Written By:
David B. Rosenfeld, M.D., F.A.C.S., F.A.S.C.R.S.
This is an information sheet on condyloma (warts). Warts are caused by the
Human Papilloma Virus (HPV) infection. This infection is one of the most
common sexually transmitted diseases. Most men and women are carriers of
this virus.
CONDYLOMA PHYSIOLOGY
Warts are an overgrowth of tissue caused by the Human Papilloma Virus
(HPV). The virus lives in your cells and can either remain dormant or
activate the cell to create warts.
HPV TRANSMISSION
The most common way of contracting the Human Papilloma Virus is
through anal intercourse or anal sexual activity. This could have
happened years ago and now the warts are developing. It is known that
women who engage in intercourse at an early age (15) and with more than
2 partners have a 95% chance of contracting the Human Papilloma Virus.
This shows the prevalence of this virus.
TREATMENT
There are typically 2 ways to treat warts.
o Topical therapy
Podophyllin (requires office visits for application.
Bichloroacetic acid – a mild acid applied by a physician in
the office. The acid burns the condyloma which sloughs off
in 36-48 hours. Typically this treatment will cause mild
discomfort/pain. It must be washed off with a warm bath 6
hours after application.
Aldara – a cream used 3 days a week for 12 weeks Efudex –
a cream used 2 times a day for 2-4 weeks.
o Surgery
Typically for warts located outside the anus I remove them
with a scalpel. For warts inside the anus I burn them off with
cautery.
POST SURGERY PAIN
Is the surgery painful? This question depends on where the surgery is
performed. If done in a surgery center, the pain will be excruciating for up
to a week or longer. If done in the office the majority of patients do quite
well with pain lasting only 2-3 days. I find that patients having surgery
done in the operating room require 40 or more Vicoden and most need a
refill. When the same procedure is done in the office patients, on average,
use 6-8 Vicoden with no refills needed. As a specialist who truly is
dedicated to this problem I strive to treat warts efficiently with minimal
pain.
CONDYLOMA RECURRENCE
Once you are infected with the virus you are infected with thousands of
virus particles, and therefore, it is always prevalent within your cells. Like
weeds, once removed, new warts will grow back as only some of the virus
particles are destroyed. .For this reason even if celibacy is entertained,
you always be at risk for recurrence.
RE-INFECTION
Re-infection occurs when you contract more virus from your partner or
other people with whom you are sexually active. After you are treated for
warts one cause of recurrence is obtaining more virus after intercourse.
HPV AND ANAL CANCER
The natural history of the Human Papilloma Virus and anal cancer is
unknown. This means that at present there is no scientific data to support
that having HPV will cause cancer. Recent studies; however, suggest that
this virus may be associated with anal cancer. It is well known that the
Human Papilloma Virus causes cervical cancer. Cervical cells and anal
cells are very similar. The incidence of anal cancer is rising (especially in
the HIV population) and the theory is that the same virus types that cause
cervical cancer may be associated with anal cancer.
***For more information regarding anal cancer and HPV please read the
pamphlet “Human Papilloma Virus (HPV) and the Risk of Anal Cancer”
I received this information sheet on condyloma
and treatment.
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