread of genital warts to other areas of the skin and mucous membranes.

You can not shave the area affected by genital warts, as warts are easily injured.

The patient must have his own personal hygiene items. He is forbidden to use someone else's washcloth, towel, soap.

For prevention, you can use Panavir Intim spray before and after each sexual contact. Strengthening the immune system will help keep the activation of the virus in the body. healthy image life and refraining from frequent changes of sexual partners are reliable defenders against HPV.

Every specialist dermatologist is well aware of what warts are. We are talking about benign neoplasms, the structure of which is represented by papillae. The causative agent is a viral infection, and more specifically, the human papillomavirus.

To date, more than 40 HPV subtypes are known, the activity of which leads to the occurrence of genital warts. This virus deserves great attention for the reason that with their uncontrolled activity, an environment is created for the development of oncological diseases, among which penile cancer and cervical cancer are equally dangerous.

In the vast majority of cases, warts affect external genitalia as well as the perineum and anus. Often they can be found on the arms, legs and other parts of the body. In some areas, they are presented in the form of single rashes, while in other areas they can affect in the form of numerous groups. If the disease has been progressing for a long time, then similar formations gradually grow together, as a result of which they look like cauliflower.

If certain external or internal factors have led to a weakening of the body's immune system, then this provides an opportunity for the active activity of the virus, which can greatly affect the body.

Laser warts removal: pros and cons

For decades, many surgical operations performed using a laser. Modern medicine has quite advanced laser equipment, with which you can perform various tasks. The use of a laser allows you to perform operations with minimal time, while eliminating bleeding. A similar result is achieved due to the fact that with the help of powerful laser radiation, only that part of the tissue that needs surgical intervention is processed.

In order to perform the removal of warts with a laser without consequences for the patient, local anesthesia is used. Pain-relieving ointments or injections of novocaine and lidocaine act as such drugs. The operation takes a maximum of 15 minutes. In order to remove a neoplasm unit, it is necessary to spend about 1 minute.

When exposed to condylomas by a laser, it experiences radiation that is fatal to itself, while the blood vessels are in no way affected and continue to function without disturbance. This method also allows eliminate the microflora located in the wound area. Due to the high precision of the laser beam, it is possible to ensure the complete safety of delicate tissues. Carrying out the removal of genital warts by a similar method, the surgeon selects the necessary power of the laser beam, determines the area of ​​the affected area, as well as the width and depth of the incision.

In cases where the disease has been progressing for a long time and it has become necessary to remove many warts, the operation is divided into several stages. Here it is very important to maintain the necessary duration of pauses between stages, which can reach from 2 to 4 weeks. If everything is done correctly, then after removal of genital warts, the likelihood of scarring is almost eliminated. The wound that has arisen after the removal of genital warts must be provided with special care: injury and contact with water should be avoided during the day.

Flaws

The method of removing genital warts with a laser has gained popularity due to its high efficiency. This procedure is not only fast, but also eliminates bleeding. However, when using this method, the patient feels pain discomfort. An important point It is also the fact that it is possible to achieve good results when removing genital warts with a laser only if complex treatment is carried out. If you do not pay enough attention to your health and do not undergo antiviral and immuno-strengthening therapy, then after a certain period of time you can again find similar neoplasms on your body.

As mentioned earlier, the development of genital warts provokes HPV infection. Unfortunately, if this virus remains in the human body all the time, he is constantly at risk of developing these neoplasms. For this reason, regardless of which method will be used to remove genital warts, the patient cannot be sure that in the future he will not have to deal with the treatment of these neoplasms again. All methods available today to combat warts can eliminate only external manifestations of this disease.

However, there is a positive point that needs to be said: relapses of this disease are observed only in 30% of patients. Therefore, you should not consider the operation to remove genital warts so hopeless. It is in the power of each person to prevent the recurrence of this disease if he pays enough attention to his health and strengthens the immune system. In the vast majority of cases, upon completion of the operation to remove genital warts, the process of wound regeneration takes quite a bit of time. However, in each case rehabilitation period may take a different time. Here, much depends on what method was used to combat these neoplasms.

Such patients can return to their full sexual life only if when the wounds heal resulting from the operation. Also, a prerequisite for the removal of restrictions is the appearance of a new epithelium on the skin and mucous membranes of the genital organs.

The operation to remove genital warts can lead to various consequences. Worst of all, if the chosen method turned out to be ineffective, and warts began to appear again. In the absence of preventive measures, it can be expected that after three months new warts will begin to form.

At the same time, the situation considered is not the only negative consequence that a patient who has had warts removed may face. Serious inconvenience to the patient can be delivered bleeding, welts and scars, discomfort, risk of injury, and burning sensation. There are cases when, after removal of genital warts in the anus, a person felt pain discomfort during defecation.

Prevention of genital warts

To avoid unpleasant consequences after the removal of neoplasms, the patient must adhere to certain rules.

The cost of getting rid of genital warts

Modern clinics dealing with genital warts removal offer different prices for their services. When calculating the cost take into account several factors:

• sizes of neoplasms;
• their number;
• location.

Depending on which method was chosen to remove genital warts - electrocoagulation, exposure to radio waves or chemicals, the cost of the operation will be determined, which can be from 30 to 300 dollars for each course of procedures.

For example, in order to remove warts with the help of laser therapy with the number of neoplasms equal to 10 pieces, the patient will have to pay about 130-150 dollars.

The cost of the operation to remove genital warts using the radio wave method is about 25-60 dollars per unit.

If the method of exposure to liquid nitrogen was chosen to remove genital warts, then the cost of the operation will be $ 10-15 per piece.

Thus, laser therapy is not the only method of dealing with these neoplasms. Each person can choose best option operations, taking into account their financial capabilities.

Etiology and clinical manifestation of genital warts

Condylomas are specific, often in the form of scallops, formations on the skin and mucous membranes, in the female genital tract or male genital organ and / or anogenital region.

Warts are caused by infection with the human papillomavirus (HPV). This virus is classified as a sexually transmitted infection, and the route of transmission is direct contact with the skin or mucous membrane of an infected partner. Infection occurs both during traditional sexual intercourse and non-traditional sexual contacts: oral, anogenital, homosexual.

About 80% of the sexually active population of the world becomes infected with HPV during their lifetime, and in 80% of cases these people self-heal the virus without infection and treatment. In other cases, the virus is either detected by PCR without clinical manifestations, or manifests itself in the form of genital warts.

Currently, more than 150 types of the virus are known, and each type of HPV affects a specific target tissue. Only about 40 types of human papillomavirus affect the anogenital area. Among them, HPV types 16 and 18 have the greatest oncogenic potential, which can cause cancer of the cervix, vagina, vulva, and rectum.

The carriage of HPV type 16.18 does not indicate that an oncogenic disease is necessarily realized. The human immune system fights viral aggression and in 80% of cases on its own, without treatment immune preparations copes with this infection.

Women carriers of HPV type 16.18 need to be examined by a gynecologist once a year, with a mandatory cytological examination for cancer cells from the cervix (Pap test).

It is desirable to screen all women over 30 years for oncogenic HPV, along with a Pap test, to reduce the incidence of cervical cancer. In addition to HPV types 16.18, 10 more types of the virus have carcinogenic potential (31,33,35,39.45,51,52,56,58,59). These types are less common, but can also cause cancer, more often of the cervix.

The human papillomavirus, with good immunity, may not manifest itself for a long time. A woman can be a carrier without knowing it. As soon as the immune system weakens (stress, pregnancy, hormonal disorders, exacerbation of chronic diseases), HPV carriers may develop clinical symptoms of the virus, in particular warts. It may take several years from the time of infection to the onset of symptoms. Therefore, it is almost impossible to accurately determine the moment of infection.

The main sign of human papillomavirus infection is single or multiple rashes (formations) on the external and internal genital organs of women, they can also appear in the oral cavity, in the anus and in the rectum.

Types of genital warts

Experts distinguish the most common types of exophytic (visible) genital warts:

genital warts - proliferation of the epithelium of the skin or mucous membrane in the form of outgrowths on a thin or wide base, resembling a "rooster's comb" or a type of "cauliflower". Warts can spread to a large area of ​​the skin or mucosa in the anogenital region;

tumor-like condylomas - the disease manifests itself in the form of a tumor-like formation, more often on the mucous membrane. In women, this is the mucous membrane of the vagina and cervix;

papular condylomas, outwardly resemble pigmented warts, and are located on the skin of the external genital organs;

keratotic condylomas - occur in the form of spots rising above the skin or mucous membranes with a keratinizing surface.

Exophytic (visible) warts in women often cause HPV types 6, 11. These 2 types of virus are not carcinogenic, that is, they do not cause cancerous degeneration.

Specialist examination

The timeliness of contacting specialists and the correct diagnosis of the disease are fundamental factors for successful treatment. It must be emphasized that there are skin diseases with a skin rash that is not associated with HPV, therefore, a specialist examination is necessary before adequate treatment is prescribed. The absence of clinical manifestations of the virus (warts), in the presence of HPV, requires an additional examination (taking a Pap test, performing a colposcopy), but this is decided by the doctor at the appointment.

It is important to emphasize that treatment is not always prescribed for carriers of the virus without clinical manifestations, since the human immune system fights the virus on its own, and in in large numbers cases causes the complete death of the virus in the body. The task of specialists in identifying HPV is to reassure patients and set them up for a successful outcome in the treatment of the disease.

The main purpose of the examination is to make the correct diagnosis, prescribe treatment in the presence of clinical manifestations of the virus and psychologically calm the patient.

Therapy for genital warts

There are various methods for removing genital warts.

Treatment at home:

podophyllotoxin (cream 0.15% or solution 0.5%), condilin

imiquimod (cream 5%)

Clinical treatment:

chemical treatment (solcoderm, ferezol, trichloroacetic acid)

scalpel excision

electric or radio wave removal

cryotherapy

argon plasma ablation

laser removal

The choice of method of therapy depends on the type and prevalence of genital warts, and occurs by mutual agreement between the doctor and the patient. Since warts disappear on their own in some patients (for example, after childbirth), none of the methods can be optimal for their different localization.

Condylomas of the anogenital area

Warts in the area of ​​the labia (vulva)

Vulvar warts are caused by infection with the human papillomavirus. This virus enters the female body more often during sexual intercourse. With a good immune system, this disease may not manifest itself for years, and a woman, not knowing that she is sick, can infect her partners with it, with insufficient local immune protection in them. With a decrease in immunity, the virus can make itself felt. Condylomas may appear on the labia, internal genital organs, perineum, in the anus.

Genital warts of the vulva must be removed without fail, and not only because of their non-aesthetics, but given their growth and spread. This disease can progress and spread to the vaginal mucosa and cervix and to the skin of the anogenital region.

Treatment of warts should be carried out by a gynecologist, who will determine the treatment regimen.

Methods of treatment of warts in the area of ​​the labia (vulva)

If you have warts on the vulva, you should immediately contact a gynecologist. Today, there are several approaches to the treatment of this disease, and an experienced professional, having established the correct diagnosis and assessed the degree of damage to the body, will be able to choose the right treatment regimen.

As a rule, condylomas in the vulva area are usually treated in the clinic in the following ways:

excision with a scalpel;

cryodestruction - cold treatment;

The excision procedure is performed using laser or electrosurgical devices (radio wave device with argon-enhanced coagulation).

Vaginal warts

Condylomas in the vagina, also a consequence of infection with the human papillomavirus (HPV). The diagnosis is established by a gynecologist when examined in the mirrors of the vaginal mucosa, specified during colposcopy, and confirmed by performing a PCR test for HPV and, in doubtful cases, by taking a biopsy of the formation.

Condylomas in the vagina bring a lot of problems to a woman, and can affect sexual behavior. Symptoms may include: the presence of growths in the vagina palpated by the woman herself during genital hygiene, an inflammatory reaction, itching, the appearance of cracks in the mucosa, pain during intercourse.

This disease can progress and pass to the cervix, although it does not lead to oncology. Therefore, experts recommend treating genital warts in the vagina immediately after their discovery.

Treatment methods for vaginal warts

To remove neoplasms, there are the following destructive methods of treatment:

· cryodestruction;

laser removal, the most optimal destructive method;

argon plasma ablation;

radio wave (high-frequency) removal, better with argon-enhanced coagulation.

Destructive methods of influence do not guarantee a recurrence of the disease, therefore, in our country, the use of antiviral drugs is practiced. Immunotherapy is not always reasonably used, more often it is prescribed blindly, without an appropriate examination. This method sometimes gives side effects in the presence of genital warts, and as monotherapy is ineffective, but in some cases it can give a good result, but it is impossible to predict. The best effect is achieved in a combination of destructive and conservative treatment.

Key points:

Treatment of condylomas of the vulva and vagina leads to a positive result in most patients within 1 to 6 months. At the same time, the virus can remain and be determined in 30% of women, without clinical manifestations, which no longer requires treatment, but observation.

It is important to note that warts that appear on new areas of the skin or mucosa during treatment or after completion of treatment do not require a change in the treatment method. The appearance of new formations in the area where the impact was carried out requires a change in the treatment method.

Patients should be informed about the observance of sexual rest during treatment and conduct examinations until the complete disappearance of genital warts.

Sexual partners should be examined and treated only if there are warts on the penis.

Cervical warts

Condyloma of the cervix is ​​one of the varieties of HPV manifestations. Infection with this disease also occurs during sexual intercourse with an infected partner. In the absence of exophytic (visible) warts on the penis, the sexual partner may not be aware of the carriage of this virus.

Cervical condyloma is not always the result of HPV type 6 or 11. The cervix is ​​also affected by other types of viruses, which also have an oncogenic risk.

A feature of condyloma on the neck is its shape. Condyloma may be flat and not visible when viewed in mirrors, or it may be protruding (typical). Flat condyloma of the cervix is ​​detected during colposcopy. This painless technique involves examining the vulva, vagina, and cervix under a microscope, stained with special solutions. Areas affected by condyloma flatus are isolated after staining with solutions.

To finally confirm the diagnosis, in addition to a cytological examination (Pap test), a PCR test for HPV and a biopsy or removal of the altered area with histological confirmation are performed.

It should be noted that any formation on the cervix, even a typical genital warts, should be subjected to histological examination after removal. If the gynecologist does not doubt the diagnosis of condyloma of the cervix, then using treatment methods after which it is not possible to conduct a histology, it is necessary to take a biopsy before treatment.

Treatment of condylomas of the cervix

Removal of warts on the cervix is ​​a mandatory procedure in terms of the spread of infection and the prevention of cervical cancer.

Cervical warts can be removed in the following ways:

· laser vaporization is an effective technique with a low recurrence rate and does not affect the reproductive function of nulliparous patients;

argon plasma ablation good effect, especially in nulliparous patients;

radio wave removal - a technique that allows, after removal, to conduct a histological examination;

Cryodestruction is a popular method, but effective for small lesions;

Solkovagin - cauterization of single genital warts with the help of a chemical preparation.

Each of the above methods has its own advantages and disadvantages. In every specific case the choice of treatment remains with the doctor and depends on the availability of equipment and the qualifications of the specialist.

With the help of destructive methods of treatment, part of the affected tissue of the cervix, visible or determined by colposcopy, is removed, but not the virus itself. Therefore, gynecologists, along with removal, for the prevention of relapse and the fight against the virus, recommend antiviral or immunomodulatory drugs of local or general action. The effect of this treatment is not predictable, but in some cases there is a positive result. It is wrong to assume that antiviral drugs are the main ones in the fight against HPV. These medicines activate the immune system, and it already resists viral aggression. In the practice of treating genital warts of any localization, these drugs have their own niche of application. There is no clear evidence of the effectiveness of these dosage forms, so they are practically not used in world practice.

Vulvar warts during pregnancy

Pregnancy can provoke the development of exophytic warts (visible), which previously did not bother, and did not make themselves felt. Condylomatosis is the result of the human papillomavirus in the body. This virus, once in the body of a woman, may not manifest itself in any way if the immune system is strong. However, during pregnancy there is a temporary decrease in immunity, due to the presence of a fetus, which is half of the foreign genetic material (protein) belonging to the husband. The papillomavirus, if present, and was in an inactive state, may begin to appear as neoplasms on the external and internal genital organs of a woman, in the perineum, in the vicinity of the anus.

Condylomas during pregnancy are subject to mandatory removal due to their active growth, and the sooner this is done, the better.

Treatment of genital warts during pregnancy should be carried out by an obstetrician-gynecologist who is well versed in the removal technique. Treatment of exophytic warts is preferable with the most effective modern laser and radio wave equipment with argon-enhanced coagulation. These operations are usually performed in a hospital under intravenous or epidural anesthesia. With extensive condylomatosis, removals are sometimes carried out in several stages. Epithelialization of the wound surface in pregnant women occurs quite quickly, due to increased blood circulation in the genital area. Therefore, the removal of genital warts can be carried out with early term up to 36 weeks of pregnancy. Before the planned removal of genital warts, it is necessary to conduct an examination to exclude possible complications occurring against the background of pregnancy (for example, the threat of interruption, preeclampsia, etc.). Carry out sanitation with an inflammatory reaction in the genital area.

During pregnancy, only external genital warts should be removed. It is better not to touch condylomas in the vagina and on the cervix, as this is associated with an increased risk of bleeding and the threat of interruption. As practice shows, warts after childbirth regress on their own, especially in the vagina.

In pregnant women, in the presence of genital warts, immunotherapy is carried out only locally. Virus carrying, without clinical manifestations (presence of visible genital warts), is not a basis for therapy. Treatment is best started before removal and continued after surgery. The goal is to reduce the risk of warts recurrence.

In order not to burden you with the treatment of genital warts during pregnancy, it is preferable to undergo an HPV test before planning a pregnancy. If this virus is detected, it is first necessary to improve the body's defenses and only then plan a pregnancy. If this is not done, then there is a chance that you will develop warts during pregnancy.

It is not possible to guarantee the cure of a woman from a virus carrier before a planned pregnancy with the help of modern drugs. Treatment of the identified inflammatory process of the genital tract, before a planned pregnancy, is a sufficient measure to prevent exacerbation of HPV.

It should be emphasized that the carriage of HPV of any type, without clinical manifestations (presence of exophytic warts), is not a contraindication to pregnancy.

Childbirth with condylomatosis

I would like to remind you that warts themselves are a manifestation of the human papillomavirus (HPV). This virus can pose a risk of infection of the fetus and the development of papillomatosis of the larynx in the unborn child. Studies do not confirm that 100% of women with the virus are infected with the fetus. Unfortunately, it is impossible to predict the infection of a child during pregnancy and childbirth with a virus. Undoubtedly, the presence of genital warts increases the risk of infection, so it is better to remove neoplasms.

The need for delivery by caesarean section in women with condylomatosis is decided individually. It is preferable to give birth on your own, even despite the presence of formations in the area of ​​​​the external or internal genital organs, which are present before childbirth. There are cases that children born by caesarean section from pregnant women with HPV carriers suffer from laryngeal papillomatosis. The operation of caesarean section is performed for pregnant women, in the presence of extensive condylomatosis of the external genital organs, when this prevents childbirth through the natural birth canal, or in combination with other complications and diseases during pregnancy.

It should be noted that termination of pregnancy with condylomatosis of the anogenital region is usually not carried out.

Condylomas in the rectum (anus)

Anal warts, like other varieties of similar neoplasms, are the result of infection of the body with the human papillomavirus. Condylomas in the anus is a rather complex disease, which is accompanied by the following symptoms:

the appearance of education in the anus;

an increase in the number of warts in this area;

traumatization of warts under mechanical action.

Condylomas of the rectum are subject to treatment without fail. A profile doctor who is able to correctly diagnose this disease is a proctologist. As soon as you have one of the above discomforts, you should immediately consult a doctor. Condylomas in the anus, experts are also called perianal.

Papillomavirus is transmitted through sexual intercourse. In this case, anal sex plays a role.

Treatment of anal warts

Perianal warts require immediate treatment due to the many inconveniences they cause to the patient and the likely progression of the disease. Modern specialists, along with excision of formations by various methods, simultaneously affect the patient's immune system.

Treatment of condyloma in the anus will be effective if you contact a specialist in a timely manner and strictly follow all his recommendations. A competent effect on the immune system of a patient with condylomatosis activates the protective abilities of the body, and directs all their efforts to combat the papilloma virus.

HPV progression factors are:

acute and exacerbation of chronic inflammatory diseases of the genital organs (trichomoniasis, chlamydia, mycoplasma genitalium, virus herpes simplex and etc.);

the presence and exacerbation of systemic diseases ( diabetes, systemic lupus erythematosus, thyroid disease, etc.);

immunosuppressive therapy (for example, after organ transplantation);

hormonal disorders;

contraception (taking COCs > 5 years);

• stressful situations.

Treatment of condylomatosis at home

The main disadvantages of various destructive methods of treatment is the recurrence of the disease, which varies, depending on the method, from 20 to 50% of cases.

Imiquimod cream, commercial name "Aldara" (Aldara) is a highly effective remedy in the fight against genital warts. This cream, when applied topically to the skin, acts as an immunomodulator, stimulating the production of interferons. This leads to a decrease and then to the disappearance of genital warts and a decrease in the amount of HPV in the tissue.

Cream "Aldara", available in sachets (sachets) for disposable, is applied to warts and the skin around them 3 times a week before going to bed, and the next morning the application area is cleaned with soap and water. Treatment continues until the disappearance of warts, an average of 4 weeks, but not more than 16 weeks. When applied, a local skin reaction in the form of redness (erythema) may occur. In this situation, you can pause until the reaction disappears, and continue treatment. More information about the method of application is set out in the instructions for the Aldara cream.

Numerous clinical researches indicate that imiquimod (Aldara cream) can achieve significant improvement in 8-10 weeks of use. There is a low recurrence rate of 13%. Additionally, it should be noted that the drug stimulates the regeneration of the skin, and improves their appearance in actinic (senile) keratosis.

Complications with condylomatosis

With equal susceptibility to condylomatosis of both sexes, this disease is more dangerous for women than for men. Benign anogenital warts (condylomas), in 90% of cases are caused by HPV types 6 and 11 and are benign. Patients with visible warts may also be infected with highly oncogenic HPV types 16 and 18, which may be flat and not visible during routine examination. These last 2 types can cause cancer of the lower genital tract (cervix, vagina, and vulva).

Genital warts caused by HPV types 6 and 11 are benign growths. Such neoplasms are not dangerous, and cannot lead to oncological degeneration. They cause a lot of inconvenience to a person, and pose a danger to sexual partners due to the high probability of infection.

Experts consider flat lesions more dangerous, due to the complexity of their timely diagnosis. It is viral lesions of the flat type that can cause tissue degeneration.

Bushke-Levenshtein condyloma is a fairly rare disease. Medical science does not have accurate statistics due to the external similarity of this formation with epidermoid cancer.

In the initial stages, the giant condyloma of Buschke-Levenshtein manifests itself in the form of elements similar to papillomas, warty-like nodules and genital warts. All elements of the neoplasm grow rapidly, merge together, and form a tumor with a specific broad base. The surface of such a giant condyloma is characterized by growths and vegetations. All surface elements are separated by grooves. With growth, individual parts of the tumor become more pronounced, superficially covered with horny scales.

This is a rare type of disease associated with HPV types 6 and 11, characterized by aggressive growth.

Giant warts are usually localized in the anogenital region.

Features and diagnosis of giant warts

The giant condyloma of Buschke-Levenshtein has a characteristic clinical feature: progressive growth. There is a marked tendency to recurrence this disease, even after complete excision of the existing formation. Exophytic growth is predominantly observed against the background of the presence of invasive. The result is the fusion of individual parts of the neoplasm, which forms its external similarity with the cauliflower inflorescence.

Bushke-Levenshtein's condyloma, from the point of view of the histological picture, is diverse: areas of benign warts are interspersed with areas of atypical cells or squamous cell carcinoma.

To confirm this diagnosis, specialists should carry out differential diagnostics, the purpose of which is to exclude the following possible diagnoses:

squamous cell carcinoma;

wide condyloma, which accompanies syphilis;

common genital warts.

Difficulties in diagnosis may arise due to the transformation of a giant or ordinary genital warts into an atypical tumor. The disease requires multiple sectional biopsies and computed tomography (CT) or magnetic resonance imaging (MRI).

For the final exclusion of oncology, a complete excision of the neoplasm with a histological examination is performed.

The difference between papilloma and condyloma

During life, a variety of formations appear on the human body. The most common benign formations include the following:

• papillomas;

  warts;

It should be understood that not all educations are safe. It is always preferable to consult a dermatologist to find out the danger of a particular skin formation.

Papillomas are tender papillary formations on human skin that appear as a result of infection of the skin with certain strains of the human papillomavirus (HPV). The virus is transmitted by contact from the skin of an infected person to the skin of an uninfected person. Papillomas can be on the human body all his life, these neoplasms are considered safe. Dermatologists still strongly recommend removing papillomas due to the possibility of damaging them or inadvertently plucking them, which can lead to negative consequences.

Condyloma is a rough scallop formation on the skin and mucous membranes of the genital organs, the anogenital region and the oral cavity. Condylomatosis is a disease that is caused mainly by HPV types 6 and 11. In this case, the transmission route is sexual (sexual route). Condylomas (warts) develop as a result of a decrease in the protective abilities of the body, and are subject to mandatory removal, which is one of the stages in the complex treatment of this problem.

The main difference between warts and papilloma lies in their location on the human body. Also, these neoplasms have different structural features. In any case, self-diagnosis and self-treatment should not be done. If you are interested in an effective solution to the problem, it is preferable to contact a specialized specialist: in the genital area, this is a gynecologist, on the skin of another area, a dermatologist.

Prevention of condylomatosis

Condylomatosis is a consequence of infection of the body with the human papillomavirus (HPV), which is mainly transmitted sexually. It manifests itself in the form of warts, called warts. Such formations can appear on the external and internal genital organs, in the anal region, the oral cavity.

Therefore, to prevent condylomatosis, you should avoid:

the presence of sexually transmitted infections;

Neglect of means of protection during sexual intercourse;

smoking;

Mechanical trauma to the skin or mucous membrane of the genital organs.

Self-regression of warts

The sexually active population can become infected with HPV during their lifetime, according to statistics, 80% of people are susceptible to this. Most HPV heals spontaneously without clinical manifestations and without treatment. This is due to the activation of local and general immunity of an infected person. Approximately 10% of patients have clinical manifestations of the virus, including anogenital warts and patients with precancer and cervical cancer.

As practice shows, condylomas in pregnant women regress on their own after childbirth, especially in the vagina.

Behavior after removal of genital warts

Inform the patient that it may take 1 to 6 months for the warts to disappear. During this time, relapses of the disease are possible, but a complete cure will still occur.

Reassure the patient that due to the long persistence of the virus after infection (the virus is in an inactive state in the body), the appearance of genital warts in only one sexual partner in a permanent relationship does not mean sexual contact on the side of the other partner.

Smokers with poor response to treatment should stop smoking, as there is an association between smoking and genital warts.

Advise the use of a condom to reduce the risk of reinfection or additional infection.

Recommend avoiding excessive sun exposure (sunburn) and using sunblock when relaxing in the south, as excessive sun exposure stimulates the development of the virus, if present in body tissues.

Warn about the inadvisability of various warm-ups (sauna, bath, hot bath), this can also provoke the activity of the human papillomavirus when carrying a virus.

Healing after removal of genital warts

After removing warts, the resulting wounds, as a rule, are recommended to be treated with Baneocin powder. Accordingly, for some time there may be profuse serous or slight spotting after removal of genital warts, which are absolutely normal and should not frighten the patient.

After removal of genital warts, swelling and pain may occur, which can last from two to five days. Their duration is related to the size of the removed neoplasms and the individual sensitivity of the person.

In most cases, during the healing process, itching may occur after the removal of genital warts, which is also absolutely normal, as well as for the healing of any other area of ​​​​the skin.

After removal of genital warts, limit physical activity and exclude sexual life, for about 2-3 weeks, before epithelialization (healing) of the wound surface.

Sexual life after warts removal

Patients should be warned about the need to observe sexual rest, both in the presence of genital warts, during conservative and after destructive treatment.

Against the background of treatment with Aldara, erythema (redness) of the skin in the area of ​​application of the cream may occur. Therefore, sexual life can provoke pain, the appearance of cracks with bloody discharge.

After destructive treatment, the presence of a wound surface is a direct contraindication to sexual activity, as it can lead to infection and will not promote healing.

After epithelization of the wound surface, advise patients to use a condom with new sexual partners, and not necessarily use it with constant sexual partner with whom there was a relationship before therapy. The use of a condom after the detection of the virus does not affect the development of HPV-related diseases in the partner.

If condylomas were removed on the vulva, then after this manipulation, pain and the appearance of small cracks during sexual intercourse are possible. As a rule, this takes place up to 3 months after removal, then these discomforts go away.

Sex after removal of warts is possible after about 2-3 weeks, it depends on the volume of the surgical field and the complete epithelization of the wound surface. In any case, after the removal of genital warts, the next visit to the doctor should be no earlier than 3 weeks from the date of the operation. The gynecologist, based on the speed of healing, will be able to accurately answer the question of when sex is possible after removal of genital warts.

Such an unpleasant manifestation of HPV as condylomas must be removed at their first detection. After removing the warts, the wounds remaining in their place are tightened for a certain period. Also, the patient may experience symptoms such as swelling, redness, skin irritation. To help tissues recover faster after the removal procedure, appropriate care is needed. Then the rehabilitation period will be shorter and more painless.

As a rule, condylomas are located on the mucous membranes of the genital organs. To eliminate them, various methods are used, characterized by an aggressive effect on tissues. Mainly:

• burning with chemicals (ointments, solutions with a necrotizing effect);
• elimination by hardware methods (removal of pointed growths with an electric knife, laser, radio waves);
• surgical intervention (cutting with a scalpel).

All these methods negatively affect the healthy tissues surrounding the growth. An inflammatory process can begin in them, manifested by various symptoms.

After burning and cutting out the wart, a hole remains in its place, overgrown with a crust. It plays the role of a protective coating that the body creates.

It is impossible to comb the site of removal of condyloma and tear off the crust, as it is possible to bring the infection into the wound. You need to wait until the dead cells come down on their own.

After the wound heals, the protective crust falls off, and newly created tissues remain in its place. To make this process go faster, you need to perform caring procedures.

Consequences of removal

Healthy mucosal cells can react differently to intervention in the body. In some patients, this process passes without a trace, without any symptoms. In others, local inflammation develops in the tissues, which is expressed in the following manifestations:

• pain in the intimate area during movement, friction;
• itching, burning on the walls and inside the vagina;
• rashes, redness in the genital area;
• it hurts to go to the toilet (with anal warts);
• the wound may fester and bleed;
• swelling around the removal site.

Slight irritation, swelling are a normal reaction of the body to exposure chemical substances. Usually these symptoms disappear during the rehabilitation period. Proper skin care should help tissue heal.

Serious complications after removal of warts in the intimate area occur in rare cases. They can develop due to infection in the wound. Therefore, it is very important to observe the rules of hygiene during this period and take care of the surface of the genitals.

The use of methods such as laser therapy or electrocoagulation can sometimes result in scars or scars. There is a high probability of their occurrence when extensive overgrown formations are removed. The manifestation of such consequences must be taken into account when choosing a method for eliminating genital warts.

Rehabilitation period

The recovery period varies from person to person. Therefore, it is impossible to say exactly how long it takes to care for the skin. The rehabilitation process is influenced by such factors as the individual characteristics of the patient and the degree of spread of formations. A wound may take approximately 7 to 30 days to heal.

Strengthening the immune system plays an important role in the complex treatment of HPV. If the protective functions of the body are strong enough, it fights inflammation faster.

The rehabilitation period depends on the type of technique used to eliminate condylomas. Healing after removal may take the following time:

• 7-14 days - with cryodestruction;
• 7-10 days - removal by radio wave method;
• about two weeks - electrocoagulation;
• 7-14 days - laser therapy;
• up to one month - surgical intervention;
• 7-21 days - treatment with chemical agents.

The most dangerous way is cutting with a scalpel. It is used only in difficult cases, when overgrown warts cannot be removed by another method. After the operation, sutures remain at the site of the colonies, which can heal for a rather long time.

Electrocoagulation and laser treatment are less traumatic methods. With their help, both single growths and large formations are removed. During the operation, local anesthesia is required, since without anesthesia, cutting off the warts is quite painful. The downside of these procedures is the risk of scarring.

The safest method, which is easily tolerated by patients, is recognized as radio wave. There is no pain during this procedure at all. The rehabilitation period is short, and there are almost no undesirable consequences.

Removal of papillomas intimate zone liquid nitrogen is an affordable and therefore widespread procedure. The woman feels only a slight burning sensation, and the recovery period fits within a two-week period.

After therapeutic cauterization with solutions and ointments of necrotic action, irritation and allergic reactions of the mucosa may occur. Many of these products contain aggressive substances that adversely affect healthy tissues. Therefore, they must be used with extreme caution.

Postoperative treatment

After the invasion of the body, HPV remains in the epithelium for life. It is impossible to completely eliminate it. Therefore, after the physical removal of genital warts, it is necessary to continue to treat the virus in order to suppress its effect. This will reduce the risk of re-formation of growths. You need to take immunomodulatory drugs and vitamins, as well as normalize your diet.

At the same time, the places of removal of genital warts are treated locally with various antiviral agents. They accelerate the healing of wounds, stop inflammation, improve skin condition.

These preparations are produced in the following consistencies:

• ointments, creams;
• gels;
• sprays;
• solutions.

In the case when the warts were located inside the vagina or in the cervical region, patients are prescribed suppositories with antiviral properties. In addition to drugs that deactivate the infection, agents with a caring effect are used.

Therapy after removing warts depends on the method used. Since the impact on tissues is carried out using different technologies, treatment and care occur by different means.

After treatment with liquid nitrogen, the condyloma dies off, and small depressions remain on the surface of the skin. After about 1-2 weeks, the tissues in this place are restored. Immediately after the operation, patients experience slight swelling. There is also pain in the area.

To relieve these symptoms, the following drugs are prescribed:

• Ketorol;
• Solpadein;
• Ibuprofen.

These drugs have analgesic and anti-inflammatory effects. Your doctor may prescribe Isoprinosine to prevent the growth of new warts. After cryotherapy, women should also wash themselves with a solution of manganese or a decoction of chamomile and calendula. Medicinal herbs soothe inflamed tissues, enhance their regeneration.

After laser therapy, traces of burns may remain on the skin or mucous membranes. It is necessary to wait until the brown crust at the site of the growths falls off on its own, it is not necessary to tear it off. Gynecologists recommend using Epigen gel as care.

Additionally, you can douche or do baths with infusions medicinal herbs. It can be chamomile, linden flowers, calendula, plantain, etc.

Recommendations for skin care after electrocoagulation are that it is impossible to remove the protective crusts formed at the site of the wounds. Dead cells will fall off on their own in a few days. For disinfection, you need to wash with a solution of manganese or Furacilin. If the site of removal of the papilloma began to swell, the doctor prescribes Ketorol or Nimesin.

Radio wave therapy is considered the safest procedure, with virtually no side effects. After this operation, it is enough to do baths using medicinal herbs or potassium permanganate. In case of irritation of the mucosa, you can use Panavir gel.

The consequences of chemical removal of genital warts are characterized by a long period of treatment. The acids contained in caustic ointments often cause allergic reactions, rashes, irritation, etc. Wounds after such therapy may not go away for a long time, start to fester or bleed. To restore tissues, drugs Baneocin, Ketorol, Panavir, etc. are prescribed. You can also wipe the skin with a decoction of chamomile, calendula.

For the treatment of mucous membranes after removal of genital warts, it is necessary to use drugs prescribed by a doctor. It is dangerous to choose products on your own, you can harm the skin.

For disinfection of the genital area, it is forbidden to use products with a strong cauterizing effect. These include:

• alcohol tinctures;
• hydrogen peroxide;

• brilliant green.

IN postoperative period great importance adheres to basic hygiene rules. It is necessary to exclude any ingress of dirt into the wound. Rinsing should be as gentle as possible to avoid irritation due to friction. Recommendations regarding personal hygiene after warts removal include the following rules:

• You need to wash several times a day;
• Not only the vagina should be treated with detergent, but also the anus area, since microbes can get on the genitals from there;
• When applying and washing off the gel, you need to make movements from front to back. Such actions exclude the possibility of infection;
• Wipe the genital area with caution, using a separate towel for this;
• For hygiene procedures it is necessary to use special products for the intimate area. They are more gentle on the mucous membrane;
• It is not recommended to use tampons during menstruation, it is better to use pads. If, nevertheless, there was a need for them, it is necessary to replace them with fresh ones every two hours;
• Small discharge from the vagina in the form of an ichor is considered normal and should not cause concern. If available, daily panty liners should be used.

Preventive measures to avoid infection are expressed in refusing to visit baths, saunas, swimming pools and other similar public places for the rehabilitation period. Bathing in natural waters should also be avoided until the wound heals completely. In the first two days after the operation, it is better not to sunbathe in a solarium or under the open sun.

intimate life

Many women are interested in whether it is possible to have sex during the rehabilitation period. The opinions of doctors agree that in this case there is a need for a complete rejection of sexual intimacy. Such a ban is justified by the fact that one should not once again expose the genital area to mechanical stress.

The scab left after the removal of warts is easy to tear off with any friction. When the protective crust is lost, the wound opens and bacteria can penetrate into it. As a result, an inflammatory process begins, which threatens with a serious complication.

Another reason why you can not have sex in the postoperative period is pain in the vagina. Discomfort when pressing on the wound is a normal reaction of the body, but with intimacy this is an undesirable condition.

Gynecologists recommend waiting with sexual relations for about two weeks. After this period, a woman can begin sexual activity in the absence of any unwanted symptoms. If the patient has doubts about the healing of the mucosa in the cervical region, it is better to consult a doctor.

When resuming sexual relations, it is necessary to use a contact form of contraceptives. In this case, there is the least risk of re-formation of genital warts.

In rare cases, patients complain of pain in the vaginal area after the wounds have completely healed. This may be a manifestation of residual processes of inflammation of the affected tissues. With severe discomfort, a woman is advised to interrupt sexual intercourse for a while. If the pain does not go away within 2-3 months, you should consult a gynecologist.

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