What are genital warts and how can they be removed?

Genital warts (condyloma) are an embarrassing and common problem. Marek Kwiecień, Doctor of Medicine from the Medfemina Health Centre in Wrocław talks about what they are and how to remove them.

How to remove genital warts?

Marek Kwiecień, MD:

What are genital warts (condyloma)? Causes and symptoms.

Genital warts are caused by the human papillomavirus called HPV. There are many types of virus so for ease and order they are numbered. Type 6 and 11 is what causes condyloma. It is a sexually transmitted infectious disease and affects both men and women.

The infection manifests itself by the initial appearance of small pink, rough, hard growths that over time clump together to form non-painful, cauliflower-shaped masses that can grow to enormous sizes. In women, genital warts are most commonly found around the labia minora, vaginal vestibule, anus, thighs and buttocks, with less frequent locations around the clitoris, cervix and urethra. In men, warts occur on the foreskin, glans of the penis, urethra, and anus.

Genital warts usually appear weeks to months after sexual contact with an infected person. These lesions are very common, in addition, in Poland, over the past 15 years, the number of new cases of condyloma acuminata has more than tripled.

What can be the consequences of genital warts?

Virus types 6 and 11 are responsible for the formation of condyloma and do not cause neoplastic lesions, but it should be borne in mind that during sexual contact, many types of virus can be simultaneously infected, often occurring together, including subtypes with the ability to form neoplastic lesions. In view of this, complications of infection can be dangerous and difficult to treat. HPV types with high oncogenic potential most often lead to cervical cancer (over 90%). They are also responsible for anal, vulvar, penile, vaginal, and many types of oral, pharyngeal, and laryngeal cancers (HPV types 21, 22, and 23).

Chronic infections with high-oncogenic virus types (mainly 16 and 18), which the body cannot cope with and eliminate the virus, after years progress to an advanced state, called CIN (short for the presence of cancer cells in the epithelium of the cervix). The severity and extension of these lesions involving an increasing number of diseased cells is already a prelude to cancer development. HPV often causes cancer of the mouth and throat if it infects another area. According to some scientists, oral sex increases the risk of developing cancer of the mouth and throat.

Pregnant women. Transmission of HPV virus to the baby during the perinatal period can cause a syndrome called RRP (respiratory papillomatosis syndrome), which is responsible for persistent hoarseness or changes that make breathing difficult.

How to recognize condyloma?

Condylomas are usually recognized by their characteristic appearance. Every gynaecologist has encountered condyloma many times and is able to recognize it at first glance. As the patient may be infected with more than one type of HPV, we also strive to perform a Pap smear on women with genital warts, looking for abnormal cervical cells. Occasionally, the natural shape of the penile mucosa or the inside of the labia minora may resemble a viral infection. These are called pearly papules and are perfectly normal. However, doubts should always be resolved by a specialist.

How to remove genital warts? Methods of Procedure. 

It is very important to treat both sex partners to prevent re-transmission of the infection. Depending on the size and location of the lesions, we select an appropriate method. Treatment options for condylomata include pharmacotherapy of the lesions – as a long and tedious method, it works well for limited, small growths. Large, diffuse lesions can be removed by physical methods – freezing, electrocoagulation, or during surgical excision. The most modern way to treat condyloma is to use a laser that allows for effective, painless, quick removal of lesions during a short procedure. Using laser energy, we destroy the lesion along with the place where it „grows”. Often, the destruction of most lesions causes such a defensive mobilization of the organism that the remaining, smaller ones, spontaneously disappear. The latter method has been successfully used at our centre in every stage of the disease. The patient must be pre-consulted by a doctor before the procedure, but no special preparation is required for this type of procedure. And immediately after, the patient can return to daily activities.