Health Society of South Africa

CONDYLOMA

CONDYLOMA : A COMMON PROBLEM

Condyloma (genital warts) is one of the most common sexually transmitted diseases (STDs). These warts often appear as tiny "bumps" in the genital area. Like other types of warts, they are caused by a virus. Fortunately, condyloma is treatable - as long as both you and your partner are examined and receive treatment, if necessary. Be sure to return for any recommended follow up. Recurrences are common and treatment may need to be repeated.

Who's at Risk?
Genital warts occur most often in young, sexually active men and women - especially those who have had more that one partner and those who don't use protective condoms for birth control. If you're pregnant, condyloma can be transmitted to your infant during delivery or warts may block a vaginal delivery, making a caesarean (surgical) delivery more likely.

Condyloma Can be Treated
Genital warts can best be treated when you, your doctor and your partner work together. Understand condyloma so you understand how the virus is spread. Get an early diagnosis and talk to your partner so you can both be treated before serious problems arise. Finally, follow your medical treatment plan to help eliminate the warts.

UNDERSTAND CONDYLOMA

Condyloma affects your genital area and is usually associated with two specific types of HPV (human paillomavirus). Like many viruses, HPV is highly contagious. And since this virus is typically passed through direct genital contact, both you and your partner may need treatment. Without medical evaluation and treatment, HPV may cause changes in your cells that could put you at a higher-than-normal risk for genital cancer.

Condyloma in Woman
Genital warts may be found on your vulva, labial fold or cervix, or in your vagina, urethra or anus.

On the cervix
Condyloma is usually not directly associated with cancer. But it may be present along with other types of HVP that are linked to abnormal changes (dysplasia) in the cells of the cervix. Left untreated, these changes may progress to a pre-cancerous state.

<Condyloma in Men
Genital warts may be found on the shaft, foreskin, head or opening of your penis, on the scrotum, or in your urethra or anus.

On the penis
Genital warts are typically found on the shaft of the penis. A medical examination is important because warts on the penis are often flat or very small, making them difficult to see without a special evaluation.

What Condyloma Looks Like
Genital warts vary in appearance and may develop singly or in clusters. They may appear as raised granules or cauliflower growths, or they may be flat and barely visible, even microscopic. Condyloma may be flesh-coloured, pink or darker than surrounding skin.

GET AN EARLY DIAGNOSIS

If you notice any unusual bumps in your genital area, make an appointment with your doctor right away. An early diagnosis gives you the best chance of successfully treating condyloma. If you're a woman, early diagnosis also decreases the likelihood that any cellular changes will advance to cancer or that you'll have a problem pregnancy. To diagnose genital warts, your doctor will ask questions about your medical exam and sexual history and perform a physical exam, which may include a few simple tests. If you do have warts, you'll want to talk with your partner, so you can both be examined and treated, if necessary.

Questions Your Doctor May Ask
Your medical and sexual history helps your doctor diagnose when and how you developed warts and whether they are likely to return in the future.

Your Medical History
Have you noticed bumps in your or your partner's genital area?
Do you have any history of herpes or other STDs?
Do you have any itching in your genital area?
Do you have illnesses that could you lower your immune response?
Are you pregnant?

Your Sexual History
Are you in a relationship with one person?
Have you been in your relationship a long time?
Do you have more than one sex partner?
Do you use birth control?
Do you always use a condom during intercourse?

Your Physical Exam
FOR WOMEN
Your doctor looks at your genital and anal areas and gives you a pelvic exam. You also may have a Pap test to examine cervical cells for any signs of change. If the Pap test indicates anything abnormal, you may have colposcopy. This procedure allows your doctor to visually examine your cervix and vagina. If you're diagnosed with HPV, regular Pap tests can detect cellular changes before they become serious.

FOR MEN
Your doctor examines your genital and anal areas both for visible condyloma and for microscopic changes. Invisible to the naked eye, these can often be found using penoscopy. This procedure uses a special magnifying lens to scan the surface of the penis. To locate flat warts, your doctor may use an acetowhite test, a simple procedure involving external application of a mild, vinegar-like acetic acid solution. You may also be checked for other STDs, such as syphilis. If you have warts on the head of your penis, you may be referred to a specialist for treatment.

Talk with Your Partner
Talking with your partner about condyloma can be difficult, but it's the most caring thing you can do. As soon as you're diagnosed, take a quiet, private moment to discuss your treatment and why your partner needs evaluation and possible treatment, too. Don't blame each other or pry into each other's past. Be honest and show you care, even if your partner resists being examined.

YOUR MEDICAL TREATMENT PLAN

MEDICAL TREATMENT
If you have condyloma, you'll want to know about procedures that can be used to remove the warts. Your doctor may recommend one of the following treatments for you, and possibly your partner. Although most procedures can be done quickly in your doctor's office, follow-up treatments are often needed to eliminate the warts.

Topical Medication
The most common treatment for external genital warts for both men and women is medication applied directly to the warts by your doctor.

Podophyllin is a chemical absorbed by the wart, destroying it from the inside out. It causes a mild burning sensation, a reminder that you must wash it off as instructed by your doctor. Never have it applied if you are pregnant.

TCA (Trichloroacetic Acid) is an effective medication that can be applied to warts if you are pregnant.

5 - Flourouracil cream is used externally and for warts inside the urethra.

Freezing
Cryosurgery freezes wart tissue. Surprisingly quick and relatively painless, it can be used on either internal or external areas.

Heat
Electrosurgery destroys external warts with electrical heat. This office procedure can be done under local anaesthetic.

Laser
This relatively new treatment "evaporates" wart tissue. Laser can be used on both internal and external warts.

Abstain Briefly
Your doctor may caution you to abstain from sex for a short time after treatment to help healing and prevent reinfection.

YOUR ROLE
You play an important role in helping to prevent future outbreaks of condyloma. Insist that your partner be examined, and if necessary, undergo treatment. Be sure you both keep your follow-up appointments, and use condoms to help prevent the spread of genital warts. Show you care and your partner will know you're willing to go through both the good and the bad times together.

Your Partners Exam
It can't be stressed enough: Your treatment includes encouraging your partner to be examined too. If your partner is reluctant to see a doctor, offer to accompany him or her to the appointment. Showing support may help protect the health of you both.

Follow-up Visits
Keep all follow-up appointments with your doctor. At first, these visits may be scheduled every few weeks or months. Anytime you see new warts developing, call your doctor. As with many viruses, reinfection and recurrence are possible.

Practice Safer Sex
Because genital warts are a sexually transmitted disease, you'll help prevent reinfection and limit any chance of spreading the virus if you follow safer sex practices. A condom with spermicide helps prevent infection from condyloma as well as other types of STDs. If you're starting a new relationship, choose your partner wisely and share you sexual histories with each other.

IN A CARING RELATIONSHIP

Good, lasting relationships are built not only on having fun, but also on caring about each other's well being. If you or your partner has condyloma, you can work together to deal with a health problem that belongs to both of you. By taking steps toward treatment, you're taking steps that show you care.

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