Proctology

Perianal Genital Warts

Perianal Genital Warts

Genital perianal warts represent a papillary formation gray-pink in color, sometimes in the form of separate islets, between which is visible to unaffected skin, sometimes in the form of papillae, confluent and form a whole conglomerate that can close the anus, are giant condyloma of up to 20 cm or more in diameter. In appearance they resemble cauliflower.

The most common so-called ordinary genital warts, and giant condyloma also called tumors Buske—Levenshtein the names of the authors who first described in 1925, the giant pointed condyloma of the penis.

Causes

It is now established that a simple and giant condyloma caused by human papillomavirus (HPV) type 6 and 11.

Symptoms

Patients with perianal warts complain of the presence of growths around the anus, feeling of a foreign body in the crotch area, burning, itching, sensation IOC-note in the anus, the presence of large warts are often concerned about the pain and discharge of blood due to trauma clothes and defecation. The greatest concern deliver large warts that secrete a fetid liquid, in the growths can be moves by the type of the fistula, the local inflammatory process leads to intoxication and affects the General health. The rate of growth of warts can be very high.

Complications

Genital perianal warts tend to recur after conservative treatment with different drugs, and after their surgical removal.

Described cases of developing squamous cell carcinoma, is more often observed in the presence of giant warts {tumor Buske—Levenshtein) and especially in the dissemination of warts in the anal canal. This circumstance dictates the necessity of careful examination of patients before and during surgery to determine the nature and extent of the process and histological study of removed warts.

Diagnostics

Diagnosis is made after external examination of the perineum. Should pay attention to sexual organs, as there can also be localized genital warts.

Sure is finger examination of the anal canal and rectum, sometimes even with a small condylomatosis the excrescences on the perianal skin warts found in the anal canal in the form of small nodules rather compact. When the giant condyloma lesion of the anal canal more common.

Sigmoidoscopy is a required study of such patients, quite often there is hyperemia of the mucous membrane of the rectum, sometimes the graininess of it. Above the anorectal line, i.e. in the most the rectum, genital warts do not happen.

Whichever method of treatment of genital warts in a specific patient was not supposed to be screened for HIV infection and syphilis is mandatory.

Differential diagnosis. Genital perianal warts most often differentiated from syphilitic warts. The latter is visually more flat, whitish, in the form of individual plaques, their surface is wet. Final diagnosis is made after carrying out serological tests and examination of venereal diseases.

In the differential diagnosis with malignant tumors of this region play a decisive role the results of morphological studies.

Treatment

Conservative treatment of perianal genital warts usually used for small warts, when separate piles growths there is a gap of healthy skin. Use a solution kondilin: using special sticks (it is attached to the vial) cauterizing solution applied to warts, you will need to fear getting the solution on healthy skin. There are antiviral drugs in the form of ointments — podophyllin, bonafton. Local treatment is recommended in combination with Immunostimulants.

Quite often after a course of conservative therapy is electrocoagulation or laser destruction of more than warts and excision of them.

Surgical treatment is undertaken most often in the presence of large nodes and lesions of the anal canal. Excision is performed with a scalpel, or electronicam, or laser. Sometimes if you have large warts surgical removal is not at once formed extensive wounds can lead to deformation in the region of the anus.

Forecast. Recurrence of warts observed equally frequently in all the ways of removal. Relapse is due to the fact that the disease is caused by a virus and if the body can not cope with the infection, it is only a local effect on the warts (burning, removal) will not give permanent cure. Treatment should be complex: antiviral drugs, Immunostimulants, removal of the warts.

Reviewed by the QSota Medical Advisory Board