The human papilloma virus (HPV) causes the appearance of multiple benign lesions on the skin and mucous membranes. Anal condylomas (genital) are a type of viral wart with a high degree of contagiousness and the risk of malignancy. Complications can only be avoided with timely, adequate therapy.
What are anal warts and why are they dangerous?
Genital warts are soft, resembling papillae, pedicle formations, prone to fusion. Most often appear in the anogenital region. They cause discomfort with friction on underwear, sexual problems, psychological inconvenience.
Genital warts (the so-called anal condylomas) are the most common manifestation of human papillomavirus infection. They have a long chronic nature of the course, are prone to relapse. Initially, the neoplasm in appearance resembles a small flat pink papule, then takes the form of a papilla on a flesh-colored leg. With a strong growth and fusion, the neoplasms in appearance become similar to the cockscomb.
Genital warts are widespread and prone to renewal. They do not develop stable immunity, if you do not follow the rules of safe sex, you can get infected again. Constant trauma to genital warts can lead to the development of bleeding, increases the risk of their degeneration from benign to malignant.
Anal warts: causes
Papillomavirus has more than 100 strains. They cause a variety of pathologies. Strains HPV6 and HPV11 (Human papillomavirus) affect the anogenital tract and cause the appearance of genital warts.
Papillomavirus infection is often asymptomatic. Many people live with her for years, do not suspect anything, and reveal it only with immunological studies and the presence of indications for their conduct, for example, pregnancy. Weakened immunity contributes to the appearance on the skin and mucosa of anal condylomas. There are other factors that increase the risk of infection:
- Promiscuous sexual intercourse. Frequent changes in sexual partners primarily affect immunity, a person becomes more susceptible to infection with various diseases, especially viral ones.
- The presence of chronic pathologies.
- Early transmitted diseases that are transmitted sexually.
- Weakening of the protective functions of the body caused by constant stress, lack of vitamins.
- Pregnancy and the early postpartum period.
- Violation of the microflora of the vagina (gardnerellosis).
Pathogenesis
Papillomavirus is transmitted by contact from a sick person to a healthy one. And immediately you can "pick up" several types of human papillomavirus infection. The disease can be a fairly long period of latency. In order for clinical signs to appear, a sufficient amount of virus must accumulate in the body. Under the influence of various factors, immunity is reduced, and the virus is activated, its manifestations appear on the skin.
In the body, HPV primarily affects epithelial tissue. In an infected cell, papillomavirus is in two forms:
- Episomal is a benign form. HPV is located outside the cell chromosomes, does not cause changes in the cells and does not manifest itself clinically.
- Introsomal - a malignant form.
The active virus multiplies rapidly, changing the differentiation of epithelial cells. Their intense and uncontrolled division leads to the growth of the skin and the formation of genital warts. They may arise several pieces, and sometimes tens. Condylomas in the anus occur simultaneously, very rarely within 2-3 days.
Clinical manifestations
The symptomatology of the disease depends on the size and location of the genital warts. When friction between themselves or underwear, they cause discomfort, a person begins to look for the cause of unpleasant sensations. As a rule, patients consult a doctor when condylomas become clearly visible and can be felt on their own. When collecting an anamnesis, patients indicate the following symptoms:
- Sensation of irritation, tingling in the preanal area. There is a desire to scratch the place of itching.
- Swelling, hyperemia of the anal area.
- Painful bowel movement.
- As a result of injury to genital warts in the anus on the underwear there is blood.
- Discomfort and sometimes pain during intercourse.
- The psychological inconvenience.
- The presence of blood in the feces.
How is the diagnosis
Patients mostly go to the doctor after the virus has acquired an intrasomal form and the symptoms of the disease began to manifest. Therefore, a clinical examination allows the doctor to put a preliminary opinion. But in order to establish an accurate diagnosis in order to prescribe the most appropriate therapy, it is necessary to undergo an examination.
- A blood test for PCR HPV (determination and typing).
- A blood test for antibodies to HPV.
- If you suspect condylomas in the anal canal (endophytic), anoscopy is performed.
- Screening for syphilis, HIV and other infections that are transmitted through sexual contact.
After determining the method of treatment and its conduct, the removed wart is sent for histological examination.
Therapies
None of the modern methods of therapy individually can completely rid the human papilloma virus completely. Treatment of anal warts should be comprehensive. But subsequently no one can rule out the reappearance of warts. In medicine, several methods of treating genital warts are practiced, each of them has indications, contraindications, limitations:
- Cosmetology procedures.
- Surgical procedures
- The use of chemicals.
- Drug therapy.
The goal of therapy is the removal of neoplasms and containment of the virus in an episomal form. In order to avoid the reappearance of genital warts, it is necessary to undergo an examination with the sexual partner. If he does not have visible signs of the disease, this does not mean that he is not infected. A blood test for the presence of antibodies to HPV can confirm or refute the presence of a virus in the body.
Laser Anal Removal
Laser coagulation - the evaporation of tissue by exposure to laser radiation. The radiation beam removes the neoplasm completely without bleeding and trauma to nearby tissues. The procedure has a number of advantages:
- Laser coagulation is performed under local anesthesia. After the procedure, the patient can immediately leave the medical facility.
- Manipulation does not require special training.
- Allows you to remove both single and overgrown condylomas.
- There is no scar left after the procedure.
- Short rehabilitation period.
Unfortunately, the procedure is not suitable for everyone, because it has contraindications:
- The presence of cancer.
- Diabetes.
- Blood disease.
- Epilepsy.
- The acute form of herpes.
- Thrombocytopenia.
- Pregnancy and lactation.
Cryodestruction
Removal of anal genital warts with liquid nitrogen is indicated only with a few merged warts. The essence of the procedure is freezing, in which the protein structure of the neoplasm is destroyed. The surface of the wart is treated with liquid nitrogen (no more than 30 seconds), after which it disappears, leaving a wound.
The disadvantages of the method are the risk of incomplete removal of the anal warts and long healing of the wounds. The advantage is that the manipulation is performed without anesthesia. This is very convenient for patients with personal intolerance to the components of anesthesia.
Cryodestruction is not applicable under the following conditions:
- Large area of defeat.
- Chronic pathologies in the acute stage.
- The presence of malignant tumors.
- Local inflammation of the skin of infectious genesis.
- Pregnancy (throughout the term).
Also, the procedure is not applicable for nulliparous women.
Electrocoagulation
This method consists in cauterizing anal warts with an electrode, to which a high-frequency current is supplied. Until recently, the method was considered one of the best for dealing with intimate warts. But today it is used extremely rarely due to the presence of serious shortcomings:
- The procedure is very painful.
- When using an electric knife, damage to nearby tissues occurs.
- Long healing.
- High probability of scar formation.
- It is used only for single condylomas.
- The inability to use the method in women who did not give birth.
Chemotherapy
To destroy and remove anal condylomas, cytotoxic drugs are also used locally. The action of chemicals of cytotoxins is to start the process of necrosis within the neoplasm. The most popular drugs are:
- "Condilin" is a solution for external use.
- "Podophylline."
- Keraworth.
- "Imichimod."
- "Phenol".
- 5-Fluorouracil-Ebeve.
The drugs have a neurotoxic effect. The use of solutions should be carried out only by medical personnel in special rooms. During treatment, blood must be examined to suppress blood formation. Analyzes are carried out at least 3 times a week.
Antiviral and immunomodulating drugs
Anal condylomas are warts of viral origin. Therefore, antiviral drugs, as well as immunomodulators, are necessarily included in complex therapy:
- "Isoprinosine" is a synthetic preparation (in tablets) with antiviral and immunomodulatory effects.
- "Cycloferon" is an interferon inducer, available in tablets.
- “Lycopid is a synthetic analogue of the peptidoctan of a bacterial cell. Dosage form: tablets.
- "Polyoxidonium" is an immunomodulator of complex action. It is produced in tablets, lyophilisate, suppositories.
- "Immunomax" - a tool designed to correct weakened immunity, the treatment of pathological conditions caused by HPV.
- "Viferon" - interferon with antiproliferative, antiviral properties. Most often, rectal suppositories are used. Also effective is the use of Viferon ointment from anal condylomas.
Topical antiviral agents
Means for external use, as well as for internal use, are aimed at combating the virus and increasing the protective properties of the body. The main indication for the use of ointments, gels, sprays of local action is to prevent the growth of condylomas. Means are used not only for therapy, but also for preventive purposes. Overview of the most popular products for external use:
- "Epigen intim" is an antiviral immunostimulating spray. Ammonium glycyrrhizinate, which is an active pharmaceutical substance of the drug, has a complex effect. The substance accumulates in the lesions, inactivating the papillomavirus. Improves the ability of skin cells and mucous membranes to repair damage in DNA molecules.
- “Panavir is an antiviral immunomodulator that includes potato shoot extract. The product is well tolerated (does not cause allergies) and has virtually no contraindications.
- “Keravort” is an immunomodulatory cream. Direct antiviral agent. Quickly absorbed, the result is observed after the first application.
- "Vartotsid" is an immunomodulator for external use. The use of cream helps to reduce the processes of angiogenesis.
Prevention of genital warts
Even the most effective therapy does not guarantee that a person will not get sick again and the virus does not appear in the form of genital warts. Removal of anal warts is the elimination of symptoms, it is also necessary to deal with the cause - the human papillomavirus. The most effective is preventive measures:
- The use of condoms. For maximum effectiveness after sexual intercourse, the use of Epigen Intimate Spray will be appropriate.
- Rejection of bad habits.
- Application of measures to increase the protective functions of the body (hardening, proper nutrition).
- Elimination of factors that reduce immunity (stress, lack of vitamins and others).
- After treatment, virological monitoring is performed. Women need to undergo a histological examination once a year.